Form ID

Publication date

Location of premises

Certificate

Septic System Replacements, Tender Number 003/2006

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Ontario Realty Corporation
Address of Owner
Del Management Solutions Inc., 310 Highway #7, Green River,
Name of Contractor
G.C. Green Construction
Address of Contractor
349 Pefferlaw Road, Pefferlaw, ON L0E 1N0

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

Del Management Solutions Inc., 310 Highway #7, Green River, R.R. #1, Locust Hill, Ontario L0H 1J0