Form ID

Publication date

Location of premises

Certificate

Installation of Watermains and Appurtenances and Sanitary Forcemain, Sanitary Pumping Station and Sanitary Sewers

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Mac 5 Corp.
Address of Owner
490 Dundas Street West, Belleville, ON K8N 5V7
Name of Contractor
McInroy Maines Construction Ltd.
Address of Contractor
121 Parks Drive, RR #5, Belleville, ON K8N 4Z5
Name of Certifier
G.D. Jewell Engineering Inc.
Address of Certifier
RR #7 5503 Hwy #62 Box 7200, Belleville, ON K8N 4Z7

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

Mac 5 Corp., 490 Dundas Street West, Belleville, ON K8N 5V7