Form ID

Publication date

Location of premises

Certificate

Installation of Residential/ Commercial/ Industrial Water, Sanitary & Storm Sewer Service Connections

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Corporation of the City of Vaughan
Address of Owner
2141 Major Mackenzie Drive, Vaughan, ON L6A 1T1
Name of Contractor
A. Donofrio Construction Co. Ltd.
Address of Contractor
203 Waterside Cres., Maple, ON L6A 1V3
Name of Certifier
Dan Stevens
Address of Certifier
Same as owner

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

City of Vaughan, Clerks Department (Same Addess as Above)