Form ID

Publication date

Location of premises

Certificate

Project 0100-12170-0404 for the Reconstruction of Metcalf Street from Peel Street to Main Street in the City of Woodstock

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Woodstock
Address of Owner
500 Dundas Street (PO Box 40) Woodstock, ON N4S 1C4 (N4S 7W5
Name of Contractor
United Contracting (London) A Division of 1123491 Ontario Inc.
Address of Contractor
2074 Dundas Street East, London, ON N5V 1R2
Name of Certifier
Sil Nadalin P.Eng.
Address of Certifier
Same as owner

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

as above