Form ID

Publication date

Location of premises

Certificate

Interior Fit Out Dental Office

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Drs. Fawzia Husain & Ali Kapasi
Address of Owner
11-50 Townsend Dr Breslau
Name of Contractor
Nith Valley Construction (2008) Ltd.
Address of Contractor
568 Huron Street, New Hamburg, ON N3A 1J9

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

11-50 Townsend Dr Breslau