Form ID

Publication date

Location of premises

Certificate

Catch basin / manhole adjustments, surface asphalt placement, line markings, concrete sidewalks / curbs and landscaping

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Corporation of the City of London
Address of Owner
300 Dufferin Avenue, PO Box 5035, London, ON N6A 4L9
Name of Contractor
J-Aar Excavating Limited
Address of Contractor
3003 Page Street, London, ON N5V 4J1
Name of Certifier
AECOM Canada Ltd.
Address of Certifier
250 York Street, Suite 410, London, ON N6A 6K2

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

Corporation of the City of London, 300 Dufferin Avenue, PO Box 5035, London, Ontario, N6A 4L9