Form ID

Publication date

Location of premises

Certificate

Construction of Office Build Out

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
London Life Insurance Company
Address of Owner
Corporate Properties, Dpt. 132, 100 Osborne Street North, Wi
Name of Contractor
S & R Construction Ltd.
Address of Contractor
265 North Front Street, Suite 200, Sarnia, ON N7T 7X1

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

London Life Insurance Company, Corporate Properties, Dpt. 132, 100 Osborne Street North Winnipeg, MB R3C 3A5