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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 Portiand <br />,,`o «~,,,,` <br />s e `oa° <br />, ~ <br />~F /M[~~~~ <br />cca ~ass <br />CONDITIONAL AFFIDAVIT, LIEN WANER AND RELEASE <br />With reference to construction of the Courthouse Square Project on the site at Court & High <br />~ ~~ <br />Streets, Salem, Oregon (the 'Project ), the undersigned for value received, acknowledges tliat, <br />when a check for $ 1,343,142.00 has been properly endarsed 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 Apri130 , 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 h-ansported 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. "['he <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 witll <br />processing and authorizing funding requests for payment. <br />Dated this 3rd day of May 2000. <br />Company: enc Kell Construction Inc. <br />By: ~. <br />Title: Dave Hays - Project Mana~er <br />STATE OF OREGON) <br />) ss. <br />Counry of Marion ) <br />The foregoing inshument was acknowledged before me this 3rd day of May , 2000, by Dave <br />Hays : of Pence/Kelly Construction, Inc. a corporation on behalf of the corporation <br />OFFICIAL SEAL <br />AAATTHEW L. SMITH <br />PlOTARY PUBLIC - OREGON <br />COMMISSION N0. 303013 <br />NY COMMISSION EXPIRES JULY 14, 2001 <br /> <br /> <br />~ ~ <br />i~ <br />i <br />Notary' Public for Oregon <br />My commission expires: July 14, 2001 <br />Form E.1 <br />"Creating Landmarks of Excellence" <br />