Form ID

Publication date

Location of premises

Certificate

to provide all labour, materials, tools, equipment and supervision required to complete: Queenston Terrazzo Floor Rehabilitation

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Niagara Falls Bridge Commission
Address of Owner
14154 Niagara River Parkway, Queenston Heights Niagaraon-the-Lake, ON L0S 1J0
Name of Contractor
Star Tile Centre Ltd.
Address of Contractor
155 HWY No. 20 East, Fonthill, ON L0S 1E0
Name of Certifier
Macdonald Zuberec Ensslen Architects Inc.
Address of Certifier
39 Queen Street, St. Catharines, ON L2R 5G6

Identification of Premises

Niagara Falls Bridge Commission

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

Lewiston Queenston Plaza 14154 Niagara River Parkway (at Hwy 405), Queenston Heights Niagara-on-theLake, Ontario L0S 1J0