Form ID

Publication date

Location of premises

Certificate

For the supply and placement of hot mix asphalt and shoulder gravel under Wellington County Project No. - CW2010-19, Part - 9

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Corporation of the County of Wellington
Address of Owner
74 Woolwich Street, Guelph, ON N1H 3T9
Name of Contractor
The Murray Group Limited
Address of Contractor
P.O. Box 40, 83 McGivern Street, Moorefield, ON N0G 2K0
Name of Certifier
Mark Eby, P. Eng., Construction Manager
Address of Certifier
Same as Owner

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

County of Wellington, Clerk's Office, 74 Woolwich Street, Guelph, ON N1H 3T9