Form ID

Publication date

Location of premises

Certificate

Parking Lot Reconfiguration

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Costco Wholesale
Address of Owner
999 Lake Drive, Issaquah, Washington, 98027
Name of Contractor
Chandos Construction
Address of Contractor
120-6330 12th St. SE Calgary, AB T2H 2X2
Name of Certifier
MMM Group Limited
Address of Certifier
100 Commerce Valley Drive West, Thornhill, ON L3T 0A4

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

Costco Wholesale, 999 Lake Drive, Issaquah, WA 98027