Form ID

Publication date

Location of premises

Certificate

Port Davidson Road Realignment at the intersection of Vaughn Road

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Township of West Lincoln
Address of Owner
318 Canborough Road, P.O. Box 400, Smithville, ON L0R 2A0
Name of Contractor
Anthony's Excavating Central Inc.
Address of Contractor
5982 Elcho Road, Wellandport, ON L0R 2J0
Name of Certifier
Township of West Lincoln
Address of Certifier
318 Canborough Road, P.O. Box 400, Smithville, ON L0R 2A0

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

Owner Address As Above