Form ID

Publication date

Location of premises

Certificate

Utility Cut Restoration - Asphalt Repairs - City of Windsor Contract 59-05

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Corporation of the City of Windsor
Address of Owner
350 City Hall Square West, Windsor, ON N9A 6S1
Name of Contractor
Jet Paving Company Ltd.
Address of Contractor
6690 Disputed Road, Lasalle, ON N9H 1Y1
Name of Certifier
Michael Palanacki, P. Eng.
Address of Certifier
Same as owner

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

The Corporation of the City of Windsor, Attention
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