Form ID

Publication date

Location of premises

Certificate

Construction of Concrete Sidewalks

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Kingston
Address of Owner
Same as above
Name of Contractor
Sousa Ready Mix
Address of Contractor
1406 McAdoo’s Lane, Glenburnie, ON K0H 1S0
Name of Certifier
Speros Kanellos, P.Eng.
Address of Certifier
216 Ontario St., Kingston, ON K7L 2Z3

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

216 Ontario St., Kingston