Form ID

Publication date

Location of premises

Certificate

Pumphouse modifications, including well and well head modifications new well pump, new M.C.C. process piping modifications and associated mechanical and electrical works

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Township of Wellington North
Address of Owner
7480 Sideroad 7, Kenilworth, Ontario N0G 2E0
Name of Contractor
Wellington Construction Inc.
Address of Contractor
R.R. #1, Palmerston, ON N0G 2P0
Name of Certifier
Frank Vanderloo, P.Eng., B.M. Ross and Associates Limited
Address of Certifier
P.O. Box 1179, 206 Industrial Drive, Mount Forest, Ontario N

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

Township of Wellington North