Form ID

Publication date

Location of premises

Certificate

Contract No.: M179 Road Improvements and Surface Treatment

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Township of Pelee
Address of Owner
1045 West Shore Road, Pelee Island, ON N0R 1M0
Name of Contractor
Shepley Excavating and Road Maintenance Ltd.
Address of Contractor
2964 Road 12, Essex, ON N8M 2X6
Name of Certifier
BTS Consulting Engineers
Address of Certifier
1725 North Talbot Road, R.R. #1, Windsor, ON N9A 6J3

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

Township of Pelee, 1045 West Shore Road, Pelee Island, ON N0R 1M0