Form ID

Publication date

Location of premises

Certificate

Contract No. 4, Project No. 88-1338-01 &88-1350-01

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Corporation of the Municipality of Bayham
Address of Owner
P.O. Box 160, 9344 Plank Road North, Straffordville, Ontario
Name of Contractor
Omega Contractors
Address of Contractor
4104 Breck Ave., London, ON N6L 1B5
Name of Certifier
Acres & Associated Environmental Limited
Address of Certifier
4342 Queen Street, P.O. Box 1001, Niagara Falls ON L2E 6W1

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

Clerk, The Corporation of the Municipality of Bayham, P.O. Box 160, 9344 Plank Road North, Straffordville, Ontario N0J 1Y0