Form ID

Publication date

Location of premises

Certificate

Contract No. 2002-33, Hot Mix Asphalt Paving County Road 124

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The
Name of Contractor
Georgian Aggregates & Construction Inc.
Address of Contractor
P.O. Box 340, Collingwood, Ont. L9Y 3Z7.
Name of Certifier
William H. Brown, P. Eng., County Engineer
Address of Certifier
1110 Highway 26, Administration Centre, Midhurst, ON L0L 1X0

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

County Clerk, The Corporation of the County of Simcoe, 1110 Highway 26, Administration Centre, Midhurst, ON L0L 1X0