Form ID

Publication date

Location of premises

Certificate

COPS Skateboard Park.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Town of Cochrane.
Address of Owner
P.O. Box 490, Cochrane, Ont. P0L 1C0.
Name of Contractor
Pedersen Construction Inc.
Address of Contractor
P.O. Box 2409, New Liskeard, ON P0J 1P0
Name of Certifier
D.J. Cooke, P. Eng.
Address of Certifier
As Owner.

Identification of Premises

COPS Skateboard Park, Hillcrest Park, Fourth Street.

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

Town of Cochrane, P.O. Box 490, Cochrane, Ont. P0L 1C0.