Form ID

Publication date

Location of premises

Certificate

Underground Servicing (Watermain) and Road Works

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
1232046 Ontario Inc.
Address of Owner
P.O. Box 760, Rockwood, ON N0B 2K0
Name of Contractor
Drexler Construction Limited
Address of Contractor
R.R. #1, 5274 County Road 27, Rockwood, ON N0B 2K0
Name of Certifier
Philips Engineering Ltd.
Address of Certifier
3215 North Service Road, Box 220, Burlington ON L7R 3Y2

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

As above