Form ID

Publication date

Location of premises

Certificate

Door Replacement.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Bluewater Disrict School Board.
Address of Owner
351 First Avenue North, Chesley, Ont. N0G 1L0.
Name of Contractor
Dwight Burley Construction Limited.
Address of Contractor
R.R. 2, Kemble, ON N0H 1S0.
Name of Certifier
Erdmann W. Knaack, Architect.
Address of Certifier
P.O. Box 327, Chatsworth, Ont. N0H 1G0.

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

351 First Avenue North, Chesley, Ont. N0G 1L0.