Form ID

Publication date

Location of premises

Certificate

Collect & Test Transformer Samples for PCB Testing

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Brantford Power Inc.
Address of Owner
84 Market St., Brantford, ON N3T 5N8
Name of Contractor
K-Line Maintenance & Construction Ltd.
Address of Contractor
50 Passmore Ave. Toronto, ON M1V 4T1

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

84 Market Street Brantford, ON N3T 2Z7