Form ID

Publication date

Location of premises

Certificate

Construction of Office Build Out

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Great-West Life Assurance Company
Address of Owner
Corporate Properties, Dpt. 132, 100 Osborne Street North, Wi
Name of Contractor
Smith Brothers’ Contracting Corp.
Address of Contractor
1354 Sandhill Drive, Ancaster, ON L9G 4V5

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

The Great-West Life Assurance Company, Corporate Properties, Dpt. 132, 100 Osborne Street North Winnipeg, MB R3C 3A5