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what’s up... down, in and out? Metro Toronto Convention Centre, North Building | May 28, 2013 9th Annual Conference Insights on Directions, Trends, Issues, Strategies and Opportunities in Land Investment and Development Activity CONFERENCE CHAIRS Paul Golini • John Marotta KEYNOTE SPEAKERS Douglas Porter • George Carras PRESENTERS Remo Agostino • Robert Armstrong • Wayne Barwise • Paul Bedford • Yosi Behar • Bob Blazevski • Gil Blutrich Andrew Brethour • Christopher Broccolo • Michael Brooks • Tom Burns • Scott Cameron • John Campbell • Michael Carragher John Crombie • Lindsay Dale-Harris • Jeffrey Davies • Stephen Deveaux • Lauren Doughty • Michael Emory • Shelley Fenton Mary Flynn-Guglietti • John Fox • Wissam Francis • Andrea Gabor • John Galluzzo • David Gerofsky • Derek Goring • Niall Haggart Hugh Heron • Bruno Iacovetta • John Knechtel • Lisa Lafave • Sheldon Levitt • Antony Lorius • Barry Lyon • Leor Margulies • Finley McEwen Jim McIntosh • Sandy McNair • Andrew McNeill • Jeff Miller • Leith Moore • Gary Morassutti • Mimi Ng • Peter Norman • Jeff Parkes LeeParsons • Noah Rechtsman • Mark Reeve • Michael Rice • Neil Rodgers • Tim Sanderson • Johann Schumacher • Dori Segal Ari Silverberg • Miguel Singer • Craig Smith • Tom Smith • Steven Street • Jim Tadeson • Elliott Taube • John Tory • Lyn Townsend Bryan Tuckey • Alan Vihant • Michael Whelan • Leslie Woo Platinum Sponsors Gold Sponsors
Transcript

what’s up...down, in and out?

Metro Toronto Convention Centre, North Building | May 28, 2013

9th Annual Conference

Insights on Directions, Trends, Issues, Strategies and Opportunities in Land Investment and Development Activity

CONFERENCE CHAIRS Paul Golini • John Marotta KEYNOTE SPEAKERS Douglas Porter • George Carras

PRESENTERS Remo Agostino • Robert Armstrong • Wayne Barwise • Paul Bedford • Yosi Behar • Bob Blazevski • Gil Blutrich Andrew Brethour • Christopher Broccolo • Michael Brooks • Tom Burns • Scott Cameron • John Campbell • Michael Carragher John Crombie • Lindsay Dale-Harris • Jeffrey Davies • Stephen Deveaux • Lauren Doughty • Michael Emory • Shelley Fenton Mary Flynn-Guglietti • John Fox • Wissam Francis • Andrea Gabor • John Galluzzo • David Gerofsky • Derek Goring • Niall Haggart Hugh Heron • Bruno Iacovetta • John Knechtel • Lisa Lafave • Sheldon Levitt • Antony Lorius • Barry Lyon • Leor Margulies • Finley McEwen Jim McIntosh • Sandy McNair • Andrew McNeill • Jeff Miller • Leith Moore • Gary Morassutti • Mimi Ng • Peter Norman • Jeff Parkes LeeParsons • Noah Rechtsman • Mark Reeve • Michael Rice • Neil Rodgers • Tim Sanderson • Johann Schumacher • Dori SegalAri Silverberg • Miguel Singer • Craig Smith • Tom Smith • Steven Street • Jim Tadeson • Elliott Taube • John Tory • Lyn Townsend Bryan Tuckey • Alan Vihant • Michael Whelan • Leslie Woo

Platinum Sponsors Gold Sponsors

what's on the horizon?The 2013 Land & Development conference offers insightful presentations on the Greater Golden Horseshoe development market. The program will include 12-month review of the market and forecast on where land values are going and what developments are on the horizon for 2014 and beyond. What developers and investors are active today, tomorrow and who are they? What are their strategies and how will their behaviour impact the market?

The conference will focus on both residential and commercial development activity. Mixed use developments, low rise residential, and land banking will also be key themes throughout the program. We are very excited to bring forward a program in 2013 that will focus on: financing; large/mega development projects throughout the GGH; construction costs; community/neighbourhood developments; the explosion and implosion of employment, growth, and development nodes in the region; priorities and planning policies; infrastructure and its impact; and ancillary forces that will impact our region and in turn the development community.

