Form ID

Publication date

Location of premises

Certificate

Undeground Municipal Servicing & Surface Works

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Quirinus Versteegh
Address of Owner
4067 Colonel Talbot Road North, London, ON N6P 1P1
Name of Contractor
Classic Excavating Inc.
Address of Contractor
1752 Donnybrook Drive, Dorchester, ON N0L 1G5.
Name of Certifier
Stantec Consulting Ltd.
Address of Certifier
171 Queens Ave., 8th Floor, London, ON N6A 5J7

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

Quirinus Versteegh, 4067 Colonel Talbot Road North, London, ON N6P 1P1