Form ID

Publication date

Location of premises

Certificate

Bridge Rehabilitation

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Township of Uxbridge
Address of Owner
P.O. Box 190, Toronto Street South, Uxbridge, ON L9P 1T1
Name of Contractor
Dagmar Construction Inc.
Address of Contractor
P.O. Box 510,
Name of Certifier
M.T. Wilson, CET, Chisholm Fleming and Associates
Address of Certifier
317 Renfrew Dr., Suite 301, Markham, ON L3R 9S8

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

Mr. Walter Taylor, Clerk, Township of Uxbridge, P.O. Box 190, Toronto Street South, Uxbridge, ON L9P 1T1