Form ID

Publication date

Location of premises

Certificate

Construction of the Bell Court Extension and appurtenances

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Stan Ptasznik
Address of Owner
PO Box 248, Stratford, ON N5A 6T1
Name of Contractor
Steve Smith Construction Corporation
Address of Contractor
R.R. #2, Stratford, ON N5A 6S3
Name of Certifier
R.J. Burnside & Associates Limited
Address of Certifier
156 Erie Street, Stratford, ON N5A 2M7

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

Addresses as above