Form ID

Publication date

Location of premises

Certificate

Install Backflow Prevention Devices, Project # 430449

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Her Majesty The Queen in right of Ontario as represented by the Chair of the Management Board of Cabinet
Address of Owner
Project Manager, CBRE, 18 King St. E., Suite 1100, Toronto,
Name of Contractor
Civil Underground & Excavation Company Limited
Address of Contractor
87 Thornmount Drive, Unit 22, Scarborough, ON M1B 5S5
Name of Certifier
Mat 4Site Engineers Ltd.
Address of Certifier
620 Wilson Ave., Suite 320, Toronto, ON M3K 1Z3

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

The Chief Executive Officer, Ontario Realty Corporation, 1 Dundas St. W., Suite 2000, Ontario M5G 2L5