Form ID

Publication date

Location of premises

Certificate

Contract No. 6290-06-02 Replacement of Gracey Drain Culvert

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Corporation of the County of Elgin
Address of Owner
450 Sunset Drive, St. Thomas, ON N5R 5V1
Name of Contractor
VanBree Drainage and Bulldozing Limited
Address of Contractor
R.R. #6, Forest, ON N0N 1J0
Name of Certifier
Meredith Goodwin, Contract Administrator
Address of Certifier
Same as owner

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

Mark G. McDonald, Chief Administrative Officer, County of Elgin, 450 Sunset Drive, St. Thomas, Ontario N5R 5V1
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