Form ID

Publication date

Location of premises

Certificate

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
North Perth Public Utility Commission.
Address of Owner
580 Main Street West, Listowel, ON N4W 1A8.
Name of Contractor
H. Kerr Construction Limited.
Address of Contractor
Box 1058, Hwy 4N, Wingham, ON N0G 2W0.
Name of Certifier
J. Stephens P.Eng., Manager North Perth Public Utility Commission.
Address of Certifier
580 Main Street West, Listowel, ON N4W 1A8.

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

North Perth Public Utility Commission, 580 Main Street West, Listowel, ON N4W 1A8.