Form ID

Publication date

Location of premises

Certificate

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Municipality of Hastings Highlands
Address of Owner
33011 Hwy. 62 North, P.O. Box 130, Maynooth, ON K0L 2S0
Name of Contractor
J&P Leveque Bros Haulage Ltd.
Address of Contractor
30876 Highway 62 North, RR#5, Bancroft, ON K0L 1C0
Name of Certifier
Jason Ward P. Eng.
Address of Certifier
Perspective Engineering Inc. Box 6, Wilberforce, ON K0L 3C0

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

Municipality of Hastings Highlands, 33011 Hwy. 62 North, P.O. Box 130, Maynooth, Ontario K0L 2S0