Form ID

Publication date

Location of premises

Certificate

Stage 1 Area Grading and Municipal Servicing (area grading, underground servicing and roadworks to base course hot mix asphalt and concrete curbing)

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Activa Holdings Inc.
Address of Owner
735 Bridge Street West, Waterloo, ON N2V 2H1
Name of Contractor
Accurex Inc.
Address of Contractor
249 Dalhousie Street, Peterborough, ON K9J 2M3
Name of Certifier
M.J. Davenport & Associates Ltd.
Address of Certifier
169 Lansdowne Street East, Suite 101, Peterborough, ON K9J 7

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

Activa Holdings Inc., 735 Bridge Street West, Waterloo, ON N2V 2H1