Form ID

Publication date

Location of premises

Certificate

Road Rehabilitation III - Cold Milling and Asphalt Paving, City of Windsor Contract No. 53-06

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Corporation of the City of Windsor
Address of Owner
350 City Hall Sq. W., Windsor, ON N9A 6S1
Name of Contractor
Mill-Am Corporation
Address of Contractor
2155 Fasan Drive, R.R#1, Oldcastle, ON N0R 1L0
Name of Certifier
Michael Palanacki, P.Eng.
Address of Certifier
As owner

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

The Corporation of the City of Windsor, Attention