Form ID

Publication date

Location of premises

Certificate

Contract No.: O 97763 Construction of Industrial Park Road

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Town of Prescott
Address of Owner
PO Box 160, Prescott, ON K0E 1T0
Name of Contractor
G. Tackaberry & Sons Construction Co. Ltd.
Address of Contractor
109 Washburn Road, PO Box 70, Athens, ON K0E 1B0
Name of Certifier
Genivar Consulting Group Ltd.
Address of Certifier
9 Broad Street, Suite 306, Brockville, ON K6V 6Z4

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

Town of Prescott, PO Box 160, Prescott, Ontario K0E 1T0 Attention