Form ID

Publication date

Location of premises

Certificate

Roofing Repairs and Window Replacements

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Participation House Brantford
Address of Owner
Box 2048, 10 Bell Lane, Brantford, ON N3T 5W5
Name of Contractor
Dakon Construction Ltd.
Address of Contractor
1-275 Frobisher Drive, Waterloo, ON N2V 2G4
Name of Certifier
WalterFedy
Address of Certifier
675 Queen Street South, Suite 111, Kitchener, ON N2M 1A1

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

Participation House Brantford, Box 2048, 10 Bell Lane, Brantford, ON N3T 5W5