Form ID

Publication date

Location of premises

Certificate

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Haldimand County
Address of Owner
Caledonia Satellite Office, 282 Argyle Street South, Caledonia, ON N3W 1K7
Name of Contractor
CRL Campbell Construction & Drainage Ltd.
Address of Contractor
11675 Burnaby Rd, Wainfleet, ON L0S 1V0
Name of Certifier
Mike King, Project Manager, Municipal Infrastructure, Engineering Services Division
Address of Certifier
Same as Owner

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

Corporation of Haldimand County, Clerk's Department, 45 Munsee Street North, Cayuga, Ontario N0A 1E0