Form ID

Publication date

Location of premises

Certificate

Rooftop Shingle Replacement

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Urbandale Corporation
Address of Owner
2193 Arch Street, Ottawa, Ontario K1G 2H5
Name of Contractor
Ernest Provost Renovations Inc.
Address of Contractor
3962 County Road 16, Riceville, ON K0B 1G0
Name of Certifier
Paul Martin, Property Manager
Address of Certifier
323 Steeplechase Dr., Kanata, ON K2M 2N6

Identification of Premises

2 to 55 Tamara Way, Kanata, ON

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

Urbandale Corporation, 2193 Arch Street, Ottawa, Ontario K1G 2H5
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