Form ID

Publication date

Location of premises

Certificate

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Corporation of the City of Quinte West
Address of Owner
7 Creswell Drive, P.O. Box 490, Trenton, ON K8V 5R6
Name of Contractor
Coco Paving Inc.
Address of Contractor
6520 Hwy 62, Belleville, ON K8N 5A5
Name of Certifier
Mr. T. Colasante, Manager of Engineering of Public Works & Environmental Services
Address of Certifier
City of Quinte West

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

The CAO, Corporation of the City of Quinte West, P.O. Box 490, Trenton, ON K8V 5R6