Form ID

Publication date

Location of premises

Certificate

Management Board Secretariat, Ontario Government Building, Kemptville, Ontario New Flooring Project No.: W50032

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Ontario Realty Corporation
Address of Owner
Manager, Contract Administration, Design Services Branch, On
Name of Contractor
Villa Tile & Marble
Address of Contractor
12 Kimberly Avenue, RR #3, Kemptville, ON K0G 1J0
Name of Certifier
Mr. Victor Hughes
Address of Certifier
Postal Bag 2008, Concession Road, Kemptville, ON K0G 1J0

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

Chief Executive Officer, Ontario Realty Corporation, 77 Wellesley West, 12th Floor, Ferguson Block, Queen's Park, Toronto, ON M7A 1N3