Form ID

Publication date

Location of premises

Certificate

Base Asphalt, Curb and Gutter, Road Granulars, Partial Boulevard Restoration (Topsoil Only, No Sod), and Watermain Installation

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Corporation of the Town of Tillsonburg
Address of Owner
200 Broadway Street, 2nd Floor, Tillsonburg, ON N4G 5A7
Name of Contractor
Blue-Con Construction
Address of Contractor
1995 Crumlin Sideroad, London, ON N5V 3B8
Name of Certifier
Shayne Reitsma, B. Eng.
Address of Certifier
200 Broadway Street, 2nd Floor, Tillsonburg, ON N4G 5A7

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

200 Broadway Street, 2nd Floor, Tillsonburg, ON, N4G 5A7