Form ID

Publication date

Location of premises

Certificate

Cornwell Road Culvert Replacement (Structure No. 1-0299-00) PW-RFT19-03

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
County of Brant
Address of Owner
26 Park Avenue, Burford, ON N0E 1A0
Name of Contractor
Robert M. Simon Construction Limited
Address of Contractor
#20 Concession 6, PO Box 973, Waterford, ON N0E 1Y0
Name of Certifier
G. Douglas Vallee Limited
Address of Certifier
2 Talbot Street North, Simcoe, ON N3Y 3W4

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

County of Brant, 66 Grand River Street North, Paris, Ontario N3L 2M2