Form ID

Publication date

Location of premises

Certificate

Interior Renovation

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Great Atlantic & Pacific Company of Canada Limited
Address of Owner
Store Design & Construction Dept., P.O. Box 68, Station
Name of Contractor
Apollo General Contracting
Address of Contractor
186 Chatham Street N., Blenheim, ON
Name of Certifier
Paul Gilroy
Address of Certifier
as above

Identification of Premises

Part of PIN 07182-0384, being Part of Lot 6, Concession 1, SDS and Parts 1 and 4 on 20R-10738 and Part 5 on 20R-9941