Form ID

Publication date

Location of premises

Certificate

St. Marys Well #2A

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Town of St. Marys
Address of Owner
175 Queen Street East, 2nd Floor, Box 998, St. Marys, ON N4X
Name of Contractor
Xterra Construction Inc.
Address of Contractor
934 Guelph St., Unit A, Kitchener, ON N2H 5Z6
Name of Certifier
B.M. Ross and Associates Limited
Address of Certifier
62 North St., Goderich, ON N7A 2T4

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

Town of St. Marys, Municipal Office, address as above