Form ID

Publication date

Location of premises

Certificate

Replace Vav Boxes North Wing

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Legislative Assembly of Ontario
Address of Owner
101 Wellsley St., Queens Park
Name of Contractor
T.B.R. Mechanical
Address of Contractor
34 Seminole Ave., Scarborough, ON M1J 1N1
Name of Certifier
John Edelman
Address of Certifier
2540 Whitney Block, Queens Park, Toronto, ON

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

Room 2540 Whitney Block, Queens Park
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