Form ID

Publication date

Location of premises

Certificate

Management Board Secretariat Penrose Building, Kingston, Ontario Roof Replacement Project Number: W20073

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Ontario Realty Corporation acting as agent on behalf of Her Majesty the Queen in right of Ontario as represented by the
Address of Owner
Vice-President Project Management Branch, Ontario Realty Cor
Name of Contractor
Semple-Gooder Roofing Limited
Address of Contractor
1365 Martin Grove Road, Toronto, ON M9W 4X7
Name of Certifier
NORR Limited, Architects & Engineers
Address of Certifier
PO Box 111, 20 Gore Street, Kingston, ON K7L 4V6

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

President and Chief Executive Officer, Ontario Realty Corporation, 77 Wellesley Street West, 11th Floor, Ferguson Block, Queens Park, Toronto, ON M7A 2G3