Form ID

Publication date

Location of premises

Certificate

Construction of Calvary Pentecostal Church

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Calvary Pentecostal Church
Address of Owner
PO Box 117, Deep River, ON K0J 1P0
Name of Contractor
Owner
Address of Contractor
As above
Name of Certifier
James M. Martin - Architect
Address of Certifier
140 Cooks Lake Drive, Timmins, ON P4N 7C3

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

Church Office at 33019 Highway 17 East, Deep River