Form ID

Publication date

Location of premises

Certificate

Construction of a new industrial building.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
1177632 Ont. Ltd.
Address of Owner
115 Applewood Cres., Concord, L4K 3V5
Name of Contractor
Owner - F. Corrente.
Address of Contractor
115 Applewood Cres., Concord, L4K 3V5
Name of Certifier
Owner.
Address of Certifier
554 Millway Ave., Concord, ON L4K 3V5.

Identification of Premises

115 Applewood Cres., Concord, ON L4K 3V5.

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

554 Millway Ave., Concord, ON L4K 3V5.