Form ID

Publication date

Location of premises

Certificate

Building Fit-up

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Clarence, Rockland
Address of Owner
1560 Laurier Street, Rockland, Ontario
Name of Contractor
Michanie Construction Inc.
Address of Contractor
#6-2750 Stevenage Drive, Gloucester, ON K1G 5N2
Name of Certifier
Arden Clemens
Address of Certifier
Clarence Creek, Ontario

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

1560 Laurier Street, Rockland, Ontario