Form ID

Publication date

Location of premises

Certificate

Roofing.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
High Glen Properties.
Address of Owner
Suite 500, 370 King Street West, Toronto, Ont. M5V 1J9
Name of Contractor
Dufferin Roofing Limited.
Address of Contractor
65 Milvan Drive, Weston, ON M9L 1Y8
Name of Certifier
Jacob Hershkovich.
Address of Certifier
Suite 500, 370 King Street West, Toronto, Ont. M5V 1J9

Identification of Premises

White Shield Plaza at

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

High Glen Properties, c/o Graywood Developments Ltd., Suite 500, 370 King Street West, Toronto, Ont. M5V 1J9