Form ID

Publication date

Location of premises

Certificate

Reconstruction of Cooper Road, Madoc, ON

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Township of Madoc
Address of Owner
15651 Hwy 62, P.O. Box 503, R.R. #2, Madoc, ON K0K 2K0
Name of Contractor
Norway Asphalt Limited
Address of Contractor
R.R. #2, Lakefield, ON K0L 2H0
Name of Certifier
Steve Blakey, P. Eng.
Address of Certifier
1620 Wallbridge-Loyalist Road, RR5, Belleville, ON K8N 4Z5

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

Corporation of the Township of Madoc, 15651 Hwy 62, P.O. Box 503, R.R. #2, Madoc, Ontario K0K 2K0