Form ID

Publication date

Location of premises

Certificate

Asphalt Paving of Parking Lot

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Curtain Club
Address of Owner
400 Newkirk Road, Richmond Hill, ON L4C 3G7
Name of Contractor
I.P.A.C. Paving Limited.
Address of Contractor
9251 Yonge Street, Unit 8, Suite 872, Richmond Hill, ON L4C
Name of Certifier
Anton Kikas Ltd.
Address of Certifier
168 Bridgeland Ave., Toronto, ON M6A 1Z4

Identification of Premises

Block D, Registered Plan 5518, Part Lot 50, Concession 1, E.Y.S.

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

The Curtain Club