Form ID

Publication date

Location of premises

Certificate

Roberts Line Reconsrtruction

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Municipality of Central Elgin
Address of Owner
450 Sunset Drive, St. Thomas, ON N5R 5V1
Name of Contractor
Bre-Ex Limited
Address of Contractor
247 Exeter Road, London, ON N6L 1A5
Name of Certifier
Geoff Brooks, Engineering Technologist
Address of Certifier
Same as Owner

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

Donald N. Leitch, Chief Administrative Officer & Clerk, Municipality of Central Elgin, 450 Sunset Dr., St. Thomas, Ontario N5R 5V1