Form ID

Publication date

Location of premises

Certificate

The Georgian Peaks Club, Intake Pipeline

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Georgian Peaks Club
Address of Owner
Box 400, Thornbury, ON N0H 2P0
Name of Contractor
Galcon Marine Ltd.
Address of Contractor
7 Alden Ave., Toronto, ON M8Z 1C4
Name of Certifier
R.J. Burnside & Associates Limited
Address of Certifier
3 Ronell Crescent, Collingwood, ON L9Y 4J6

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

R.J. Burnside & Associates Limited