Form ID

Publication date

Location of premises

Certificate

Contract No.: 2004-PW-150, Revised Milford Bridge Repairs

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Corporation of the County of Prince Edward
Address of Owner
County Building/Shire Hall, PO Drawer, 1550, Picton, ON K0K
Name of Contractor
Underground Services (1983) Ltd.
Address of Contractor
135 Commercial Rd., Bolton, ON L7E 1R6
Name of Certifier
G.D. Jewell Engineering Inc.
Address of Certifier
R.R. #7, 5503 Highway 62, Box 7200, Belleville, ON K8N 4Z7

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

Corporation of the County of Prince Edward, County Building/ Shire Hall, PO Drawer, 1550, Picton, ON K0K 2T0