Form ID

Publication date

Location of premises

Certificate

Township of Southgate, Construction of Municipal Services, Given Street, Dundalk, Contract No. 4160-01

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Corporation of Southgate
Address of Owner
185667 Grey County road #9, R.R#1 Dundalk, Ontario N0C 1B0
Name of Contractor
935623 Ontario Ltd. (Moorefield Excavating)
Address of Contractor
R.R. #1, Palmerston, ON N0G 2P0
Name of Certifier
Triton Engineering Services LImited
Address of Certifier
175 Provost Lane, Fergus, ON N1M 3N3

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

Township of Southgate, 185667 Grey County road #9, R.R#1 Dundalk, Ontario N0C 1B0, Attention