Form ID

Publication date

Location of premises

Certificate

Renovation and Addition

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Susan Dicks
Address of Owner
760 Dundas St. W.
Name of Contractor
2399080 Ontario Ltd
Address of Contractor
563 Hancock Way, Mississauga, ON L5H 4L5

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

2399080 Ontario Ltd, 563 Hancock Way, Mississauga, ON L5H 4L5