Form ID

Publication date

Location of premises

Certificate

Hot Mix Paving Program /Contract No. 01-09

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
County of Lennox & Addington
Address of Owner
97 St, Thomas E. Napanee K7R 3S9
Name of Contractor
Dibblee Construction Ltd.
Address of Contractor
Postal Box 40, Station A, Kingston, ON K7M 6P9
Name of Certifier
G.D. Jewell Engineering Inc.
Address of Certifier
R.R 7, 5503 Hwy 62, Belleville K8N 4Z7

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

County of Lennox & Addington