Form ID

Publication date

Location of premises

Certificate

Asphalt Paving.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Concord Adex Developments Corp.
Address of Owner
23 Spadina Ave., Toronto, ON.
Name of Contractor
Empire Paving Ltd.
Address of Contractor
315 Deerhide Cr., Unit 4, Weston, ON M9M 2Z2.

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

23 Spadina Ave.