Form ID

Publication date

Location of premises

Certificate

Sunnyside Home entrance door replacement

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Region of Waterloo
Address of Owner
20 Weber St, Kitchener, ON
Name of Contractor
Ball Construction
Address of Contractor
5 Shirley Ave, Kitchener, ON
Name of Certifier
Russell Strathdee, Callidus Engineering
Address of Certifier
1385 North Routledge Park, Unit 9, London, ON

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

Region of Waterloo, 20 Weber Street, Kitchener, ON