Form ID

Publication date

Location of premises

Certificate

Balcony and wall repairs

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Sun Life Assurance of Canada
Address of Owner
c/o Gateway Property Management, 180 King Street South, Unit
Name of Contractor
Wall Savers Ltd.
Address of Contractor
643 Chrislea Road, Unit 8, Woodbridge, ON L4L 8A3
Name of Certifier
Brown & Beattie Ltd.
Address of Certifier
15-6400 Millcreek Drive, Suite 418, Mississauga, ON L5N 3E7

Identification of Premises

395 Martha Street, Burlington

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

Owner's Address for Service