Form ID

Publication date

Location of premises

Certificate

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Township of Perry
Address of Owner
1695 Emsdale Road, P.O. Box 70, Emsdale, ON P0A 1J0
Name of Contractor
Bruman Construction Inc.
Address of Contractor
P.O. Box 1153, North Bay, ON P1B 8K4
Name of Certifier
EXP Services Inc.
Address of Certifier
757 Main Street East, North Bay, ON P1B 1C2

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

Township of Perry 1695 Emsdale Road, P.O. Box 70, Emsdale, ON POA 1JO Att: Ms. Kim Seguin, Treasurer/Tax Collector