Form ID

Publication date

Location of premises

Certificate

Replacement of Roof Sections 101, 201, 202 and 203 as per Fishburn Specification dated January 2007

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Upper Grand District School Board
Address of Owner
500 Victoria Road North, Guelph, ON
Name of Contractor
BML Roofing Systems Inc.
Address of Contractor
15 Ryan Place, Unit 3, Brantford, ON
Name of Certifier
Fishburn Building Sciences Group Inc.
Address of Certifier
15391 Steeles Avenue, Hornby, ON

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

Address