Form ID

Publication date

Location of premises

Certificate

Contract No. EI-01-030 Hot Mix Paving

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Haldimand County
Address of Owner
Caledonia Satellite Office, 1 Greendale Drive Unit #2, Caled
Name of Contractor
Cayuga Materials & Construction Company Limited
Address of Contractor
R.R. #4, Cayuga, ON N0A 1E0
Name of Certifier
Mike King, C.E.T.
Address of Certifier
Haldimand County

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

Corporation of Haldimand County, Clerks Department, 95 Munsee St., Cayuga, ON N0A 1E0