Form ID

Publication date

Location of premises

Certificate

Shingle Replacement

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
T.S.C.C. 2215
Address of Owner
125-161 Isacc Devins Blvd.
Name of Contractor
Build Max G.C. Inc.
Address of Contractor
1295 Eglington Ave East, #25 Miss.

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

5160 Explorer Dr. #17, Miss. ON.