Form ID

Publication date

Location of premises

Certificate

2010 Tar & Chip Program

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Corporation of the Town of Amherstburg
Address of Owner
512 Sandwich Street, South, Amherstburg, ON N9V 3R2
Name of Contractor
Shepley Road Maintenance Ltd.
Address of Contractor
2964 County Road No. 12, Essex, ON N8M 2X6
Name of Certifier
Lou Zarlenga, P. Eng., Director of Engineering and Infrastructure
Address of Certifier
same as owner

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

The Corporation of the Town of Amherstburg, 512 Sandwich Street, South, Amherstburg, Ontario N9V 3R2