Form ID

Publication date

Location of premises

Certificate

Replacement of roof sections 1101, 1201 and 1203 as per specifications dated February 10, 2010

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Housing Services Inc.
Address of Owner
729 Petrolia Road, Toronto, ON
Name of Contractor
Nortex Roofing Ltd.
Address of Contractor
66 Six Points Road, Etobicoke, ON
Name of Certifier
Fishburn Building Sciences Group Inc.
Address of Certifier
15391 Steeles Avenue, Hornby, ON

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

Address