Form ID

Publication date

Location of premises

Certificate

Norwich South Area Sanitary Sewers & Watermains, Contract 295102293403 -2006

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Oxford County
Address of Owner
21 Market Square (P.O. Box 397), Woodstock, ON N4S 7Y3
Name of Contractor
969774 Ontario Limited. (Elgin Construction)
Address of Contractor
140 Burwell Road, St. Thomas, ON N5P 3R8
Name of Certifier
Dadean Assam, P. Eng., Construction Manager, Oxford County
Address of Certifier
Same as Owner

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

as above