Form ID

Publication date

Location of premises

Certificate

Roof Replacement - Bluewater Youth Centre

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Her Majesty the Queen in right of Ontario as represted by the Chair of the Management Board of Cabinet
Address of Owner
Project Manager, SNC-Lavalin Profac Inc., 304 The East Mall,
Name of Contractor
Keller Roofing & Sheet Metal Inc.
Address of Contractor
206 Victoria St. W., Exeter, ON N0M 1S2
Name of Certifier
David W. Rock, Project Manager, London PMU
Address of Certifier
900 Highbury Avenue North, London, ON N5Y 1A4

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

The Chief Executive Officer Ontario Realty Corporation, 11th Floor, Ferguson Block, Queens Park, Toronto, ON M7A 1N3