Form ID

Publication date

Location of premises

Certificate

Interior Renovation

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Corporation of Haldimand County
Address of Owner
45 Munsee St. N., Cayuga, ON N0A 1E0
Name of Contractor
Lancing Construction a division of 651272 Ontario Inc.
Address of Contractor
100 Lancing Drive, Unit 5, Hamilton, ON L8W 3L6
Name of Certifier
KLS Engineering
Address of Certifier
R.R. #5, River Road, Dunnville, ON N1A 2W4

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

Owner at above address