Form ID

Publication date

Location of premises

Certificate

Interior Alterations to CMHA Proj. #: 091404

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Michele Van Beers
Address of Owner
648 Huron St., London, ON N5Y 4J8
Name of Contractor
Mycon Construction
Address of Contractor
1615 North Routledge Park, Unit 9, London, ON N6H 5L6
Name of Certifier
Michele Van Beers
Address of Certifier
648 Huron St., London, ON N5Y 4J8

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

Addresses noted above