Form ID

Publication date

Location of premises

Certificate

Supply & Installation of Millwork Partition System.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Corporation of the City of Kingston.
Address of Owner
216 Ontario St., Kingston, Ont.
Name of Contractor
H.R. Doornekamp Construction Ltd.
Address of Contractor
588 Scotland Road, R.R. #1, Odessa, ON K0H 2H0
Name of Certifier
Alexander Wilson Architect Inc.
Address of Certifier
249 Brock St,. Kingston, Ont.

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

Registry Office, 1 Court St., Kingston, Ont.