Form ID

Publication date

Location of premises

Certificate

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Corporation of the City of Kingston
Address of Owner
216 Ontario Street, Kingston, ON K7L 2Z3
Name of Contractor
The Hybrid Construction Group
Address of Contractor
1214 McAdoo's Lane, Glenburnie, ON K0H 1S0
Name of Certifier
Utilities Kingston
Address of Certifier
85 Lappan's Lane, P.O. Box 790, Kingston, ON K7L 4X7

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

City Clerk, Corporation of the City of Kingston, 216 Ontario St, Kingston, Ontario K7L 2Z3