Form ID

Publication date

Location of premises

Certificate

Contract No. PW-R-01-021 Supply and Apply Single and Double Surface Treatment

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Corporation of Norfolk County
Address of Owner
183 Main Street, Delhi, ON N4B 2M3
Name of Contractor
Duncor Enterprises Inc.
Address of Contractor
207-4th Line South, R.R. #1 Shanty Bay, ON L0L 2L0
Name of Certifier
Judy Boughner, Operations Contract Coordinator
Address of Certifier
As owner

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

Mrs. Beverley Wood Clerk/Manager of Council Services, 50 Colborne Street, Simcoe, ON N3Y 4N5