Declaration of Last Supply

Form ID

F7-41851

Publication date

2022-11-23

Certificate

Summit Forming Ltd.

A supplier of services or materials to an improvement being made to:

Vendome - 9 Clegg Rd, Markham, ON PH 1 + 2

declares that:

1. The following services or materials were supplied:

Concrete Formwork

2. These services or materials were supplied under a contract (or subcontract) with:

H + W Development Corp

dated the

July 13, 2020

3. The last supply of services or materials made by the supplier to the improvement under contract (or subcontract) was made on:

November 17, 2022

4. No further services or materials will be supplied under the contract (or subcontract).

Declared before me at the:

City of

Toronto

on the

17th day of November, 2022

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