Form ID

Publication date

Location of premises

Certificate

Boiler Replacement

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Upper Grand District School Board
Address of Owner
40 Amelia St., Orangeville, ON L9W 3T8
Name of Contractor
Conestogo Mechanical Inc.
Address of Contractor
50 Dumart Place, Kitchener ON N2K 3C7
Name of Certifier
Mr. Joe Bryson, Demaiter Engineering Inc.
Address of Certifier
421 King St. N., Waterloo, ON N2J 4E4

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

Upper Grand Distric School Board