Form ID

Publication date

Location of premises

Certificate

Replacement Cooling Tower

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Public Works Canada
Address of Owner
457 Richmond St London ON N6A 3E3
Name of Contractor
Black & McDonald
Address of Contractor
158 South Service Road, Stoney Creek, ON L8E 3H6
Name of Certifier
Moon-Matz Ltd.
Address of Certifier
1435 Hurontario St., Mississauga, ON L5G 3H5

Identification of Premises

Town of Lincoln, Region of Niagara Part Lot 1 Concession 1 (Broken Front Conc.)

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

457 Richmond St London ON N6A 3E3