Form ID

Publication date

Location of premises

Certificate

14 Story Condominium

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
James Club Inc.
Address of Owner
as above
Name of Contractor
James Club Inc.
Address of Contractor
1135 Royal York Road
Name of Certifier
Jay Vanmali
Address of Certifier
25 Sable Street, Toronto, M6M 3K8

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

25 Sable St., Toronto, M6M 3K8