Form ID

Publication date

Location of premises

Certificate

Contract T02-014, Storm and Sanitary Sewers, Watermain, Curb and Gutter, Sidewalk and Asphalt Pavement

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Kitchener
Address of Owner
200 King Street West, Kitchener, Ont. N2G 4G7.
Name of Contractor
Terracon Underground Ltd.
Address of Contractor
P.O. Box 1561, Papple Road, Brantford, ON N3T 5P9
Name of Certifier
Hans N. Gross, P. Eng.
Address of Certifier
Same as owner

Identification of Premises

Pandora Avenue (King St. to Weber St.)

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

City Clerks Division, 200 King Street West, Kitchener, Ont. N2G 4G7.