Form ID

Publication date

Location of premises

Certificate

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Corporation of the City of Windsor, Traffic Engineering Department.
Address of Owner
1269 Mercer Street, Windsor, ON N8X 3P4.
Name of Contractor
Coco Paving (1990) Inc.
Address of Contractor
6725 South Service Road, R.R. #2, Tecumseh, ON N8N 2M1.
Name of Certifier
Dillon Consulting Limited.
Address of Certifier
3200 Deziel Drive, Suite 608, Windsor, ON N8W 5K8.

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

The Corporation of the City of Windsor, 350 City Hall Square West, Windsor, Ontario N9A 6S1 Attention