Form ID

Publication date

Location of premises

Certificate

Shoring and Rock Anchors

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
1 King West Inc.
Address of Owner
1 King West, Toronto, ON M5H 1A1
Name of Contractor
Deep Foundations Contractors Inc.
Address of Contractor
29 Ruggles Ave., Thornhill, ON L3T 3S4
Name of Certifier
Peter Kofman P.Eng.
Address of Certifier
284 King St. West, 5th Floor, Toronto, ON M5V 1J2

Identification of Premises

1. Part of Town Lot 2 on the south side of King St. now King Street West, Town of York Plan, designated as Part 1, Plan 63R-4080, City of Toronto (PIN 21407-0006) (”The Firstly Lands”) 2. Parcel 2-17 Section Y-1, being Part of Town Lot 2, Sout

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

1 King West Inc., 284 King St. West, 5th Floor, Toronto, ON M5V 1J2 Mr. Harry Stinson