Form ID

Publication date

Location of premises

Certificate

Hot Mix Asphalt - Broadway - Hwy. 19 Railway Crossing, Quarter Town Line.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Town of Tillsonburg.
Address of Owner
200 Broadway, 2nd Floor, Tillsonburg, ON N4G 5A7.
Name of Contractor
Cayuga Materials & Construction Co. Limited.
Address of Contractor
R.R. #4, Cayuga, ON N0A 1E0.
Name of Certifier
Cyril J. Demeyere Limited.
Address of Certifier
261 Broadway, Tillsonburg, ON N4G 2J1.

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

Town of Tillsonburg.