Form ID

Publication date

Location of premises

Certificate

East Site Drainage - Sydenham Campus

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Chatham-Kent Health Alliance
Address of Owner
106 Emma St., P.O. Box 2030 Chatham ON N7M 5L9
Name of Contractor
Henry Heyink Construction Limited
Address of Contractor
275 Colborne St., PO Box 1341, Chatham, ON N7M 5R9
Name of Certifier
Todgham & Case Associates Inc.
Address of Certifier
131 Heritage Road P.O. Box 1325 Chatham ON N7M 5R9

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

Owner Address as Above