Form ID

Publication date

Location of premises

Certificate

Asphalt surface treating approximately 96 kilometres of roads in the County of Oxford (being a joint tender called by the County of Oxford on behalf of the County, The Township of Norwich, South-West Oxford, Zorra-Tavistock and Blandford-Blenheim )

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
County of Oxford
Address of Owner
415 Hunter Street (P.O. Box 397), Woodstock, ON N4S 4G5 (N4S
Name of Contractor
Cornell Construction Limited.
Address of Contractor
PO Box 785 410 Hardy Road, Brantford, ON N3T 5R7
Name of Certifier
Brad Wilson P.Eng.
Address of Certifier
As owner

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

As above