Form ID

Publication date

Location of premises

Certificate

Construction of storm and sanitary sewers, watermain and asphalt pavement

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Corporation of the City of Windsor
Address of Owner
350 City Hall Sq. W., Windsor, ON N9A 6S1
Name of Contractor
Smith Contracting
Address of Contractor
5255 County Road 42 Tecumseh, ON N8N 2M1
Name of Certifier
G.T. Harding P.Eng.
Address of Certifier
As owner

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

The Corporation of the City of Windsor, Attention