Form ID

Publication date

Location of premises

Certificate

Contract No. PW-00-002 Supply and Apply Single Surface Treatment

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Corporation of the Township of Delhi
Address of Owner
PO Box 182, 183 Main Street, Delhi, ON N4B 2W9
Name of Contractor
Miller Paving Limited.
Address of Contractor
Box 4080, Markham Industrial Park P.O. Markham, ON L3R 9R8
Name of Certifier
Christopher D. Baird, C.E.T. Director of Public Works
Address of Certifier
As owner.

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

Mrs. B.M. Cadman, Clerk, The Corporation of the Township of Delhi, Box 182, 183 Main St., Delhi, ON N4B 2W9