Form ID

Publication date

Location of premises

Certificate

Clarica Life Insurance Company, partial 5th Floor renovation, commercial offices.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Clarica Life Insurance Company, Karen Tunks.
Address of Owner
5th Floor, 9050 Yonge Street, Richmond Hill, Ont. L4C 9S6.
Name of Contractor
Govan Brown & Associates Limited
Address of Contractor
555 Richmond Street West, Suite 1208, PO Box 105, Toronto, O
Name of Certifier
Rice Brydone Limited
Address of Certifier
553 Richmond Street West, Toronto, ON M5V 1Y6

Identification of Premises

In the Town of Richmond Hill, in the Regional Municipality of York and Province of Ontario being composed of:

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

Clarica Life Insurance Company, Attention