Form ID

Publication date

Location of premises

Certificate

London Rd. trunk sewer; Church St. storm sewerand storm sewer at 130 Smith St.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Township of Wellington North
Address of Owner
7480 Sideroad 7, Kenilworth, Ontario N0G 2E0
Name of Contractor
935623 Ontario Limited (Moorefield Excavating)
Address of Contractor
R.R. #1, Palmerston, ON N0G 2P0
Name of Certifier
Frank Vanderloo, P.Eng., B.M. Ross and Associates Limited
Address of Certifier
P.O. Box 1179, 206 Industrial Drive, Mount Forest, Ontario N

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

Township of Wellington North