Form ID

Publication date

Location of premises

Certificate

Roof Replacement, MTO Administration MNR Midhurst Project 470127

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Her Majesty the Queen in right of Ontario as represented by the Chair of the Management Board of Cabinet
Address of Owner
Project Manager, PROFAC Facilities Management Services Inc.,
Name of Contractor
Provincial Industrial Roofing and Sheet Metal Co. Ltd.
Address of Contractor
Unit 10 - 176 Creditstone Road, Concord, ON L4K 1P2
Name of Certifier
Douglas A. Nicholls
Address of Certifier
777 Memorial Ave., Orillia, ON L3V 7V3

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

The Chief Executive Officer, Ontario Realty Corporation, 11th Floor, Ferguson Block, Queens Park, Toronto, ON M7A 1N3