Form ID

Publication date

Location of premises

Certificate

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Haldimand County
Address of Owner
Engineering Services, Public Works Dept. 282 Argyle St. S., Caledonia, ON N3W 1K7
Name of Contractor
BGL Contractors Corp.
Address of Contractor
608 Colby Dr., Waterloo, ON N2V 1A2
Name of Certifier
Warren Wight CET, Capital Project Technologist
Address of Certifier
Same as Owner

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

Corporation of Haldimand County, Clerk's Department, 45 Munsee Street, Cayuga, Ontario N0A 1E0