Form ID

Publication date

Location of premises

Certificate

Addition & Renovation to Guelph KIA

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Dupuis Investments Limited
Address of Owner
P/O 81, Maryhill, ON N0B 2B0
Name of Contractor
Zettel-Fischer Contracting Ltd.
Address of Contractor
P/O 758, Walkerton, ON N0G 2V0

Identification of Premises

Conc 1, DVB, Pt Lot 11, RP61R1164, Part 2 & Part 3

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

Guelph KIA - 1 Malcolm Rd., Guelph, ON N1K 1A7
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