Form ID

Publication date

Location of premises

Certificate

Project #: R40023 Maplehurst Correctional Facility - Asphalt Repairs

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 Co
Name of Contractor
Cloke-Kirby Construction Limited
Address of Contractor
196 Nantucket Blvd., Scarborough, ON M1P 2N9
Name of Certifier
Kearns Mancini Architects Inc.
Address of Certifier
One Atlantic Ave., Suite 104, Toronto, ON M6K 3E7

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

President and Chief Executive Officer, Ontario Realty Corporation, 77 Wellesley Street West, 11th Floor, Ferguson Block, Queens Park, Toronto, ON M7A 2G3