Form ID

Publication date

Location of premises

Certificate

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Town of Pelham
Address of Owner
20 Pelham Town Square, PO Box 400, Fonthill, ON L0S 1E0
Name of Contractor
Alfred Beam Excavating Limited
Address of Contractor
1219 Sunset Drive, Fort Erie, ON L2A 5M4
Name of Certifier
Upper Canada Consultants
Address of Certifier
3-30 Hannover Drive, St. Catharines, ON L2W 1A3

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

Town of Pelham, 20 Pelham Town Square, PO Box 400, Fonthill, Ontario L0S 1E0