Form ID

Publication date

Location of premises

Certificate

2003 Tennis Court Painting

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Corporation of the City of London
Address of Owner
PO Box 5035, London, ON N6A 4L9
Name of Contractor
K&H Asphalt Sealing and Striping Div. of 509502 Ontario Ltd.
Address of Contractor
50 Westbrook Drive RR #3, Komoka, ON N0L 1R0
Name of Certifier
Rick Pedlow
Address of Certifier
PO Box 5035, London, ON N6A 4L9

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

City Clerks Department, c/o Corporation of the City of London