Form ID

Publication date

Location of premises

Certificate

Contract No. 6290-06-02, Double Sliplining of Graham Road Culvert - Contract #6290-06-02

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Corporation of the County of Elgin
Address of Owner
450 Sunset Dr., St. Thomas, ON N5R 5V1
Name of Contractor
A-Xcavating Limited
Address of Contractor
200 Fourth St., P.O. Box 379, Rodney, ON N0L 2C0
Name of Certifier
Meredith Goodwin, Contract Administrator
Address of Certifier
Same as Owner

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

Mark G. McDonald, Chief Administrative Officer, County of Elgin, 450 Sunset Drive, St. Thomas, Ontario N5R 5V1