Form ID

Publication date

Location of premises

Certificate

Cold In Place Recycled Expanded Asphalt Mix

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Corporation of the County of Essex
Address of Owner
360 Fairview Ave. West, Suite 315, Essex, ON N8M 1Y6
Name of Contractor
Coco Paving Inc.
Address of Contractor
485 Little Baseline Road, Windsor, ON N8N 2L9
Name of Certifier
Peter Bziuk, P.Eng.
Address of Certifier
360 Fairview Ave. West, Suite 315, Essex, ON N8M 1Y6

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

Ms. Mary Birch, County Clerk, County of Essex, 360 Fairview Ave. West, Essex, ON N8M 1Y6