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CONDITIONAL AFFIDAVTI', LIEN WAIVER AND RELEASE <br />With reference to construction of the Courthouse Syuare Project on ihe site at Court & IIigh <br />Streets, Salem, Oregon (the "Project"), the undersigned for value received, acknowledges that, <br />whcn a check for S 648,294.00 has been propcrly endorsed and has been paid by the bank <br />upon which it is drawn, it has bcen paid in full for all labor, servias, equipment and maicrials <br />provided or traiLSported in connection with the Project through May 31 , 1999, except <br />refainage, if any, and hereby fiilly and unconditionally waives and releases any and all right to <br />payment, liens, claims of lien, righLs to lieq bond claim rights, or any other clairns or demands for <br />labor, services, equipment, materials provided or transported in conneciion with the Project <br />tluough said daLe except retainage, if any, and except: <br />2. The affiant below does hereby swear and aitest that he/she has fWl authority to sign this document <br />on behalf of the undersigned company and that the undersigned campany will pay in full all of its <br />subcontractors, suppliers and consuliants for tabor, services, equipmeat, materials provided or <br />transported in connection with the Proje~t through the daie referenced in paragraph 1 above. The <br />undersigned affiant and company further acknowledge that Owner and its lenders or financing <br />sources are relying on this Conditional A~davit, Lien Waiver and Release in connection with <br />processing and authorizing funding requests for payment <br />Company: <br />By: <br />Tide: <br />STATE OF OREGOI~ <br />) ss. <br />County of Marion ) <br />The foregoing insmunent was aclmowledged befo <br />Hays : of Pence/Keilv Construction. Ine. a <br />OFFICIAL SEAL <br />MATTHEW L SMITH <br />NOTARY PUBLIC - OREGON <br />COMMISSION N0. 303013 <br />AIY COM!!ISSION EXPIRES JULY 14, 2001 <br />re me this 24" day of Mav , 1999, by Dave <br />coraoration on behalf of the corporation . <br />~ . <br />Notary Public for Oregon <br />My commissiou expires: Julv 14, 2001 <br />Form E. i <br />Dave Havs - Proiect Manager <br />