Form ID

Publication date

Location of premises

Certificate

Heating System Replacement/Upgrade - Project # G03004

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Ontario Realty Corporation acting as agent on behalf of Her Majesty the Queen in right of Ontario as represented by the
Address of Owner
Vice-President Project Management Branch, Ontario Realty Cor
Name of Contractor
Quality Contracting
Address of Contractor
2616 Falconbridge Rd., Unit 1, Garson, ON P3L 1K6
Name of Certifier
Leipciger Kaminker Mitelman & Partners
Address of Certifier
2140 Regent St. South, Suite 12A, Sudbury, ON P3E 5S8

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

Chief Executive Officer, Ontario Realty Corporation, 77 Wellesley Street West, 11th Floor, Ferguson Block, Queens Park, Toronto, Ontario M7A 1N3