Form ID

Publication date

Location of premises

Certificate

Roof Replacement

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Great-West Life Assurance Company & London Life Insurance Company c/o GWL Realty Advisors Inc.
Address of Owner
One City Centre Drive, Suite 300, Mississauga, ON L5B 1M2
Name of Contractor
King Koating Roofing Inc.
Address of Contractor
41 Peelar Road, Concord, ON L4K 1A3
Name of Certifier
TSS Building Science Inc.
Address of Certifier
71 Silton Road, Suite 8, Vaughan, ON L4L 7Z8

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

The Great-West Life Assurance Company & London Life Insurance Company c/o GWL Realty Advisors Inc., One City Centre Drive, Suite 300, Mississauga, Ontario L5B 1M2