Form ID

Publication date

Location of premises

Certificate

Thamesford North Half - Sewers and Roadwork Contract 295408-2005 (formerly 295407-2005)

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
County of Oxford
Address of Owner
21 Market Square (PO Box 397) Woodstock, ON N4S 7Y3
Name of Contractor
Elgin Construction (969774 Ontario Ltd.)
Address of Contractor
140 Burwell Road, St. Thomas, ON N5P 3R8
Name of Certifier
Dadean Assam, P.Eng.
Address of Certifier
as owner

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

As above