Laserfiche WebLink
<br />PENCE/KELLY <br />CONSTRUCTION, INC. <br />P.O. Box 4109 <br />2747 Pence Loop SE <br />Salem, OR 97302-8109 <br />``~p GfM(/~~` <br />~ ~ Sa° <br />o~a^ <br />~F /M[t\~~ <br />cca ~ass <br />(503) 399-7223 <br />(503) 585-7477 Fax <br />(503) 224-8681 Portland <br />CONDITIONAL AFFIDAVIT, LIEN WAIVER AND RELEASE <br />With reference to consh-uction of Che Courthouse Square Project on the site at Court & High <br />Streets, Salem, Oregou (the "Projeet"), the undersigned for value received, ackno~vledges that <br />when a check for $ 1,035,532.00 has been properly endorsed and has been paid by the bank <br />upon which it is drawu, it has beeu paid in full for all labor, services, equipment and materials <br />provided or transported in connection with the Project through June 30 , 2000, except <br />retainage, if any, and hereby fully and unconditionally waives and releases any aild 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 flie 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 sigi7 this docunlent <br />on behalf of the u~ldersigned 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 26th day of June 2000. <br />Company: ' Penc lKell struction Inc. <br />By: <br />Title: Dave Hays - Project Mana~er <br />STATE OF OREGON) <br />) ss. <br />County of Marion ) <br />The foregoing instrument was acknowledged before me this 26th day of June , 2000, by Dave <br />Havs : of Pence/Kelly Construction, Inc. a corporation on behalf of the corporation . <br />._..~.._.M..___~....a - -- s <br />~ ~FFiC!AL SEAL <br />'~~;~~ ~,1,0.TYH~1t~ ~. ~SMETH <br />~ tyOTRRY PUB'tIC - OREGON Notary Public for Oregon <br />COPAMlSSIOV t~n. 3a3013 <br />±~'Y (:CJ4n~4~~>SlO~ Ea:!'i~FS JULY 14, 200~ . My commission expires: July 14, 2001 <br />Form ~.1 <br />"Creating Landmarks of Excellence" <br />