Form ID

Publication date

Location of premises

Certificate

Contract No. OP-05-016 Traffic Control Markings

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Haldimand County
Address of Owner
Kohler Satellite Office, 1084 Regional Road 8, Cayuga, ON N0
Name of Contractor
TPM (ONT) LTD Trillium Pavement Marking
Address of Contractor
2270 Stevenage Drive, Ottawa, ON K1G 3W3
Name of Certifier
Mike King, C.E.T.
Address of Certifier
as owner

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

Corporation of Haldimand County, Clerks Department, 45 Munsee Street, Cayuga, ON N0A 1E0