Form ID

Publication date

Location of premises

Certificate

Underground Site Services

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
4173015 Canada Inc.
Address of Owner
c/o RioCan Real Estate Investment Trust, 700 Lawrence Square
Name of Contractor
Blue-Con Inc.
Address of Contractor
1915 Crumlin Sideroad, London, ON N5V 3B8
Name of Certifier
Robin Smith Engineering
Address of Certifier
5365 Line 4 North, Hillsdale, ON L0L 1V0

Identification of Premises

1305 Commissioners Rd. East, London, Ontario: Block 31 - Summerside Subdivision Phase 10A

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

Owner or Payment Certifier