Form ID

Publication date

Location of premises

Certificate

Lakeshore Bridge Program 2010 in the Town of Lakeshore

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Corporation of the Town of Lakeshore
Address of Owner
419 Notre Dame Street, Belle River, ON N0R 1A0
Name of Contractor
Signature Contractors Windsor Inc.
Address of Contractor
4255 7th Concession Road, R.R.#1, Windsor, ON N9A 6J3
Name of Certifier
Dillon Consulting Limited
Address of Certifier
3200 Deziel Drive, Suite 608, Windsor, ON N8W 5K8

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

Corporation of the Town of Lakeshore. Attention