Form ID

Publication date

Location of premises

Certificate

Hot Mix Asphalt at Oxford County Landfill Site, Contract 270000-HMA-2006

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Oxford County
Address of Owner
21 Market Square (PO Box 397) Woodstock, ON N4S 7Y3
Name of Contractor
Permanent Paving Limited
Address of Contractor
P.O. Box 24022, Woodstock, ON N4S 8Y4
Name of Certifier
Dadean Assam, P. Eng., Construction Manager, Oxford County
Address of Certifier
21 Market Square (PO Box 397) Woodstock, ON N4S 7Y3

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

as above
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