Form ID

Publication date

Location of premises

Certificate

Rooftop Unit Replacements

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
Black & McDonald
Address of Contractor
2460 Don Reid Drive, Ottawa, ON K1H 1E1
Name of Certifier
NORR Limited, Architects and Engineers
Address of Certifier
200 Tremblay Rd, Suite 152, Ottawa, ON K1G 3H5

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, Ontario M7A 1N3