Form ID

Publication date

Location of premises

Certificate

Boiler Replacement

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Upper Grand District School Board
Address of Owner
500 Victoria Rd. N., Guelph, ON N1E 6K2
Name of Contractor
J. Orrell Limited.
Address of Contractor
695 McMurray Road, Unit #1, Waterloo, ON N2V 2B7
Name of Certifier
Mr. Joe Bryson
Address of Certifier
421 King St. N., Waterloo, ON N2J 4E4

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

Upper Grand District School Board