Form ID

Publication date

Location of premises

Certificate

Backflow Preventor Intallation

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Public Works and Government Services Canada.
Address of Owner
457 Richmond Street, London, Ont. N6A 3E3.
Name of Contractor
L.J. Barton Mechanical Inc.
Address of Contractor
1346 Osprey Drive, Ancaster, ON L9G 4V5
Name of Certifier
Ian J. Dunbar BLJC Facility Management.
Address of Certifier
457 Richmond St., 6th Floor, London, Ont. N6A 3E3.

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

BLJC Facillity Management Services, 457 Richmond St., 6th Floor, London, Ont. N6A 3E3.