Form ID

Publication date

Location of premises

Certificate

Earth Works.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Country Club Estates (Cambridge) Ltd.
Address of Owner
c/o McCarter Grespan Robson Beynon, 675 Riverbend Drive, Kit
Name of Contractor
Nellis Construction Limited.
Address of Contractor
R.R. #1, Acton, Ontario L7J 2L7.
Name of Certifier
MTE Consultants Inc.
Address of Certifier
650 Riverbend Drive, Kitchener, Ontario N2K 3S2.

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

MTE Consultants Inc.