Form ID

Publication date

Location of premises

Certificate

Contract No. A2001-001 Local Road Resurfacing and Concrete Repairs

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Corporation of the Town of Ajax
Address of Owner
65 Harwood Ave. South, Ajax, ON L1S 2H9
Name of Contractor
Miller Paving Limited
Address of Contractor
PO Box 520, Stn. Brooklin, Whitby, ON L1M 1B5
Name of Certifier
Grant Taylor, Construction Supervisor
Address of Certifier
65 Harwood Ave. South, Ajax, ON L1S 2H9

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

M. de Rond, Town of Clerk, Town of Ajax, 65 Harwood Avenue South, Ajax, ON L1S 2H9