Form ID

Publication date

Location of premises

Certificate

Site Servicing and Earthworks - Including Fencing, Paving, Concrete Surface Works, and Retaining Walls

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Habitat for Humanity
Address of Owner
300-104 Dawson Road, Guelph, ON N1H 1A6
Name of Contractor
J.G. Goetz Construction Limited
Address of Contractor
5063 Wellington Road 32, P.O. Box 635, Guelph, ON N1H 6L3
Name of Certifier
GM BluePlan Engineering Limited
Address of Certifier
330 Trillium Drive, Unit D, Kitchener, ON N2E 3J2

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

Habitat for Humanity Wellington Dufferin Guelph, 5063 Wellington County Rd. 32, Guelph, ON N1H 6J4