Form ID

Publication date

Location of premises

Certificate

Roof Replacement

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Ontario Realty Corporation
Address of Owner
304 The East Mall, Suite 300, Etobicoke, ON M9B 6E2
Name of Contractor
Provincial Industrial Roofing
Address of Contractor
176 Creditstone Road, Unit 10, Concord, ON L4K 1P2
Name of Certifier
Ontario Roof Consultants & Assoc.
Address of Certifier
P.O. Box 22018, St. Thomas, ON N5R 6A1

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

304 The East Mall, Ste. 300, Etobicoke, ON M9B 6E2