Form ID

Publication date

Location of premises

Certificate

St. Cyr Drain - Sixteen Mile Road Culvert

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Township of Middlesex Centre
Address of Owner
R.R. #2, 10227 Ilderton Road, Ilderton, ON N0M 2A0
Name of Contractor
VanBree Drainage & Bulldozing Limited
Address of Contractor
R.R. #6, 7074 Nauvoo Road, Forest, ON N0N 1J0
Name of Certifier
M.P. DeVos, P.Eng.
Address of Certifier
155 York St., London, ON N6A 1A8

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

Township of Middlesex Centre, R.R. #2, 10227 Ilderton Road, Ilderton, Ontario N0M 2A0