Form ID

Publication date

Location of premises

Certificate

Storm Sewers /Irrigation / Field Lighting / Grading and Seeding.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Corporation of the City of London
Address of Owner
300 Dufferin Ave., PO Box 5035, London, ON N6A 4L9
Name of Contractor
Monte Vista Contracting Inc.
Address of Contractor
9361 Oriole Drive, Mount Brydges, Ont. N0L 1W0.
Name of Certifier
Earth Tech Canada Inc.
Address of Certifier
285 King Street, Suite 300, London, ON N6B 3M6

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

Corporation of the City of London (as above).