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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 />(503)399-7223 <br />(503) 585-7477 Fax <br />(503) 224-8681 Po~tiand <br />```, c~Nr,,,` <br />o e ~~ <br />I ~ tia <br />~F I Mlt\C~ <br />CCB ~63435 <br />CONDITIONAL AFFIDAVIT, LIEN WAIVER AND RELEASE <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 $ 1,766,688.00 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 tl~e Project through March 31 , 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 connection 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 further 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 />Dated this 4th day of April 2000. <br />~RBUCK~.~_ ~:.~~. ,~ <br />Company: Pence/Kelly Construction, Inc. APR Q 4 Z~~Q <br />By: ~E~~~~~~`~=_; <br />Title: Dave Hays - Project Manager <br />STATE OF OREGON) <br />J ss. <br />County of Marion ) <br />The foregoing instrument was acknowledged before me this 4th day of April , 2000, by Dave <br />Hays : of Pence/Kelly Construction, Inc. a corporation on behalf of the corporation . <br />OffICIAI SEAL _ <br />IVf~aT1~HEWi~ L SMITH <br />NOTARY PUE~Ll~ - OREGON Notary Public for Oregon <br />C0~~9MfSSIOtJ N0. 303013 My commission expires: July 14, 2001 <br />k~ CQNEAtiiSSIOy EY,PIRES JULY 14, 2001 <br />Fo~m E.1 <br />"Creating Landmarks of Excellence" <br />