Form ID

Publication date

Location of premises

Certificate

Watermain and road reconstruction

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Township of Wilmot
Address of Owner
60 Snyder’s Road West, Baden, ON N0B 1G0
Name of Contractor
Sousa Concrete
Address of Contractor
R.R. #1, Branchton, ON N0B 1L0
Name of Certifier
Tim Zavitsky
Address of Certifier
Earth Tech Canada Inc., 101 Frederick Street, Suite 502, Kit

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

Township of Wilmot