Form ID

Publication date

Location of premises

Certificate

Work roof, soffit, trough replacement & canopy restoration - T2008-134

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Region of Waterloo, Finance Dept.
Address of Owner
150 Frederick St., Kitchener, ON N2G 4J3
Name of Contractor
Jim Daly Contracting Ltd.
Address of Contractor
61 Radford Ave., Cambridge, ON N1R 5L8
Name of Certifier
K. O'Hara
Address of Certifier
235 King St. E., Kitchener, ON N2G 4N5

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

Same as Owner