Form ID

Publication date

Location of premises

Certificate

Renovation Building / Fixture

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Loblaws Inc.
Address of Owner
1 President's Choice Circle, Brampton, ON
Name of Contractor
Re-Con Retail Construction INC.
Address of Contractor
1472 Thornton Rd. North, Unit #4, Oshawa, ON L1H 7K4
Name of Certifier
Mike Angus
Address of Certifier
1472 Thornton Rd. North, Unit #4, Oshawa, ON L1H 7K4

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

181 Sandwich St. N9V 1Z9