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CONSTRUCTION, INC. <br />P.O. Box 4109 <br />2747 Pence Loop SE <br />Salem, OR 97302-8109 <br />PENCE/KELLY <br />CONDITIONAL AFFIDAVIT, LIEN WAIVER AND RELEASE <br />`~~ 4lNfIIi <br />~ ~~o~ <br />C ~ <br />i sa <br />~~ I M l1\C\ <br />cca ~ass <br />With reference to construction of the Courtho~se 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 $ 918,366.00 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 July 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 />subconri-actors, 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 />ated this _ 28th day of July 2000 <br />Company: ence/ eil C struction Inc. <br />By: <br />Title: Dave Hays - Project Manager <br />STATE OF OREGON) <br />) ss. <br />County of Marion ) <br />The foregoing instrument was acknowledged before me this 28th day of July , 2000, by Dave <br />Hays : of Pence/Kelly Construction, Inc. a corporation on behalf of the cor oration . <br />OFFICIAL SEAL <br />~,IAYTHE~'I L SPA6~'H <br />~OTARY PUBLfC - ORC-GOtJ <br />COMR~ISSIO~! N0. 3G3013 <br />A4Y C!?t:S~41S: fOhl F`~p)fi~8 .I~LY 14, 2~01 <br />~ _ <br />Notary Public for Oregon <br />My commission expires: July 14, 2001 <br />Form E.1 <br />(503) 399-7223 <br />(503) 585-7477 Fax <br />(503) 224-8681 Porttand <br />"Creating Landmarks of Excellence" <br />