Form ID

Publication date

Location of premises

Certificate

Parking Lot Asphalt replacement

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Urbandale Corporation
Address of Owner
2193 Arch Street, Ottawa, ON K1G 2H5
Name of Contractor
Vintage Paving & Construction
Address of Contractor
5755 Steuwe Drive, Manotick, ON K4M 1L2
Name of Certifier
Roger Tuttle, Construction Manager, Urbandale Corporation
Address of Certifier
2193 Arch Street, Ottawa, ON K1G 2H5

Identification of Premises

2193 Arch Street, Ottawa, ON K1G 2H5

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

Urbandale Corporation, 2193 Arch Street, Ottawa, ON K1G 2H5
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