Form ID

Publication date

Location of premises

Certificate

Water Main

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The City of Greater Sudbury
Address of Owner
P.O. Box 5000, Station “A”, Sudbury, ON P3A 5P3
Name of Contractor
Lacroix Construction Co. Ltd.
Address of Contractor
861 Lapointe St., Sudbury, ON P3A 5N9
Name of Certifier
Kevin Shaw, P. Eng.
Address of Certifier
Same as Owner

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

The Clerk, The City of Greater Sudbury, P.O. Box 5000, Stn A, Sudbury, ON P3A 5P3
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