Form ID

Publication date

Location of premises

Certificate

Project #: G53101 Chiller Replacement

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Ontario Realty Corporation acting as agent on behalf of Her Majesty the Queen in right of Ontario as represented by the
Address of Owner
Vice-President Project Management Branch, Ontario Realty Cor
Name of Contractor
A. Villeneuve Mechanical Ltd.
Address of Contractor
1880 Paquette Road, Thunder Bay, ON P7B 5E5
Name of Certifier
Profor Engineering Services Ltd.
Address of Certifier
#502-200 S. Syndicate Avenue, Thunder Bay, ON P7E 1C9

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

President and Chief Executive Officer, Ontario Realty Corporation, 77 Wellesley Street West, 11th Floor, Ferguson Block, Queens Park, Toronto, ON M7A 2G3