Form ID

Publication date

Location of premises

Certificate

PW-05-011 Supply and Apply Surface Treatment

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Municipality of Central Elgin
Address of Owner
450 Sunset Dr., St. Thomas, ON N5R 5V1
Name of Contractor
Duncor Enterprises Inc.
Address of Contractor
207 - 4th Line South, R.R. #1, Shanty Bay, ON L0L 2L0
Name of Certifier
John Gooding Engineering Technologist
Address of Certifier
As owner

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

Donald N. Leitch, Chief Administrative Officer & Clerk, Municipality of Central Elgin, 450 Sunset Drive, St. Thomas, Ontario N5R 5V1