The 9th annual Land & Development Conference will provide thought-provoking insights into new trends and development, acquisition and disposition strategies, challenges, opportunities and risks. Join us as we examine where this sector is heading from the perspective of owners, developers, investors, and lenders. With a 2012 attendance of some 600 participants and approximately 60 speakers we strongly believe the 2013 program will address and answer a large array of important and influential questions.

This special event has been organized by Informa Canada, the producers of the Real Estate Forums, in conjunction with a steering committee of developers, owners, lenders, brokers, and their intermediaries.

In keeping with the strong reputation of the Forums, The Land & Development Conference will present high-quality speakers on very topical issues at a relatively low registration fee.

Opportunities for networking and collaboration will also be available throughout the conference.

We sincerely hope you will take advantage of this important event.

John MarottaSenior Vice President, Development Eastern CanadaBentall Kennedy (Canada) LP

Paul GoliniExecutive Vice President &Co-FounderEmpire Communities

who should attend education credits• CEOs, CFOs and other senior executives of real estate companies that are

active in land investment and development • Developers and builders of ICI and residential projects • Public and private equity investors and pension funds active in real estate • Financial institutions and lenders active in land related financing • Real estate brokers specializing in ICI and residential land investment • Lawyers, accountants, appraisers, and other specialists in real estate

transactions, valuation, development, and financing • Municipal, provincial, federal government officials involved in planning, land

development, the environment, transit, infrastructure, real estate, and housing

Attendance at the Land & Development Conference may qualify for:

• Appraisal Institute of Canada• Canadian Association of Accredited Mortgage

Professionals• Certified General Accountants of Ontario• Institute of Chartered Accountants of Ontario• Real Estate Council of Ontario (RECO), REBBA 2002• The Law Society of Upper Canada

Informa Canada Inc. is solely responsible for the content of this program.

7:15 a.m. Registration & Continental Breakfast

8:00 a.m.Opening RemarksConference Co-Chairs

Paul GoliniExecutive Vice President & Co-Founder, Empire Communities

John MarottaSenior Vice President, Development, Eastern Canada, Bentall Kennedy (Canada) LP

8:05 a.m.

Keynote Presentations

Economic Insight: What is the Future of Growth in the Greater Golden Horseshoe?

Douglas PorterChief Economist & Managing Director, Economic Research, BMO Capital Markets

Intensification in Action: Dealing with the Market Realities

George CarrasPresident, RealNet Canada Inc.

9:10 a.m.Infrastructure Concerns & Solutions: How the Movement of People is Shaping Our CityPANEL Antony Lorius, John Tory, Leslie Woo

10:00 a.m. Break—Morning Refreshments

10:25 a.m.ConcurrentSessions A

Shifting Paradigms: In a Highly Condominiumized Market Have We Forgotten About the Single Family Home Builder?

MODERATOR Andrew Brethour PANEL Scott Cameron, Noah Rechtsman, Neil Rodgers, Miguel Singer

Relationship Lending is Back: What You Need to Know About Development Financing

MODERATOR Wissam Francis PANEL Michael Carragher, Bruno Iacovetta, Jeff Parkes, Ari Silverberg

Securing the Foundation: Retrospective on Past Deals and Looking Forward at Land Prices

MODERATOR Mark Reeve PANEL Lauren Doughty, John Galluzzo, Gary Morassutti, Craig Smith

11:30 a.m.ConcurrentSessions B

What Are We Buying Into: The Future of Suburban and Urban Retail Across the Region

MODERATOR John Crombie PANEL Finley McEwen, Michael Rice, Tim Sanderson, Tom Smith

Working the Land: Trends and Opportunities for Urban and Suburban Employment Lands

MODERATOR Jim McIntosh PANEL Christopher Broccolo, Mary Flynn-Guglietti, Jeff Miller, Peter Norman

Unpacking the Condo Market: What Does the Future Hold?

