Form ID

Publication date

Location of premises

Certificate

Contract No.: OP 08-012 Concrete Curb and Gutter Maintenance

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Haldimand County
Address of Owner
Operations Division, 1162 Regional Road, Cayuga, ON N0A 1E0
Name of Contractor
A-1 Asphalt Maintenance Limited
Address of Contractor
2233 Harold Rd., Burlington, ON L7P 2J6
Name of Certifier
Mike King, C.E.T.
Address of Certifier
as owner

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

Corporation of Haldimand County, Clerk's Department, 45 Munsee Street, Cayuga, Ontario N0A 1E0