Form ID

Publication date

Location of premises

Certificate

Underground Servicing Brookside Phase I

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Brookside Estates Inc.
Address of Owner
358 Horton Street, London, ON N6B 1L7
Name of Contractor
C.H. Excavating (London) Ltd.
Address of Contractor
4201 Blakie Road, London, ON N6L 1B9
Name of Certifier
Cyril J. Demeyere Limited
Address of Certifier
261 Broadway, PO Box 606, Tillsonburg, ON N4G 4J1

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

Cyril J. Demeyere Limited