Form ID

Publication date

Location of premises

Certificate

Sidewalk Reconstruction Contract No. PW-E-17-31

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Corporation of Norfolk County
Address of Owner
183 Main Street, Delhi, ON N4B 2M3
Name of Contractor
Autoform Contracting London Limited
Address of Contractor
611 Industrial Road, London, ON N5V 1V2
Name of Certifier
Kevin Verkindt
Address of Certifier
Same as Owner

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

The Corporation of Norfolk County, 50 Colborne Street South, Simcoe, Ontario N3Y 4H3