Form ID

Publication date

Location of premises

Certificate

New Store Construction

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Beer Store
Address of Owner
5900 Explorer Drive, Mississauga, ON L4W 5L2
Name of Contractor
Verly Construction Group Inc.
Address of Contractor
1321 Matheson Blvd. East, Mississauga, ON L4W 1R1
Name of Certifier
Amy Chan
Address of Certifier
5900 Explorer Drive, Mississauga, ON L4W 5L2

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

5900 Explorer Drive, Mississauga, Ontario L4W 5L2
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