Form ID

Publication date

Location of premises

Certificate

Road reconstruction

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Town of Milton
Address of Owner
43 Brown St., Milton, ON L9T 5H2
Name of Contractor
Metric Contracting
Address of Contractor
34 Bramtree Court, Brampton, ON L6S 5Z7
Name of Certifier
Philips Engineering Ltd.
Address of Certifier
3215 North Service Rd., Box 220, Burlington, ON L7R 3Y2

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

Owner - Address as Above