Form ID

Publication date

Location of premises

Certificate

Replacement of North Retaining wall for Culverts No. 221100, County Road 22

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
County of Wellington
Address of Owner
Wellington County Engineer, Administration Centre, 74 Woolwi
Name of Contractor
Subterra Waterloo Inc.
Address of Contractor
934 Guelph St., Kitchener, ON N2H 5Z6.
Name of Certifier
McCormick RankinCorporation
Address of Certifier
2655 North Sheridan Way, Mississauga, Ontario L5K 2P8

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

As Above