Form ID

Publication date

Location of premises

Certificate

Apartment building at #10 Watercress Court

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
1517275 Ontario Limited
Address of Owner
344 Meadowvale Place, Waterloo, ON N2K 3P8
Name of Contractor
same as owner
Address of Contractor
same as owner

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

Attention