Form ID

Publication date

Location of premises

Certificate

Construction of a 5,200 sq. ft. free-standing retaurant.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Kelsey’s International Inc.
Address of Owner
450 South Service Rd. West, Oakville, ON L6K 2H4
Name of Contractor
Same as owner.
Address of Contractor
Same as owner.
Name of Certifier
Chamberlain Construction Services Limited.
Address of Certifier
935 Sheldon Court, Burlington, ON L7L 5K6.

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

Kelseys International Inc., 450 South Service Rd. West, Oakville, ON L6K 2H4