Form ID

Publication date

Location of premises

Certificate

Thamesford Raw Water Transmission Main, Contract 296817A-2005, County Road 119 Watermain Extension, Contract 293411-2005, Allen Street Low Pressure Sewer, Contract 295400-2005

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Oxford County
Address of Owner
21 Market Square (P.O. Box 397) Woodstock, ON N4S 7Y3
Name of Contractor
L.T. Inc.
Address of Contractor
4169 Perkins Road, Unit B, London, ON N6L 1C2
Name of Certifier
Dadean Assam, P.Eng.
Address of Certifier
as owner

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

as above