Form ID

Publication date

Location of premises

Certificate

Project#: G55133 Roof/HVAC System Replacement

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Ontario Realty Corporation acting as agent on behalf of Her Majesty The Queen in Right of Ontario as represented by the
Address of Owner
Vice-President, Project Management Branch, Ontario Realty Co
Name of Contractor
Terra-Deco Enterprises Ltd.
Address of Contractor
212 Duke Street, Dryden, ON P8N 2T7
Name of Certifier
Calnitsky Architect
Address of Certifier
124 Nassau Street North, Winnipeg MB R3L 2H1

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

President and Chief Executive Officer, Ontario Realty Corporation, 77 Wellesley Street West, 11th Floor, Ferguson Block, Queens Park, Toronto, Ontario M7A 2G3
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