Form ID

Publication date

Location of premises

Certificate

State Farm London OC AFO Consolidation

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
State Farm Mutual Automobile Insurance Company
Address of Owner
112 East Washington Street, DTB-11, Bloomington, IL 61701
Name of Contractor
Flat Iron Building Group Inc.
Address of Contractor
2842 Bloor Street West, Toronto, ON M8X 1B1
Name of Certifier
William M. Rustemeyer
Address of Certifier
112 East Washington Street, DTB-11, Bloomington, IL 61701

Identification of Premises

965 Adelaide Street South, London, Ontario N6E 3T9