Form ID

Publication date

Location of premises

Certificate

Office Build Out

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Great-West Life Assurance Company
Address of Owner
Corporate Properties, Dpt. 132, 100 Osborne Street North, Wi
Name of Contractor
Giamberardino Contracting Inc
Address of Contractor
61 Auriga Drive, Nepean, ON K2E 8B2
Name of Certifier
Don Lecyer, Director, Corporate Properties
Address of Certifier
100 Osborne Street North, Winnipeg, MB R3C 3A5

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

The Great-West Life Assurance Company, Corporate Properties, Dpt. 132, 100 Osborne Street North, Winnipeg, MB R3C 3A5