Form ID

Publication date

Location of premises

Certificate

Interior Renovations

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Beer Store
Address of Owner
5900 Explorer Drive, Mississauga, ON L4W 5L2
Name of Contractor
Walter’s General Contracting Co.
Address of Contractor
PO Box 173, Everett, ON L0M 1J0
Name of Certifier
Coates Boulton Assoc. Inc.
Address of Certifier
155 Rexdale Blvd., Suite 607, Toronto, ON M9W 5E8

Identification of Premises

30 Anne Street, Barrie, Ontario

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

The Beer Store, 5900 Explorer Drive, Mississauga, ON L4W 5L2