Form ID

Publication date

Location of premises

Certificate

Ingersoll Water Treatment Facilities - West Street and Dunn’s Road, Contract 296818A-2005

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Oxford County
Address of Owner
21 Market Square (P.O. Box 397), Woodstock, ON N4S 7Y3
Name of Contractor
The John Hayman & Sons Company, Ltd. (Hayman Construction Inc.)
Address of Contractor
636 Wellington Street, London, ON N6A 3R9
Name of Certifier
Dadean Assam, P. Eng., Construction Manager, Oxford County
Address of Certifier
Same as Owner

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

as above