Form ID

Publication date

Location of premises

Certificate

Contract No. 01194, Water Distribution System

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Municipality of Bluewater
Address of Owner
14 Mill Street, Box 250, Zurich, ON N0M 2T0
Name of Contractor
Omega Contractors
Address of Contractor
4104 Breck Ave., London, ON N6L 1B5
Name of Certifier
B.M. Ross and Associates Limited
Address of Certifier
62 North Street, Goderich, ON N7A 2T4

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

Municipality of Bluewater, Box 250, 14 Mill St., Zurich, ON N0M 2T0