Form ID

Publication date

Location of premises

Certificate

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Municipality of West Grey
Address of Owner
402813 Grey Road 4, Durham, ON N0G 1R0
Name of Contractor
Moorefield Excavating Ltd.
Address of Contractor
RR #3, Harriston, ON N0G 1Z0
Name of Certifier
Rakesh Sharma, P. Eng., M.A.Sc.
Address of Certifier
Unit 104D, 1010, 9th Avenue West, Owen Sound, ON N5K 5R7

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

Municipality of West Grey - 402813 Grey Road 4, Durham, ON N0G 1R0