Form ID

Publication date

Location of premises

Certificate

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Corporation of the City of Owen Sound, Ontario
Address of Owner
808 - 2nd Avenue East, Owen Sound, ON N4K 2H4
Name of Contractor
Harold Sutherland Construction Ltd.
Address of Contractor
323545 East Linton Rd., Kemble, ON N0H 1S0
Name of Certifier
Corporation of the City of Owen Sound, Ontario
Address of Certifier
808 - 2nd Avenue East, Owen Sound, ON N4K 2H4

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

ATTN: City Clerk, Corporation of the City of Owen Sound, 808 - 2nd Avenue East, Owen Sound, ON N4K 2H4