Form ID

Publication date

Location of premises

Certificate

Project No. E-376-98, Hydro Service Relocation.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Corporation of the Town of Kirkland Lake.
Address of Owner
1 Dunfield Road, Postal Bag 1757, Kirkland Lake, ON P2N 3P4.
Name of Contractor
Kohut Electric Limited.
Address of Contractor
Box 1028, Kirkland Lake, ON P2N 3L1.
Name of Certifier
Owner.
Address of Certifier
Same as above.

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

Owner's Address.
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