Form ID

Publication date

Location of premises

Certificate

Contract No.: ISPU-1604 Forced Road Watermain Loop

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Corporation of the Township of Russell
Address of Owner
717 Notre Dame Street, Embrun, ON K0A 1W1
Name of Contractor
Normand Excavation Inc.
Address of Contractor
PO Box 231, Hawkesbury, ON K6A 2R8
Name of Certifier
McIntosh Perry Consulting Engineers Ltd.
Address of Certifier
115 Walgreen Rd., RR#3, Carp, ON K0A 1L0

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

The Corporation of the Township of Russell, 717 Notre Dame Street, Embrun, Ontario K0A 1W1