Form ID

Publication date

Location of premises

Certificate

Underground municipal services including electrical and Granular ‘B’ roadbase.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Ben-Der Holdings Inc.
Address of Owner
R R 2, 1081 Rife Rd., Cambridge ON N1R 5S3.
Name of Contractor
Omega Contractors.
Address of Contractor
4104 Breck Ave., London, ON N6L 1B5.
Name of Certifier
K. Smart Associates Ltd.
Address of Certifier
85 McIntyre Dr., Kitchener, ON N2R 1H6.

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

Ben-Der Holdings Inc., RR 2, 1081 Rife Rd., Cambridge, ON N1R 5S3.