Form ID

Publication date

Location of premises

Certificate

GMT172 West Welding Shop Tooling Modifications PO#532567

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Cami Automotive Inc.
Address of Owner
300 Ingersoll Street, Ingersoll, ON N5C 4A6
Name of Contractor
Hokuto North America Inc.
Address of Contractor
39 Wendy Crescent, London, ON N5X 3J6

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

300 Ingersoll Street, Ingersoll, ON N5C 4A6