Form ID

Publication date

Location of premises

Certificate

Site Servicing for civil infrastructure works only

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
1068499 Ontario Ltd. c/o Z-Land Development Deerbrook Realty
Address of Owner
59 Eugeni Street East, Windsor, ON N8X 2X9
Name of Contractor
Sherway Contracting (Windsor) Ltd.
Address of Contractor
5390 Outer Drive, R.R. #1, Windsor, ON N9A 6J3
Name of Certifier
Dillon Consulting Limited
Address of Certifier
3200 Deziel Drive, Suite 608, Windsor, ON N8W 5K8

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

The Corporation of the Town of Kingsville, Attention