Form ID

Publication date

Location of premises

Certificate

Site Preparation

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
1367169 Ontario Limited
Address of Owner
1140 Sheppard Ave. West, Unit 12, Toronto, ON M3K 2A2
Name of Contractor
Terra Bay Construction Limited
Address of Contractor
3 Director Court Unit 104, Vaughan, ON L4L 4S5
Name of Certifier
R.G. Robinson and Associates (Barrie) Ltd.
Address of Certifier
10 High Street, Barrie, ON L4N 1W1

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

1367169 Ontario Limited, 1140 Sheppard Ave. West, Unit 12, Toronto, ON M3K 2A2