Form ID

Publication date

Location of premises

Certificate

1. Controls Upgrade 2. Boiler Upgrade

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Union of Canada
Address of Owner
325 Dalhousie Street, Ottawa, ON
Name of Contractor
Lar-mex Mechanical Inc.
Address of Contractor
4-5509 Canotek Road, Ottawa, ON
Name of Certifier
Smith and Andersen Consulting Engineering
Address of Certifier
1600 Carling Ave., Suite 530, Ottawa, ON K1Z 1G3

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

Union of Canada, 325 Dalhousie Street, Ottawa, Ontario