Form ID

Publication date

Location of premises

Certificate

New Building - Balsam Street

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Williams Coffee
Address of Owner
195 King St. W., Suite 301
Name of Contractor
Stahle Construction Inc.
Address of Contractor
77-C Edwin St., Kitchener, ON N2H 4N7

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

Collingwood, Ontario