Form ID

Publication date

Location of premises

Certificate

Fire Alarm System Renovations

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
South Bruce Grey Health Centre
Address of Owner
21 McGivern St., Walkerton, ON N0G 2V0
Name of Contractor
Wayne's Electric Ltd.
Address of Contractor
626, 12th Avenue, Hanover, ON N4N 2V6
Name of Certifier
Mr. Kevin Ward, P. Eng., Demaiter Engineering Inc.
Address of Certifier
420 Weber St. N., Unit 1, Waterloo, ONN N2L 4E7

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

South Bruce Grey Health Centre@@B@@