Form ID

Publication date

Location of premises

Certificate

Bentpath East/ Booth Creek Measurement Station - C99 Construction.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Union Gas Limited.
Address of Owner
50 Keil Drive North, Chatham, ON N7M 5M1.
Name of Contractor
Campbell-Cox.
Address of Contractor
61 Arrow Road, P.O. Box 623, Guelph, ON N1H 6L3.
Name of Certifier
Union Gas Ltd. (Scott McLeod).
Address of Certifier
50 Keil Drive North, Chatham, ON N7M 5M1.

Identification of Premises

1813 Marthaville Road.

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

Office of Secretary, Union Gas, 50 Keil Drive North, Chatham, ON N7M 5M1.