Form ID

Publication date

Location of premises

Certificate

Severn Fire Hall #2

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Township of Severn
Address of Owner
1024 Hurlwood Lane, Orillia, ON
Name of Contractor
K. Knight Contracting Ltd.
Address of Contractor
6 Kitchener Street, Orillia, ON L3V 6Z9
Name of Certifier
Gerrits Engineering Limited
Address of Certifier
222 Mapleview Dr. W., Suite 300, Barrie, ON L4N 9E7

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

Owner, address as above