Form ID

Publication date

Location of premises

Certificate

Hot Mix Resurfacing, Job 10B-2002.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Corporation of the County of Essex Office of the County Engineer.
Address of Owner
360 Fairview Ave. W., Essex, Ont. N8M 1Y6.
Name of Contractor
Coco Paving (1990) Inc.
Address of Contractor
6725 South Service Road, Tecumseh, Ont. N8N 2M1.
Name of Certifier
Stuart A. Kelch, P. Eng., County of Engineer, Corporation of the County of Essex.
Address of Certifier
360 Fairview Ave. W., Essex, Ont. N8M 1Y6.

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

Corporation of the County of Essex, 360 Fairview Ave. W., Essex, Ont. N8M 1Y6.