Form ID

Publication date

Location of premises

Certificate

5th Concession Watermain

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Municipality of Kincardine
Address of Owner
1475 Concession 5, R.R. #5, Kincardine, ON N2Z 2X6
Name of Contractor
Bill & Tom Kempton Construction Limited
Address of Contractor
R.R. #1, Ripley, ON N0G 2R0
Name of Certifier
B.M. Ross and Associates Limited
Address of Certifier
62 North St., Goderich, ON N7A 2T4

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

Municipality of Kincardine, 1475 Concession 5, R.R. #5, Kincardine, ON N2Z 2X6