Form ID

Publication date

Location of premises

Certificate

Contract for Underground Services and Base Roads Alderson Estates, Carlisle, Ontario

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
1349160 Ontario Inc.
Address of Owner
PO Box 231, Carlisle, ON L0R 1H0
Name of Contractor
Elgin Construction
Address of Contractor
140 Burwell Road, St. Thomas, ON N5P 3R8.
Name of Certifier
van der Woerd & Associates
Address of Certifier
3600 Billings Court Suite 100 Burlington ON L7N 3N6

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

1349160 Ontario Inc., PO Box 231, Carlisle, ON L0R 1H0