MODERATOR Barry Lyon PANEL Derek Goring, Mimi Ng, Elliott Taube, Alan Vihant

12:30 p.m. Break—Networking Luncheon & Refreshments

1:25 p.m.ConcurrentSessions C

Densification of Cities: Mixed-Use Super Projects are Spurring a New Evolution of Cities

MODERATOR Michael Brooks PANEL Wayne Barwise, John Campbell, David Gerofsky, Johann Schumacher

Unlocking the Potential of Mid-Rise Buildings: Six Storey Wood Frame Challenges and Opportunities

MODERATOR Bryan TuckeyPANEL Paul Bedford, Sheldon Levitt, Leith Moore, Steven Street

Coming Out of the Shadows: A Look Back on Some Highly Contentious Planning Decisions

MODERATOR Leor Margulies PANEL Bob Blazevski, Jeffrey Davies, Stephen Deveaux, Shelley Fenton

2:30 p.m.ConcurrentSessions D

Changing Skylines: What New Office Developments are on the Horizon?

MODERATOR Sandy McNair PANEL Robert Armstrong, Tom Burns, John Knechtel, Lisa Lafave

Drivers of Communities: How Alternative Asset Classes Are Shaping Neighbourhoods

MODERATOR Andrea Gabor PANEL Remo Agostino, Yosi Behar, Gil Blutrich, John Fox

What’s the Plan: Regional Planning Conversation Answering the Major Questions

MODERATOR Lyn Townsend PANEL Lindsay Dale-Harris, Andrew McNeill, Lee Parsons, Michael Whelan

3:30 p.m.Executive Roundtable

Strategic Thinkers: What is in Store for Development Across the Greater Golden Horseshoe Over the Next 12–24 MonthsMODERATORS Paul Golini, John Marotta PANEL Michael Emory, Niall Haggart, Hugh Heron, Dori Segal, Jim Tadeson

4:30 p.m. Networking Reception

program at-a-glance

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FRANZ

ENVIRONMENTAL

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CONSULTING TECHNOLOGIESENGINEERING

MODERATORJim McIntosh Sr. VP, Sales Representative, Colliers International Canada

PANEL Christopher Broccolo Principal, Real Estate, Verus PartnersMary Flynn-Guglietti Partner, McMillan LLPJeff Miller VP, Industrial, Oxford Properties GroupPeter Norman Chief Economist, Research, V&A, Altus Group

Are the policies in place to encourage the appropriate use of employment lands across the GTA? Where is the greatest demand and need for these types of sites? What mechanisms, plans, policies and incentives are in place to facilitate growth? Join this panel as they examine to what degree there is a disconnect between municipal and provincial policies that designate employment lands and what the most feasible development opportunities are for these sites.

Shifting Paradigms: In a Highly Condominiumized Market Have we Forgotten About the Single Family Home Builder?

What are we Buying Into: The Future of Suburban and Urban Retail Across the Region

program informationConcurrent Sessions A | 10:25 a.m.

Keynote Presentations | 8:05 a.m.

Plenary Sessions

Keynote Presentations | 9:10 a.m.

Executive Roundtable | 3:30 p.m.

Concurrent Sessions B | 11:30 a.m.

Strategic Thinkers: What is in Store for Development Across the GGH Over the Next 12–24 Months

MODERATORSPaul Golini Executive VP & Co-Founder, Empire Communities

John Marotta Sr. VP, Development, Bentall Kennedy (Canada) LP

PANEL Michael Emory President & CEO, Allied PropertiesNiall Haggart Executive VP, The Daniels CorporationHugh Heron Principal, The Heron Group of CompaniesDori Segal President & CEO, First Capital Realty Inc.Jim Tadeson Founding Partner, Carttera Private Equities Inc.

A panel of respected senior executives representing a diverse cross-section of development activities and interest will provide their insights and perspective on the most critical issues and market trends for 2013 and beyond. Where does the condominium market go from here? What are the opportunities for more office and industrial developments? How will the increased integration of retail influence mixed-use development? What are you building next and where?

Economic Insight: What is the Future of Growth in the Greater Golden Horseshoe

Douglas Porter Chief Economist & Managing Director, Economic Research, BMO Capital Markets

With special attention to the development market across the region, Douglas will offer his insight on global and domestic issues that are driving the broader economy. Which geo-political and geo-economic trends will impact economic growth for Ontario and the Greater Golden Horseshoe specifically?

AltusGroup

Infrastructure Concerns & Solutions: How the Movement of People is Shaping our City

Antony Lorius Director, DeloitteJohn Tory Chair, Civic Action Alliance, Corp. Director & Broadcaster Leslie Woo VP, Policy, Planning & Innovation, Metrolinx

This presentation will examine the impetus for large scale transportation and infrastructure changes across 416 and 905 corridors. What are some potential forward looking solutions to the infrastructure needs of this region? Join our panel as we examine the main arteries of our region and provide an overview of exactly how people and goods move through and within the Greater Golden Horseshoe.

