Form ID

Publication date

Location of premises

Certificate

Expanded Asphalt Recycling Job 13A-2003 and Job 20A-2003

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Corporation of the County of Essex, Office of the County Engineer
Address of Owner
360 Fairview Avenue West, Essex, Ont. N8M 1Y6.
Name of Contractor
Roto-Mill Services Ltd.
Address of Contractor
12 Canam Crescent, Brampton, ON L7A 1A9

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

Corporation of the County of Essex, 360 Fairview Avenue West, Essex, Ont. N8M 1Y6