Form ID

Publication date

Location of premises

Certificate

Installation of new hoist

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 Cor
Name of Contractor
RLP Machine & Steel Fabrication Inc.
Address of Contractor
259 Preston Lane, Timmins, ON P4N 7W7
Name of Certifier
J.L. Richards & Associates Limited
Address of Certifier
37 Preston Street, Timmins, ON P4N 3M7

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

Chief Executive Officer, Ontario Realty Corporation, 77 Wellesley Street West, 11th Floor, Ferguson Block, Queens Park, Toronto, ON M7A 1N3