Form ID

Publication date

Location of premises

Certificate

Project #: W20131 - MTO Regional Office Roof Replacement

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Ontario Realty Corporation acting as agent on behalf of Her Majesty the Queen in right of Ontario as represented by the
Address of Owner
Vice-President Project Management Branch, Ontario Realty Cor
Name of Contractor
French Brothers Roofing
Address of Contractor
185 Wellington St., Belleville, ON K8P 3W9
Name of Certifier
Colbourne & Kembel Architects Inc.
Address of Certifier
739 D’Arlington Park Place, Kingston, ON K7M 8M8

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

President and Chief Executive Officer, Ontario Realty Corporation, 77 Wellesley Street West, 11th Floor, Ferguson Block, Queens Park, Toronto, ON M7A 2G3