Form ID

Publication date

Location of premises

Certificate

Roof Replacement 'A' Wing

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Her Majesty the Queen in right of Ontario as represented by the Chair of the Management Board of Cabinet
Address of Owner
Project Manager, SNC-LAVALIN PROFAC Inc., 304 The East Mall,
Name of Contractor
Keller Roofing & Sheet Metal Inc.
Address of Contractor
260 Victoria Street, West, Exeter, ON N0M 1S2
Name of Certifier
Dave Wills, IRC Building Sciences Group Inc.
Address of Certifier
4474 Blakie Road, Suite 134, London, ON N6L 1G7

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

The Chief Executive Officer, Ontario Realty Corporation, 11th Floor, Ferguson Block, Queen's Park, Toronto, Ontario M7A 1N3