Form ID

Publication date

Location of premises

Certificate

Contract No. OP-06-014 Surface Treatment

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Haldimand County
Address of Owner
Kohler Satellite Office, 1162 Regional Road 8, Cayuga, ON N0
Name of Contractor
Norjohn Contracting Limited
Address of Contractor
9101 Brown Road, Niagara Falls, ON L2E 6S5
Name of Certifier
Mike King, C.E.T.
Address of Certifier
as owner

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

Corporation of Haldimand County, Clerks Department, 45 Munsee Street, Cayuga, ON N0A 1E0
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