Form ID

Publication date

Location of premises

Certificate

Interior Finish

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Sobey's Capital Incorporated
Address of Owner
5955 Airport Road, Suite 223, Mississauga, ON L4V 1R9
Name of Contractor
1083202 Ontario Inc. o/a Carpcon Construction
Address of Contractor
5 Keefer Road, St. Catharines, ON L2M 6K4
Name of Certifier
John Tevelthuis - Sobey's Capital Incorporated
Address of Certifier
5955 Airport Road, Suite 223, Mississauga, ON L4V 1R9

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

9 Pine Street, Thorold, Ontario L2V 3Z9