Form ID

Publication date

Location of premises

Certificate

Contract No. 6-99 Merritt Street Underground & Road Reconstruction.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Town of Ingersoll.
Address of Owner
130 Oxford St., Ingersoll, ON N5C 2V5
Name of Contractor
Blue-Con Inc.
Address of Contractor
1915 Crumlin Side Road, London, ON N5V 3B8.
Name of Certifier
Town of Ingersoll, Engineering Department.
Address of Certifier
130 Oxford St., 2nd Floor, Ingersoll, ON N5C 2V5

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

130 Oxford St., 2nd Floor, Ingersoll, ON N5C 2V5