Form ID

Publication date

Location of premises

Certificate

Underground servicing & roadworks

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Long Investments Inc.
Address of Owner
R.R. #4, 44 Robinson Road, Brantford, ON N3T 5L7.
Name of Contractor
Sierra Construction (Woodstock) Ltd.
Address of Contractor
1401 Dundas Street East, Woodstock, ON N4S 8X8
Name of Certifier
J.H. Cohoon Engineering Limited
Address of Certifier
135 Tollgate Road, Brantford, ON N3R 4Z9

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

J.H. Cohoon Engineering Limited