Form ID

Publication date

Location of premises

Certificate

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Kawartha Lakes
Address of Owner
26 Francis Street, Lindsay, ON K9V 5R8
Name of Contractor
Northern Contracting and Maintenance Sault Ltd.
Address of Contractor
123 March Street, Suite 100, Sault Ste Marie, ON P6A 2Z5
Name of Certifier
Juan Rojas, P. Eng. PMP Director of Engineering & Corporate Assets
Address of Certifier
12 Peel Street, PO Box 9000, Lindsay, ON K9V 5R8

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

Town Clerk, 26 Francis Street, Lindsay, Ontario, K9V 5R8