Form ID

Publication date

Location of premises

Certificate

Salem and Achilles, Contract I - Rough Grading and Sedimentation Control

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
1563485 Ontario Limited
Address of Owner
30 MacIntosh Boulevard, Unit #9, Concord, ON L4K 4P1
Name of Contractor
Rom-Neg Construction
Address of Contractor
R.R. #4, Tottenham, ON L0G 1W0
Name of Certifier
Sernas Associates
Address of Certifier
110 Scotia Court, Unit 41, Whitby, ON L1N 8Y7

Identification of Premises

Part of Lot 6, Range 3, Broken Front Concession

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

1563485 Ontario Limited