Form ID

Publication date

Location of premises

Certificate

Lighting Retrofit

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Ontario Realty Corporation acting as agent on behalf of Her Majesty The Queen in right of Ontario as represented by the
Address of Owner
PROFAC Facilities Management Services Inc., 304 The East Mal
Name of Contractor
R.A. Barnes Electrical Contractors Ltd.
Address of Contractor
4070 Dowell Dr., London, ON N6L 1P9

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

The Executive Officer, Ontario Realty Corporation, 11th Flr, Ferguson Block, Queens Park, Toronto, ON M7A 1N3