Form ID

Publication date

Location of premises

Certificate

Contract No.: PW-E-01-031 Hot Mix Paving

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Corporation of the Norfolk County
Address of Owner
183 Main Street, Delhi, ON N4B 2M3
Name of Contractor
Cayuga Materials & Construction Co. Limited
Address of Contractor
R.R. #4, Cayuga, ON N0A 1E0
Name of Certifier
Marvin Fehrman C.E.T.
Address of Certifier
As owner

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

The Corporation of the Norfolk County, 50 Colborne Street South, Simcoe, ON N3Y 4N5