Form ID

Publication date

Location of premises

Certificate

Storm Sewer on Hyde Park Road (10m South of Fitzwilliam Boulevard to 70m South of Fitzwilliam Boulevard).

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Drewlo Holdings Inc.
Address of Owner
R.R. #3, Komoka, ON N0L 1R0.
Name of Contractor
United Contracting (London). Ltd.
Address of Contractor
2074 Dundas Street East, London, Ont. N5V 1R2.
Name of Certifier
Ken W. Hodges, P. Eng.
Address of Certifier
1069 Wellington Road, #214, London, Ont. N6E 2H6.

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

1069 Wellington Road South, Suite 214, London, Ont. N6E 2H6.