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<br />PENCE/KELLY <br />CONSTRUCTION, INC. <br />P.O. Box 4109 <br />2747 Pence Loop SE <br />Salem, OR 97302-8109 <br />CONDITIONAL AFFIDAVIT, LIEN WAIVER AND RELEASE <br />`o ct~rr~i <br />~~ ~ <br />o ~ °^ <br />i C ti' <br />~F I Ml~~~~ <br />ccs ~ass <br />With reference to construction of the Courthouse Square Project on the site at Court & High <br />Streets, Salem, Oregon (the "Project"), the undersigned for value received, acknowledges that, <br />when a check for $ 1,472,102.00 has been properly endorsed and has been paid by the bank <br />upon which it is drawn, it has been paid in full for all labor, services, equipment and materials <br />provided or transported in connection with the Project through February 28 , 2000, except <br />retainage, if any, and hereby fully and unconditionally waives and releases any and all right to <br />payment, liens, claims of lien, rights to lien, bond claim rights, or any other claims or demands for <br />labor, services, equipment, materials provided or transported in connecrion with the Project <br />through said date except retainage, if any, and except: <br />The affiant below does hereby swear and attest that he/she has full authority to sign this document <br />on behalf of the undersigned company and that the undersigned company will pay in full all of its <br />subcontractors, suppliers and consultants for labor, services, equipment, materials provided or <br />transported in connection with the Project through the date referenced in paragraph 1 above. The <br />undersigned affiant and company fiuther acknowledge that Owner and its lenders or financing <br />sources are relying on this Conditional Affidavit, Lien Waiver and Release in connection with <br />processing and authorizing funding requests for payment. <br />D~te,~tki~ 25~~f February 2000. <br />Company: <br />By: <br />(503) 399-7223 <br />(503) 585-7477 Fax <br />(503) 224-~681 Portland <br />Inc. <br />Title: Dave Hays - Project Mana~er <br />STATE OF OREGON) <br />) ss. <br />County of Manon ) <br />The foregoing instrument was acknowledged before me this 25`~' day of February , 2000, by <br />Dave Hays : of Pence/Kelly Construction, Inc. a cor oration on behalf of the corporation <br />OFFICIAL SEAL <br />P~ATTli~~ ~ SN7~l7H ` <br />NCITARY Pli~Li~ - QREGON otary Public for Oregon <br />CQMk~ISSf~!v N0. 303013 M commission ex ires: July 14, 2001 <br />AfY r,04~P~ISS!Ot~ EXP3RES JUIY 14, 2001 y p <br />Form E.l <br />"Creating Landmarks of Fxcellence" <br />