Declaration of Last Supply

Form ID

F7-22539

Publication date

2021-06-09

Certificate

Summit Concrete & Drain Ltd.

A supplier of services or materials to an improvement being made to:

The Lake Club - 330 Sunseeker Ave. Innisfil, ON

declares that:

1. The following services or materials were supplied:

Concrete & Drain Work, Interior Drains & Site Servicing

2. These services or materials were supplied under a contract (or subcontract) with:

The Lake Club Inc., 7300 Keele St. Suite 100, Concord, ON L4K 0E5

dated the

October 15, 2019

3. The last supply of services or materials made by the supplier to the improvement under contract (or subcontract) was made on:

May 25, 2021

4. No further services or materials will be supplied under the contract (or subcontract).

Declared before me at the:

City of

Toronto

on the

25th day of May, 2021

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