Intensification in Action: Dealing with the Market Realities

George Carras President, RealNet Canada Inc.

This insightful presentation will provide the key facts and perspectives that you need to know through a detailed examination and critical analysis of the GTA market. What are the emerging trends, key risks and the market’s response in sales, inventories and prices for both the new home and land and investment market?

MODERATORAndrew Brethour President, PMA Brethour Group

PANEL Scott Cameron President, Cameron Stephens Mortgage Capital Ltd.

Noah Rechtsman Associate VP, Cap. Mkts., Cushman & Wakefield Ltd.

Neil Rodgers VP Acquisitions & Land Dev., Tribute Communities Miguel Singer Principal, Madison Properties

Are the traditional subdivisions of detached homes a dying breed or are they just flying under the radar? With the reduction of greenfield sites available for low-rise housing development across the GTA and the impact of the Provincial Places to Grow strategy, what are the challenges facing this sector of the market? Join our panel as we turn the focus away from the condominium market and back to understanding what lies ahead for traditional single family homebuilders.

A1MODERATORJohn Crombie Sr. MD, National Retail Services, Brokerage, Cushman & Wakefield Ltd.

PANEL Finley McEwen Sr. VP, Dev., The Cadillac Fairview Corporation Michael Rice President, Rice Commercial Group Ltd.Tim Sanderson Co-Founder & Principal, Northwest AtlanticTom Smith Sr. VP Dev. & Leasing, Enclosed Malls, SmartCentres

The retail market is undergoing some of the most dramatic pressures of any property class. Innovation and a proactive approach to demographic shifts are opening up new opportunities for creative infill and mixed use projects across the region. Our panel will examine how retail developers are reacting to these trends. From the impact of shopping using e-commerce to the significant growth in inner city populations, the challenges to traditional formats are resulting in real notable changes across this sector.

B1

Relationship Lending is Back: What You Need to Know About Development Financing

MODERATORWissam Francis VP, Ernst & Young Real Estate Services Inc.

PANEL Michael Carragher VP, Mortgage Investments, Firm CapitalBruno Iacovetta MD, Development Finance Group, MCAP Financial Jeff Parkes VP, Commercial Real Estate, HSBC Bank Canada

Ari Silverberg President, Harbour Equity Capital Corp.

How has the financing market changed over the past twelve months for both residential and commercial properties? Have condominium developers overextended themselves with too many projects? Are lenders now approaching high levels of caution and risk assessment as they respond to the concerns of OSFI, the Minister of Finance and the BOC? Our panel will provide insights into pricing, sources, underwriting criteria, and the availability of debt, equity and construction financing.

A2 Working the Land: Trends and Opportunities for Urban and Suburban Employment Lands

B2

Securing the Foundation: Retrospective on Past Deals and Looking Forward at Land Prices

MODERATORMark Reeve Partner, Urban Capital

PANEL Lauren Doughty Sales Associate, CBRE LimitedJohn Galluzzo Partner, The Morassutti GroupGary Morassutti MD, RBC Capital MarketsCraig Smith Founder, President, Ashlar Urban Realty Inc.

Pressure continues to mount on the availability of land and feasible sites for both residential and commercial development purposes. Where is pricing heading across the Greater Toronto Area and where are the best opportunities now? What types of terms are getting the deals done? A panel of industry experts specializing in land sales and valuations will discuss current market conditions across the 416 and 905.

A3 Unpacking the Condo Market: What Does the Future Hold?

MODERATORBarry Lyon Sr. Partner & President N. Barry Lyon Consultants Limited

PANEL Derek Goring VP, Land Development, Infrastructure OntarioMimi Ng VP of Marketing, Menkes Developments Ltd.Elliott Taube VP, Sales & Marketing, International Home MarketingAlan Vihant Sr. VP of Development, Great Gulf Group of Companies

With a new Condominium Act on the horizon, threats to the investor driven model and escalating land prices, this session will examine what is in store for high-rise developments for the remainder of 2013 and beyond. Discussion will also focus on escalating construction costs, development charges, and land costs and what these factors will mean to the condominium market across the GTA.

