Form ID

Publication date

Location of premises

Certificate

W12A Landfill - General Site Works.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Corporation of the City of London.
Address of Owner
P.O. Box 5035, 300 Dufferin Ave., London, Ont. N6A 4L9.
Name of Contractor
504802 Ont. Inc. o/a JCJ Contracting.
Address of Contractor
PO Box 371, Virgil, ON L0S 1T0.
Name of Certifier
Earth Tech Canada Inc.
Address of Certifier
285 King St., Ste. 300, London, Ont. N6B 3M6.

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

Corporation of the City of London.