Form ID

Publication date

Location of premises

Certificate

Southdale Line Construction

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Municipality of Central Elgin.
Address of Owner
450 Sunset Drive, St. Thomas, ON N5R 5V1.
Name of Contractor
McKenzie & Henderson Ltd.
Address of Contractor
Box 116, Arkona, ON N0M 1B0.
Name of Certifier
Lloyd J. Perrin
Address of Certifier
Same as owner

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

Donald N. Leitch, Chief Administrative Officer & Clerk, The Municipality of Central Elgin, 450 Sunset Drive, St. Thomas, ON N5R 5V1.