Form ID

Publication date

Location of premises

Certificate

Axford Parkway Crossing of Mill Creek.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Doug Tarry Limited
Address of Owner
358 Elm Street, St. Thomas, ON N5R 1K1
Name of Contractor
Anders Contracting.
Address of Contractor
P.O. Box 340, Hagersville, ON N0A 1H0.
Name of Certifier
Cyril J. Demeyere Limited
Address of Certifier
261 Broadway, PO Box 606, Tillsonburg, ON N4G 4J1

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

Cyril J. Demeyere Limited