Form ID

Publication date

Location of premises

Certificate

Renovations and addition

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Carmik Foods Ltd.
Address of Owner
170 Simcoe Street, Tillsonburg, ON N4G 4Z6
Name of Contractor
Grand River Contracting Inc.
Address of Contractor
231 Frederick Street, Kitchener, ON N2H 2M7

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

170 Simcoe Street, Tillsonburg, ON