Form ID

Publication date

Location of premises

Certificate

Traffic Lights and Civil Works

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Town of Shelburne
Address of Owner
203 Main Street East, Shelburne, ON L0N 1S0
Name of Contractor
Stacey Electric Company Ltd.
Address of Contractor
179 Bartley Drive, Unit B, Toronto, ON M4A 1E8
Name of Certifier
R.J. Burnside & Associates Limited
Address of Certifier
15 Townline, Orangeville, ON L9W 3R4

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

Town of Shelburne, 203 Main Street East, Shelburne, ON L0N 1S0