Form ID

Publication date

Location of premises

Certificate

B Line Connection

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Lake Huron Primary Water Supply System, Joint Board of Management
Address of Owner
300 Dufferin Ave., P.O. Box 5035, London, ON N6A 4L9
Name of Contractor
Van Bree Drainage and Bulldozing Ltd
Address of Contractor
R.R. 6, Forest, ON N0N 1J0
Name of Certifier
B.M. Ross and Associates Limited
Address of Certifier
62 North St., Goderich, ON N7A 2T4

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

300 Dufferin Ave., P.O. Box 5035, London, ON N6A 4L9