Form ID

Publication date

Location of premises

Certificate

Construct 200mm watermain

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Municipality of Chatham-Kent Public Utilities Commission
Address of Owner
320 Queen St., PO Box 70, Chatham, ON N7M 5K2
Name of Contractor
Delway Contractors Ltd.
Address of Contractor
R.R. #8, Chatham, ON N7M 5J8
Name of Certifier
Thames Valley Engineering Inc.
Address of Certifier
392 Park Avenue East, Suite 100, Chatham, ON N7M 5Y5

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

Office of owner