Form ID

Publication date

Location of premises

Certificate

Otterville fire station No. 1

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Township of Norwich
Address of Owner
210 Main Street E., P.O. Box 100, Otterville, ON N0J 1R0
Name of Contractor
PK Construction Limited
Address of Contractor
37 Tillson Street, Unit A, Tillsonburg, ON N4G 0B7
Name of Certifier
G. Douglas Vallee Limited
Address of Certifier
2 Talbot Street, Simcoe, ON N3Y 3W4

Identification of Premises

Part of Lot 9, Concession 9 Geographic Township of South Norwich Oxford County

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

210 Main Street E., P.O. Box 100, Otterville, Ontario N0J 1R0