Form ID

Publication date

Location of premises

Certificate

Construction of Sidewalk, Curb & Gutter and the Repair of Concrete Pavement City of Windsor, Contract No. 55-05

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Corporation of the City of Windsor
Address of Owner
350 City Hall Square West, Windsor, ON N9A 6S1
Name of Contractor
Ingratta Cement & Drainage Inc.
Address of Contractor
6167 Malden Rd, RR #1, Maidstone, ON N0R 1K0
Name of Certifier
Michael Palanacki, P. Eng.
Address of Certifier
same as owner

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

The Corporation of the City of Windsor, Attention