Form ID

Publication date

Location of premises

Certificate

Watermain Repiars Parkwood Hospital

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
St. Joseph’s Health Centre
Address of Owner
PO Box 5777, London, ON N6A 4V2
Name of Contractor
Blue-Con Inc.
Address of Contractor
1915 Crumlin Side Road, London, ON N5V 3B8
Name of Certifier
Development Engineering (London) Limited
Address of Certifier
361 Dufferin Ave., London, ON N6B 1Z5

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

Addresses as above