Form ID

Publication date

Location of premises

Certificate

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Corporation of the City of Kingston
Address of Owner
216 Ontario Street, Kingston, ON K7L 2Z3
Name of Contractor
Greenwood Paving (Pembroke) Ltd.
Address of Contractor
177 MacKay Street, Pembroke, ON K8A 1C2
Name of Certifier
Anthony Simmons Engineering Services
Address of Certifier
Same as Owner

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

On Property Title, Land Registry Office, 1201 Division St., Kingston, ON K7K 6X4; City Clerk, Corporation of the City of Kingston, 216 Ontario St., Kingston, ON K7L 2Z3