Form ID

Publication date

Location of premises

Certificate

Second Line, 30 Sideroad and Trunk Services Johnson Controls.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Town of Shelburne
Address of Owner
203 Main Street East, Shelburne, ON L0N 1S3.
Name of Contractor
935623 Ontairo Ltd. (Moorefield Excavating).
Address of Contractor
R.R. #1, Palmerston, ON N0G 2P0.
Name of Certifier
R.J. Burnside & Associates Limited
Address of Certifier
15 Townline, Orangeville, ON L9W 3R4

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

Town of Shelburne, 203 Main Street East, Shelburne, ON L0N 1S3.