Form ID

Publication date

Location of premises

Certificate

Interlink Duct, Concrete Work, Paving Stone, Surface Milling, Asphalt Paving and Pavement Markings

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Corporation of the Town of Tillsonburg
Address of Owner
200 Broadway Street, 2nd Floor, Town Center Mall, Tillsonbur
Name of Contractor
Cayuga Materials & Construction Co. Ltd.
Address of Contractor
R.R. #4, Cayuga, Ont. N0A 1E0.
Name of Certifier
Corporation of the Town of Tillsonburg
Address of Certifier
Operations Services, 10 Lisgar Avenue, Tillsonburg, ON N4G 5

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

Corporation of the Town of Tillsonburg, 200 Broadway Street, 2nd Floor, Town Center Mall, Tillsonburg, ON N6G 5A7