Form ID

Publication date

Location of premises

Certificate

Site Servicing up to and including base course asphalt

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Werner Bromberg Limited
Address of Owner
44 Saltsman Drive, Unit #5, Cambridge, ON N3H 4R7
Name of Contractor
Brantford Engineering and Construction Limited
Address of Contractor
54 Ewart Avenue, RR #8, Brantford, ON N3T 5M1
Name of Certifier
IBI Group
Address of Certifier
105 Lexington Rd., Unit 17, Waterloo, ON N2J 4R7

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

Werner Bromberg Limited, 44 Saltsman Drive, Unit #5, Cambridge, ON N3H 4R7