Form ID

Publication date

Location of premises

Certificate

Site Servicing of Phase II Evergreen Country Estates, Town of Collingwood County of Simcoe, Contract No. 98250-2

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
1281406 Ontario Ltd. (Belmar Homes)
Address of Owner
460 Phillip Street, Suite 200, Waterloo, ON N2L 5J2
Name of Contractor
Georgian Aggregates & Construction Inc.
Address of Contractor
P.O. Box 340, Collingwood, ON L9Y 3Z7
Name of Certifier
C.C. Tatham & Associates Ltd.
Address of Certifier
115 Hurontario Street, Suite 201, Collingwood, ON L9Y 2L9

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

Owner