Form ID

Publication date

Location of premises

Certificate

Underground Services, Granulars, Curbs and Asphalt Known as Project No. 4541

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Hanover Bentinck Brant Agricultural Society
Address of Owner
PO Box 20040, Midtown Postal, Hanover, ON N4N 3T1
Name of Contractor
935623 Ontario Limited (Moorefield Excavating)
Address of Contractor
R.R. #1, Palmerston, ON N0G 2P0
Name of Certifier
George A. Davis, P.Eng.
Address of Certifier
101 11th Avenue, Hanover, ON N4N 3W1

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

Hanover Bentinck Brant Agricultural Society, PO Box 20040, Midtown Postal, Hanover, ON N4N 3T1