Form ID

Publication date

Location of premises

Certificate

Contract No: 106101D Excavation and construction of roadway including sub-base and granular base and culvert replacements

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
County of Grey
Address of Owner
Transportation and Public Safety Department, 595-9th Avenue
Name of Contractor
Harold Sutherland Construction Ltd.
Address of Contractor
RR2, Kemble, ON N0H 1S0
Name of Certifier
Patrick Hoy, P. Eng.
Address of Certifier
Same as owner

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

County of Grey, Transportation and Public Safety Department - address as above