Form ID

Publication date

Location of premises

Certificate

Concrete curb & gutter and concrete sidewalk, topsoil & sod at various locations in the Town of Tillsonburg

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Corporation of the Town of Tillsonburg
Address of Owner
200 Broadway Street, 2nd Floor, Town Center Mall, Tillsonbur
Name of Contractor
J. Franze Concrete Ltd.
Address of Contractor
4130 Brigham Road, London, ON N6P 1P3
Name of Certifier
Corporation of the Town of Tillsonburg
Address of Certifier
Operations Services, 10 Lisgar Avenue, Tillsonburg, ON N4G 5

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

Corporation of the Town of Tillsonburg, 200 Broadway Street, 2nd Floor, Town Center Mall, Tillsonburg, ON N4G 5A7