Form ID

Publication date

Location of premises

Certificate

Storm Sewer and Sanitary Sewer Installation.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Township of West Lincoln.
Address of Owner
6218 London Road, Smithville, ON L0R 2G0.
Name of Contractor
V. Gibbons Contracting Ltd.
Address of Contractor
P.O. Box 40, Ridgeway, ON L0S 1N0
Name of Certifier
Philips Planning and Engineering Ltd.
Address of Certifier
3215 North Service Road, Box 220, Burlington, ON L7R 3Y2.

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

Owner - Address as above.