Form ID

Publication date

Location of premises

Certificate

New Automotive Dealership and Repair Facility

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Reginald MacDonald Holdings Inc.
Address of Owner
p/o 1030, Owen Sound, ON N4K 6K6
Name of Contractor
ZettelFischer Contracting Ltd.
Address of Contractor
p/o 458 Walkerton, ON N0G 2V0
Name of Certifier
Dawley Engineering
Address of Certifier
RR#1, Hanover, ON N4N 3B8

Identification of Premises

Lot 65, rp jp-535, Owen Sound, Grey County, Highway 21

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

Reginald MacDonald Holdings Inc., p/o 1030, Owen Sound, Ontario N4K 6K6