Form ID

Publication date

Location of premises

Certificate

Contract No. 2004-PW-116 Hot Mix Paving and Road Surface Pulverizing

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Corporation of the County of Prince Edward
Address of Owner
County Building/Shire Hall, PO Drawer 1550, Picton, ON K0K 2
Name of Contractor
Cruickshank Construction Limited
Address of Contractor
55 Rigney Street, Kingston, ON K7K 6Z3
Name of Certifier
G.D. Jewell Engineering Inc.
Address of Certifier
R.R. #7, 5503 Highway 62, Box 7200, Belleville, ON K8N 4Z7

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

Corporation of the County of Prince Edward, County Building/Shire Hall, PO Drawer 1550, Picton, ON K0K 2T0