Form ID

Publication date

Location of premises

Certificate

Road Reconstruction and Wastewater Main Replacement

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Town of Milton
Address of Owner
43 Brown St., Milton, ON L9T 5H2
Name of Contractor
King Paving and Materials Company
Address of Contractor
3385 Harvester Road, Box 699, Burlington, ON L7R 3Y5
Name of Certifier
Philips Engineering Ltd.
Address of Certifier
3215 North Service Road, Box 220, Burlington ON L7E 3Y2

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

Owner - Address as Above