B3

program informationConcurrent Sessions D | 2:30 p.m.Concurrent Sessions C | 1:25 p.m. thank

youTo all our ParticipatingSponsorsincluding

The 9th Annual Land & Development Conference | Metro Toronto Convention Centre, North Building | May 28, 2013

Densification of Cities: Mixed-Use Super Projects are Spurring a New Evolution of Cities

C1 Changing Skylines: What New Office Developments are on the Horizon?

MODERATORMichael Brooks Partner, Aird and Berlis LLP

PANEL Wayne Barwise Executive VP, Dev., The Cadillac Fairview Corp.John Campbell President & CEO, Waterfront TorontoDavid Gerofsky CEO, First Gulf CorporationJohann Schumacher VP Development, Oxford Properties Group

With an influx of Super Projects on the horizon, this panel will review key developments that could ultimately shape our cities across the GTA. The conversation will examine what will bring these projects to fruition, how will infrastructure be impacted, what challenges to density will occur, and how developers are accommodating completely different uses within the same site. Discussion will also examine financing structures, presale strategies and development thesis.

MODERATORSandy McNair President, Altus InSite

PANEL Robert Armstrong MD, Avison Young Commercial Real EstateTom Burns Executive VP & COO, Allied Properties GroupJohn Knechtel Sr. Director of Leasing, The Cadillac Fairview Corp.Lisa Lafave Sr. Portfolio Manager, HOOPP

New office product has continued to receive support with a number of notable projects recently being launched or about to proceed. How will design guidelines, sustainability and tenant requirements influence these new developments as they move from planning to construction? What impact is the South Core having on the rest Toronto’s financial district and what is driving this tenant demand? The past year witnessed a boom of new construction and 2013 seems to be continuing the trend.

D1

Unlocking the Potential for Mid-Rise Buildings: Six Storey Wood Frame Challenges and Opportunities

MODERATORBryan Tuckey President & CEO, BILD

PANEL Paul Bedford Adjunct Professor, Urban & Regional Planning, University of Toronto & Ryerson UniversitySheldon Levitt Principal, Quadrangle ArchitectsLeith Moore President, Ontario Home Builders' Association, VP, Development, Sorbara Development GroupSteven Street Tech Dir., Ontario Wood WORKS/Can. Wood Council

A new report captures the planning rationale for changing the Ontario Building Code from four to six storey wood frame building. Will it increase the diversity of living choices for new home buyers while facilitating a major step towards achieving planned intensification goals of the provincial Growth Plan and all regional and municipal Official Plans? Is this a potential solution to deliver affordability back into the marketplace?

C2 Drivers of Communities: How Alternative Asset Classes are Shaping Neighbourhoods

MODERATORAndrea Gabor Partner, Urban Strategies Inc.

PANEL Remo Agostino Director of Development, The Daniels Corp.Yosi Behar President & Broker of Record, Behar Realty GroupGil Blutrich Chairman & President, Skyline InvestmentsJohn Fox Barrister & Solicitor, Robins, Appleby & Taub LLP

How do social housing, places of worship, retirement communities, and hospitality and entertainment projects ignite and spur development activity? How do these communities form and grow? What are the planning considerations and demographic requirements that are needed? What legacy are they creating and what are the considerations that need to be acknowledged when undertaking specialty developments?

D2

Coming Out of the Shadows: A Look Back on Some Highly Contentious Planning Decisions

MODERATORLeor Margulies Barrister & Solicitor, Robins, Appleby & Taub LLP

PANEL Bob Blazevski VP, Diamond Corp.Jeffrey Davies Lawyer, Davies Howe Partners LLPStephen Deveaux VP of Land Development, Tribute CommunitiesShelley Fenton President, Reserve Properties

A panel of builders and industry experts will examine some of the most hotly contested GTA developments in the past decade and see how these projects have eventually been integrated into their respective neighbourhoods. What were the obstacles, opportunities, costs and hurdles they needed to satisfy to fulfill their development vision? Using a case study format, this session will take a deep dive into select urban developments.

C3 What’s the Plan: Regional Planning Conversation Answering the Major Questions

MODERATORLyn Townsend Partner, Townsend and Associates

PANEL Lindsay Dale-Harris Partner, Bousfields Inc.Andrew McNeill Manager, Downtown Collaborative, City of MississaugaLee Parsons Founding Partner, Malone Given Parsons LtdMichael Whelan VP, Development, BUILD Toronto Inc.

