Form ID

Publication date

Location of premises

Certificate

C99 Parkway Modifications.

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
Adam Clark Company Ltd.
Address of Contractor
451 Elgin St., Brantford, Ont. N3T 5R7.
Name of Certifier
Union Gas Ltd. (Scott James).
Address of Certifier
50 Keil Drive North, Chatham, ON N7M 5M1.

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.