Form ID

Publication date

Location of premises

Certificate

Municipal Services & Roadworks.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
A & P Staffieri.
Address of Owner
33 Weldick Road East, Richmond Hill, ON L4C 8W4.
Name of Contractor
Hollingworth Construction Co.
Address of Contractor
Box 424, 41 Cardico Drive, Gormley, Ont. L0H 1G0.
Name of Certifier
Stevenson Engineering Limited.
Address of Certifier
238 Olympic Cres, London, ON N6G 3P7.

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

A & P Staffieri, 33 Weldick Road East, Richmond Hill, ON L4C 8W4.