Form ID

Publication date

Location of premises

Certificate

Interior Renovation to Payless ShoeSource store # 6990

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Payless ShoeSource Canada Inc.
Address of Owner
191 The West Mall, Suite 1100, Etobicoke, ON M9C 5K8
Name of Contractor
Brofort Inc.
Address of Contractor
2161 Thurston Drive, Ottawa, ON K1G 6C9
Name of Certifier
The Stanchion Group
Address of Certifier
12 Mandalane Drive, Schomberg, ON L0G 1T0

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

Payless ShoeSource Canada Inc., 191 The West Mall, Suite 1100, Etobicoke, Ontario M9C 5K8