Form ID

Publication date

Location of premises

Certificate

Construction of the North Tillsonburg Water Service Upgrades, Phase 'A', Watermain Construction and Conversion (Contract No. 296819-2007-WM) in the Town of Tillsonburg, Ontario

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Oxford County
Address of Owner
21 Reeve Street, (P.O. Box 614) Woodstock, ON N4S 3G1
Name of Contractor
Xterra Construction Inc.
Address of Contractor
934 Guelph Street, Kitchener, ON N2H 5Z6
Name of Certifier
Dadean Assam, P. Eng.
Address of Certifier
same as owner

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

as above