Form ID

Publication date

Location of premises

Certificate

Site Servicing.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Alpa Holdings Ltd. and 2006235 Ontario Ltd.
Address of Owner
1397 County Road 22, R.R. #3, Belle River, Ont. N0R 1A0 and
Name of Contractor
D'Amore ConstructionLtd.
Address of Contractor
2501 Ouellette Ave., Windsor ON N8X 1L5
Name of Certifier
Dillon Consulting Limited.
Address of Certifier
3200 Deziel Drive, Ste. 608, Windsor, Ont. N8W 5K8.

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

The Corporation of the Town of Lakeshore, Attn