Form ID

Publication date

Location of premises

Certificate

Contract T03-017 Sanitary Sewer Replacement

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Kitchener
Address of Owner
200 King Street West, Kitchener, ON N2G 4G7
Name of Contractor
Elgin Construction
Address of Contractor
140 Burwell Road St. Thomas, ON N5P 3R8
Name of Certifier
Larry Lynch
Address of Certifier
as owner

Identification of Premises

Kingsway-Fairway Sanitary Easement

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

City Clerks Division, 200 King Street West, 2nd Floor, Kitchener, ON N2G 4G7