Form ID

Publication date

Location of premises

Certificate

Contract #: C.I.D # 2006-4750 Design supply and install one eighty foot by one hundred and sixty foot (80’ x 160’) cast in place Concrete foundation and all other work required as per the contract at the Brockville Patrol Yard

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Her Majesty the Queen in Right of Ontario as represented by the Minister of Transportation
Address of Owner
Ministry of Transportation, 530 Tremblay Rd., Ottawa, ON K1G
Name of Contractor
Storage Systems Construction Corp.
Address of Contractor
20 Shamrock Rd., Unit #8, Erin, ON N0B 1T0

Office to which claim for lien must be given to preserve lien

Director, Legal Services Branch, 1st Floor, West Tower, 1201 Wilson Avenue, Downsview, Ontario M3M 1J8
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