Form ID

Publication date

Location of premises

Certificate

Contract No. 291029-2004 - Bridge Rehabilitation, Thames River Bridge, Oxford County Road 2, Thamesford, Township of Zorra

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
County of Oxford
Address of Owner
415 Hunter St., (P.O. Box 397) Woodstock, ON N4S 4G5 (N4S 7Y
Name of Contractor
Weathertech Restoration Services Inc.
Address of Contractor
553 Clarke Road, London, ON N5V 2E1
Name of Certifier
Douglas Ellis, P. Eng., Construction Manager, County of Oxford
Address of Certifier
as above

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

as above