Form ID

Publication date

Location of premises

Certificate

Office Alteration, Management Board Secretariat, 720 & 808 Robertson Street, Kenora, Ont. Project No. MBS 85087

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Her Majesty the Queen in right of Ontario as represented by the Ontario Realty Corportion
Address of Owner
Director, Contract Management Branch Ontario Reealty Corpora
Name of Contractor
David Sundmark Construction
Address of Contractor
903 Valley Drive, Kenora, ON P9N 4A9
Name of Certifier
Leo Kornas
Address of Certifier
Suite 102, 810 Robertson St., Kenora, ON P9N 4J5

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

Director of Legal Services Ontario Realty Corporation, Ferguson Block, Queen's Park, Toronto, ON M7A 1N3