Form ID

Publication date

Location of premises

Certificate

Renovations and Retrofit

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Concession Wentworth Medical Inc.
Address of Owner
501 Concession Blvd., Hamilton, ON L9A 1C1
Name of Contractor
Ti On Line Inc.
Address of Contractor
30 International Blvd., Toronto, ON M9W 5P3

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

503 Concession Blvd., Hamilton, ON