Form ID

Publication date

Location of premises

Certificate

Contract No. 1999-08/Port Bruce Bridge Deck Rehabilitation.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The County of Elgin.
Address of Owner
450 Sunset Drive, St. Thomas, ON N5R 5V1.
Name of Contractor
Theo Vandenberk Construction Inc.
Address of Contractor
15673 Fifteen Mile Road, R.R. #2, Denfield, ON N0M 1P0.
Name of Certifier
Peter Dutchak, CET.
Address of Certifier
As owner.

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

Mark G. McDonald, Administrator/ Clerk, County of Elgin, 450 Sunset Drive, St. Thomas, ON N5R 5V1.