Form ID

Publication date

Location of premises

Certificate

Roof Replacement, Window Replacement for Lambton (North Wing) & Recladding Exterior (EIFS System).

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Ontario Realty Corporation acting as agent on behalf of HER MAJESTY THE QUEEN in right of Ontario as represented by the
Address of Owner
Vice President, Project Management Branch, Ontario Realty Co
Name of Contractor
Ross-Clair Contractors, Division of R.O.M. Contractors.
Address of Contractor
25 Curity Avenue, Unit 4, Toronto, ON M4B 3M2
Name of Certifier
Paul Quiterio Architect.
Address of Certifier
3 Church St., Ste. 600, Toronto, Ont. M5E 1M2.

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

Chief Executive Office, 77 Wellesley St. W., 11th Floor, Ferguson Block, Queens Park, Toronto, Ont. M7A 1N3.