Form ID

Publication date

Location of premises

Certificate

Interior Alterations

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
CIMA Canada Inc.
Address of Owner
415 Baseline Road, Bowmanville, ON
Name of Contractor
Braelin General Contracting Ltd.
Address of Contractor
415 Baseline Road, Bowmanville, ON
Name of Certifier
Brad Pitre
Address of Certifier
457 Wilson Drive, RR 2, Baltimore, ON K0K 1C0

Identification of Premises

Con BF Pt Lot 14 Now RP;40R14408 Part 2

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

415 Baseline Road, Bowmanville, ON