Form ID

Publication date

Location of premises

Certificate

Surface Treatment Various Locations Contract # 17-05

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
United Counties of Leeds and Grenville
Address of Owner
25 Central Ave. West, Suite 100 Brockville, ON K6V 4N6
Name of Contractor
Smiths Construction Company
Address of Contractor
276 Madawaska BLVD. Arnprior, ON K7S 3H4

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

25 Central Ave. West, Suite 100 Brockville, ON. K6V 4N6