Form ID

Publication date

Location of premises

Certificate

Renovations/Alterations

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Shell Canada
Address of Owner
400 - 4th Ave. S.W., Calgary, AB
Name of Contractor
Laurin and Company
Address of Contractor
11-52 Antares Dr. Nepean, ON K2E 7Z1
Name of Certifier
Mike Papulkas, Shell Canada
Address of Certifier
As owner

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

Shell Canada, 400 - 4th Ave. S.W., Calgary, AB