Form ID

Publication date

Location of premises

Certificate

Contract 3 - Above Ground and Completion Works

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Fultondale Enterprises Inc.
Address of Owner
4110 Yonge Street, Suite 602, Willowdale, ON M2P 2B7
Name of Contractor
Goldmar Contracting Ltd.
Address of Contractor
1116 Midway Blvd, Unit 9, Mississauga, ON L5T 2H2
Name of Certifier
David Schaeffer Engineering Ltd.
Address of Certifier
610 Alden Road, Suite 201, Markham, ON L3R 9Z1

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

Refer to Owner Noted Above