Form ID

Publication date

Location of premises

Certificate

Hot Mix Paving

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Township of Uxbridge
Address of Owner
51 Toronto St. S., P.O. Box 190, Uxbridge, ON L9P 1T1
Name of Contractor
Furfari Paving Co. Ltd.
Address of Contractor
2751 Markham Rd., Scarborough, ON M1X 1M4
Name of Certifier
Ben Kester
Address of Certifier
51 Toronto St. S., P.O. Box 190, Uxbridge, ON L9P 1T1

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

Debbie Leroux, Clerk, 51 Toronto St. S., P.O. Box 190, Uxbridge, ON L9P 1T1