Form ID

Publication date

Location of premises

Certificate

Interior Renovations

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
A & P Services
Address of Owner
25 Vickers Rd., Bldg. A, Etobicoke, ON M9B 1C1
Name of Contractor
Apollo General Contracting
Address of Contractor
186 Chatham St. N., Blenheim, ON N0P 1A0
Name of Certifier
Ed Milan
Address of Certifier
same

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

Parcel 10-1 Section M-586 being part of Lot 10, the whole of Lots 11 and 1, Part of Lot 65, Part of Lots 13, Part of Lots 14, 15, 16, 17, 18, 19, 20, 21 and 22 all on Plan M-586