Form ID

Publication date

Location of premises

Certificate

Contract No.: EI 04-030 Hot Mix Paving and Cold-in-Place Asphalt Recycling

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Haldimand County
Address of Owner
Caledonia Satellite Office, 282 Argyle St. S., Caledonia, ON
Name of Contractor
Cayuga Materials & Construction Co. Limited
Address of Contractor
R.R. #4, Cayuga, Ont. N0A 1E0
Name of Certifier
Tyson Haedrich, M. Eng., P. Eng.
Address of Certifier
Same as owner

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

Corporation of Haldimand County, Clerks Department, 95 Munsee St., Cayuga, ON N0A 1E0