Form ID

Publication date

Location of premises

Certificate

Roof Replacement

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Bell Canada
Address of Owner
479 Clarence St., London, ON
Name of Contractor
Espanola Roof
Address of Contractor
897 Second Street, Espanola, ON P5E 1A9
Name of Certifier
Brian Beurink, Project Manager
Address of Certifier
Nexacor Realty Mgmt., 479 Clarence St., London, ON

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

Espanola Roof Maintenance & Repair Ltd.