Form ID

Publication date

Location of premises

Certificate

Supply & Install New Structure and Associated Concrete Modifications

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Kitchener
Address of Owner
9th Floor, 200 King St. W.
Name of Contractor
935623 Ontario o/a Moorefield Excavating
Address of Contractor
R.R. #1, Palmerston, ON N0G 2P0
Name of Certifier
Muirtec Incorporated
Address of Certifier
312 St. Anne Ave. PO Box 178, St. Agatha, ON N0B 2L0

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

Muirtec Incorporated