Form ID

Publication date

Location of premises

Certificate

Hot Mix Resurfacing Job 27-2005

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Corporation of the County of Essex Office of the County Engineer
Address of Owner
360 Fairview Avenue West, Essex, ON N8M 1Y6
Name of Contractor
Coco Paving Inc.
Address of Contractor
6725 South Service Road, Windsor, ON N8N 2M1
Name of Certifier
Richard D. Fazecash, P. Eng., Assistant County Engineer
Address of Certifier
Corporation of the County of Essex, 360 Fairview Avenue W.,

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

Corporation of the County of Essex, 360 Fairview Avenue W., Essex, ON N8M 1Y6