Form ID

Publication date

Location of premises

Certificate

Installation of Street Lighting

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Walloy Excavating Company Limited
Address of Owner
358 Horton Street, London, ON
Name of Contractor
Southwood Diversified Ltd.
Address of Contractor
2096 Jetstream Road, London, ON N5V 3P6
Name of Certifier
Whitney Engineering Inc.
Address of Certifier
630 Colborne Street, London, ON N6B 2V2

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

Whitney Engineering Inc.