Form ID

Publication date

Location of premises

Certificate

Site Servicing Works including Bulk Fill, Sewers, Watermains and Paving

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
RioCan Holdings Inc.
Address of Owner
700 Lawrence Avenue West, Suite 365B, Toronto, ON M6A 3B4
Name of Contractor
E.C. King Contracting
Address of Contractor
2125-16th Avenue E., PO Box 457, Owen Sound, ON N4K 5P7
Name of Certifier
Robin Smith Engineering
Address of Certifier
Box 35, Moonstne, ON L0K 1N0

Identification of Premises

Blue Mountain Mall, 55 Mountain Road, Town of Collingwood

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

Office of Owner