Form ID

Publication date

Location of premises

Certificate

Storm and Sanitary Sewers, Watermains, Services, Concrete Curb and Gutter and Base Asphalt.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
1078217 Ontario Ltd.
Address of Owner
P.O. Box 3130, Tecumseh, ON N8N 2M3
Name of Contractor
M.R.
Name of Certifier
Stantec Consulting Ltd.
Address of Certifier
3260 Devon Dr., Windsor, ON N8X 4L4.

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

1078217 Ontario Ltd. P.O. Box 3130, Tecumseh, ON N8N 2M3