Form ID

Publication date

Location of premises

Certificate

Hot Mix Overlayment and Granular Shouldering Job 6B-99.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Corporation of the County of Essex.
Address of Owner
Office of the County Engineer, 360 Fairview Avenue West, Ess
Name of Contractor
Coco Paving Inc.
Address of Contractor
6725 South Service Road, Windsor, ON N8N 2M1.
Name of Certifier
Stuart A. Kelch, P.Eng., County Engineer.
Address of Certifier
Corporation of the County of Essex, 360 Fairview Ave West, E

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

Corporation of the County of Essex, 360 Fairview Avenue West, Essex, ON N8M 1Y6.