Form ID

Publication date

Location of premises

Certificate

Supply & Install Millwork Kiosk, U/C Fridge, Stand Up Counter & Bar Stools (7)

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Lori Degrace
Address of Owner
589 Old Stouffville Rd., Uxbridge, ON
Name of Contractor
Degrace & Associates Ltd.
Address of Contractor
As above
Name of Certifier
As above
Address of Certifier
As above

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

Olar Limited, 28 Vansco Road, Toronto, ON M8Z 5J4