Form ID

Publication date

Location of premises

Certificate

Sidewalk Installation

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Town of Dundas
Address of Owner
60 Main Street, Dundas, ON L9H 2P8
Name of Contractor
Lafarge Construction
Address of Contractor
525 Victoria Ave. N., PO Box 65 LDC#1,Hamilton, ON L8L 7V1
Name of Certifier
Philips Engineering Ltd.
Address of Certifier
3215 North Service Road, Box 220, Burlington, ON L7R 3Y2

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

Owner - Address as above