Form ID

Publication date

Location of premises

Certificate

Dock St. shorewall improvements

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Corporation of Norfolk County
Address of Owner
95 Culver St., Simcoe, ON N3Y 2V5
Name of Contractor
Robert M. Simon Construction Ltd.
Address of Contractor
P.O. Box 973 R.R.#1, Waterford, ON N0E 1Y0
Name of Certifier
Riggs Engineering Ltd.
Address of Certifier
1240 Commissioners Rd. West, Suite 205, London, ON N6K 1C7

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

95 Culver St., Simcoe, Ontario N3Y 2V5