Form ID

Publication date

Location of premises

Certificate

Surface Works including Curb repairs, grading, pavement removal and asphalt paving

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Active Management Inc., Attention: Ms. Kelly Fabello Re: 1526 Upper Ottawa St.
Address of Owner
5510 Mainway, Burlington, ON L7L 6C4
Name of Contractor
Bowes & Associates Ltd.
Address of Contractor
100 Lancing Drive, Unit 5, Hamilton, ON L8W 3L6
Name of Certifier
C.F. Crozier & Associates Inc.
Address of Certifier
110 Pine Street, Collingwood, ON L9Y 2N9

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

C.F. Crozier & Associates Inc.