Form ID

Publication date

Location of premises

Certificate

Contract No’s. 2A, 2B. Project No. 88-1345-01

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Township of Malahide
Address of Owner
87 John Street south, P.O. Box 664, Aylmer, ON N5H 2C3
Name of Contractor
Elgin Construction 969774 Ontario Limited
Address of Contractor
140 Burwell Road St. Thomas, ON N5P 3R8
Name of Certifier
Cyril J. Demeyere Limited
Address of Certifier
P.O. Box 606, 261 Broadway, Tillsonburg, Ontario N4G 4J1

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

Township of Malahide, 87 John Street south, P.O. Box 664, Aylmer, ON N5H 2C3