Form ID

Publication date

Location of premises

Certificate

Replacement of the Town of Mono Bridge Number 20

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Town of Mono
Address of Owner
Town of Mono, R.R. #1, Orangeville, ON L9W 2Y8
Name of Contractor
Premier Concrete Limited
Address of Contractor
Box 285, 32 Sparling Street, Seaforth, ON N0K 1W0
Name of Certifier
R.J. Burnside & Associates
Address of Certifier
3 Ronell Crescent, Collilngwood, ON L9Y 4J6

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

Town of Mono