Form ID

Publication date

Location of premises

Certificate

-Mortar Replacement

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Her Majesty the Queen in right of Ontario as represented by the Chair of the Management Board of Cabinet
Address of Owner
Project Manager, PROFAC Facilities Management Services Inc.,
Name of Contractor
Roof Tile Management
Address of Contractor
2535 Drew Rd., Mississauga, ON L4T 1G1
Name of Certifier
Jonathan Rose
Address of Certifier
One Stone Road West, Guelph, ON N1G 4Y2

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

The Chief Executive Officer, Ontario Realty Corporation, 11th Floor, Ferguson Block, Queens Park, Toronto, ON M7A 1N3