Form ID

Publication date

Location of premises

Certificate

Oxford Road 55 - Culvert Replacement, Contract 930200-C-2010

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
County of Oxford
Address of Owner
21 Reeve Street, P.O. Box 1614, Woodstock, ON N4S 7Y3
Name of Contractor
SLR Contracting Group Inc.
Address of Contractor
6260 Westar Drive, Windsor, ON N9J 3W3
Name of Certifier
Dadean Assam, P.Eng.
Address of Certifier
County of Oxford

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

as above