Form ID

Publication date

Location of premises

Certificate

Resurfacing of Brookdale Ave., 99-T48.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Cornwall.
Address of Owner
1225 Ontario St., Cornwall, Ont.
Name of Contractor
Cornwall Gravel Company Ltd.
Address of Contractor
390 Eleventh Street West, PO Box 67, Cornwall, ON K6H 5R9.
Name of Certifier
Norm Levac.
Address of Certifier
As Above.

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

City of Cornwall.