Form ID

Publication date

Location of premises

Certificate

17th Hole Renovation & Maintenance Road

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Thornhill Country Club
Address of Owner
7994 Yonge Street, Thornhill, ON L4J 1W3
Name of Contractor
Bruce S. Evans Limited
Address of Contractor
P.O. Box 10039 50 Keith Road, Bracebridge ON P1L 1W6
Name of Certifier
Carrick Design Inc.
Address of Certifier
Suite 302 - 255 Duncan Mill Road, Don Mills, ON M3B 3H9

Identification of Premises

Same as above

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

Same as above