Form ID

Publication date

Location of premises

Certificate

Reconstruction of 2nd St. E. #02-T20

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Cornwall
Address of Owner
1225 Ontario St., Conrwall Ontario
Name of Contractor
Cornwall Gravel Co. Ltd.
Address of Contractor
390 11th Street West, Cornwall, ON K6H 5R9
Name of Certifier
Jean Lemire
Address of Certifier
As Above

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

City of Cornwall