Form ID

Publication date

Location of premises

Certificate

Princeton Water System - Watermains, Contract 960418-2009

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
County of Oxford
Address of Owner
21 Reeve Street, P.O. Box 1614, Woodstock, ON N4S 7Y3
Name of Contractor
Tri-Con Excavating Inc.
Address of Contractor
#113 4023 Meadowbrook Drive, London, ON N6L 1E7
Name of Certifier
Dadean Assam, P. Eng.
Address of Certifier
Same as owner

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

as above