Join the conversation as our panel of planners and consultants discuss macro level planning issues, questions, concerns, opportunities, risks and rewards that apply to the GTA. What influence will green developments have on planning, city requirements, construction costs and construction quality? How are residential, commercial and employment lands changing and how will that impact city building?

D3

Presented by:

For updates, more information or for full session details, please call 416.512.3807 or visit www.realestateforums.com and select “Land & Development Conference”.

Afternoon Refreshments

Lanyards

Media

Presenter Biographies

Pens JournalsLAND SERVICES GROUP

Principal Association

HA

RBOUR EQUITY

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A P I TA L C O RP

Supporting Associations

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3ways to registerFull RegistrationThe registration fee to attend the conference is:

$497.20 (Up to May 3) or $548.05 (After May 3)

Fee includes 13% HST. All registrations include a light breakfast, morning and afternoon refreshments, reception and luncheon.

Refunds & SubstitutionsRefunds will be provided for cancellations in writing prior to May 21, 2013, with a processing fee of $75. We regret that refunds cannot be offered after that date. However, delegate substitution for the day is permitted.

Discount Hotel RateFor a limited time only, reserve your Land & Development room at the Intercontinental Toronto Centre for a special rate of $209.00 (plus tax). To guarantee this rate, reservations must be made directly with the Intercontinental Toronto Centre by May 2, 2013. Book on-line through the Real Estate Forums website or call 1.800.235.4670 and ask for the Land & Development special rate.

Discount Flight RatePorter Airlines is offering Land & Development attendees a 15% discount for travel between May 25–May 31, 2013, on all fare classes. Book on line at www.flyporter.com or call 1.888.619.6822 and quote promo code: LDC13.

ONLINERegister on-line at www.realestateforums.com. Select "Land & Development Conference" and "Register Now", proceed from there.

BY FAXComplete the registration form below and fax to:416.512.1077

BY MAILComplete the registration form below and send with payment to:

Informa Canada Inc.10 Alcorn Avenue, Suite 100, Toronto, ON M4V 3A9

Need Help?For more information, please call 416.512.3807 or visit www.realestateforums.com and select "Land & Development Conference".

IMPORTANT – CONCURRENT SESSIONSPlease review the concurrent sessions throughout the program and indicate the ones you would like to attend by checking the box below. As space may be limited, seating will be on a "first come, first served" basis.

There will be no sales at the door–ADVANCE SALES ONLY. Payment can be made by cheque or credit card (VISA, MasterCard or AMEX).

Deadline to Register: May 21, 2013

PLEASE PRINT LEGIBLY. Your registration form will not be processed unless completed in full. For additional registrations from the same organization, please photocopy this form. To receive confirmation by email, you must register by May 21, 2013. Do not scan and email credit card information.

PAYMENT INFORMATION

YES! I require a Completion Certificate for RECO Continuing Education Credits–subject to Registrar (REBBA 2002) approval. Please check www.realestateforums.com for updates and completion information. RECO #

Please check the most appropriate description of your organization.

Informa Canada Inc. is solely responsible for the content of this program.

HST #871719241 RT0001 | Informa Canada Inc. will appear on your credit card statement.

Please select payment amount

$497.20 – Up to May 3, 2013($440.00 + $57.20 HST)

$548.05 – After May 3, 2013($485.00 + $63.05 HST)

registration formMetro Toronto Convention Centre, North Building | May 28, 2013

First Name

Surname

Title

Company/Organization

Full Mailing Address

City Province Postal Code

Telephone Fax

Email Address

Real Estate & Property Management

Building Owner / Developer / Investor

Asset Management

Real Estate Broker

Financial Services / Real Estate Financing

Government / Real Estate

Lawyer

Homebuilder

Urban Planner

Consultant

Municipal Economic Development

Government / Residential

Other (specify below)

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11:30 a.m.

1:25 p.m.

2:30 p.m.

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or

or

or

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or

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B1

C1

D1

Cheque enclosed (Please make cheque payable to "Informa Canada Inc.")

VISA MasterCard AMEX Total Payment $

Card Number Expiry Date /

Name as it appears on Credit Card

Signature (must be signed to be valid)

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