Form ID

Publication date

Location of premises

Certificate

Contract 17T08 Asphalt Resurfacing & Concrete Works on Various City Streets

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Cornwall
Address of Owner
1225 Ontario St., Cornwall, ON
Name of Contractor
Cornwall Gravel Co. Ltd.
Address of Contractor
390 11th St. W, Cornwall, ON K6J 3B2
Name of Certifier
Jamie Fawthrop, P. Eng.
Address of Certifier
Same as Owner

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

City of Cornwall