Form ID

Publication date

Location of premises

Certificate

Site Servicing.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Avonmanor Inc.
Address of Owner
Georgian Project Managers Ltd., 160 Trader Blvd. East, Suite
Name of Contractor
Goldmar Contracting Ltd.
Address of Contractor
1116 Midway Blvd, Unit 9, Mississauga, Ont. L5T 2H2.
Name of Certifier
Cosburn Patterson Mather Limited.
Address of Certifier
7270 Woodbine Ave., Suite 300, Markham, ON L3R 4B9.

Identification of Premises

Subdivision of Part of Lot 5, Registered Plan 419.

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

160 Traders Blvd. East, Suite 200, Mississauga, ON L4Z 3K7.