Form ID

Publication date

Location of premises

Certificate

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Corporation of the City of Quinte West
Address of Owner
7 Creswell Drive, P.O. Box 490, Trenton, ON K8V 5R6
Name of Contractor
Cobourg Development Services Ltd.
Address of Contractor
609 William St., Cobourg, ON K9A 3A6
Name of Certifier
Mr. T. Colasante Manager of Engineering of Public Works & Environmental Services City of Quinte West
Address of Certifier
Same as Owner

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

The CAO, Corporation of the City of Quinte West, P.O. Box 490, Trenton, ON K8V 5R6