Form ID

Publication date

Location of premises

Certificate

Contract No. 6090-04-01 Crack Sealing Various County Roads

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Corporation of the County of Elgin
Address of Owner
450 Sunset Dr., St. Thomas, ON N5R 5V1
Name of Contractor
788893 Ontario Limited o/a Niagara Crack Sealing
Address of Contractor
40 Stonebridge Drive, Port Colborne, ON L3K 5V4
Name of Certifier
Peter Dutchak, CET
Address of Certifier
As owner

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

Mark G. McDonald, Chief Administrative Officer, County of Elgin, 450 Sunset Drive, St. Thomas, ON N5R 5V1