Form ID

Publication date

Location of premises

Certificate

Rivers Edge Subdivision Top Asphalt Roadworks Contract

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
1319790 Ontario Inc.
Address of Owner
157 Gladman Avenue, London, ON N6J 1X6
Name of Contractor
Lafarge Paving & Construction Limited
Address of Contractor
1865 Clarke Road, P.O. Box 2815, Terminal “A”, Lon
Name of Certifier
Development Engineering (London) Limited
Address of Certifier
361 Dufferin Avenue, London, ON N6B 1Z5

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

Addresses as above