Form ID

Publication date

Location of premises

Certificate

Watermain Replacement

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Hamilton
Address of Owner
77 James Street North, Suite 320, Hamilton, ON L8R 3K2
Name of Contractor
LM Enterprises
Address of Contractor
27 Crooks St., Hamilton, ON L8R 2Z7
Name of Certifier
Philips Engineering Ltd.
Address of Certifier
3215 North Service Road, Box 220, Burlington, ON L7R 3Y2

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

Owner - Address as above