Form ID

Publication date

Location of premises

Certificate

Road Reconstruction

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Town of Dundas
Address of Owner
60 Main Street, Dundas Ontario L9H 2P8
Name of Contractor
Anders Contracting.
Address of Contractor
93 Main Street, Hagersville, ON N0A 1H0.
Name of Certifier
Philips Engineering
Address of Certifier
3215 North Service Road, Box 220, Burlington ON L7R 3Y2

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

Owner - Address as Above