Form ID

Publication date

Location of premises

Certificate

LCBO Store Relocation

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Liquor Control Board of Ontario
Address of Owner
55 Lakeshore Blvd., 2nd Floor, Toronto, ON
Name of Contractor
Robert Bice Construction Inc.
Address of Contractor
10657 Lamont Drive, Komoka, ON N0L 1R0
Name of Certifier
Joe Liebregts, LCBO Property Services, London
Address of Certifier
1100 Dearness Dr., London, ON N6E 1N9

Identification of Premises

Plan 35, Lot(s) #25, Township of Pelee, Province of Ontario

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

M. Bowman - Manager, Property Services - 55 Lakeshore Blvd. 2nd Floor, Toronto, ON M5E 1A4