Form ID

Publication date

Location of premises

Certificate

00-001 Asphalt and Concrete Requirements

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Corporation of the Town of Ajax.
Address of Owner
65 Harwood Ave. S., Ajax, Ont. L1S 2H9
Name of Contractor
Bennett Paving and Materials
Address of Contractor
1255 Wilson Rd N., Oshawa, ON L1H 7L3.
Name of Certifier
Alan Robinson, Construction Inspector
Address of Certifier
65 Harwood Avenue South, Ajax, ON L1S 2H9.

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

M. deRond, Clerk, Town of Ajax, 65 Harwood Ave S., Ajax, ON L1S 2H9