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CS_Courthouse Square
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3650553
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1/8/2015 11:09:43 AM
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8/1/2011 12:29:47 PM
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Building
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Courthouse Square
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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 Portland <br />``~o uNr~,,` <br />o e~°t <br />i C ti~ <br />~~ / M ( iVC~ <br />CCB #3435 <br />UNCONDITIONAL 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, aclalowiedges that it <br />has been paid in full for all labor, services, equipment and materials provided ar transported in <br />connection with the Project through June 30 , 2000, except retainage, if any, and hereby <br />fully and uncondirionally waives and releases any and all right to payment, liens, claims of lien, <br />rights to lien, bond claim rights, or any other claims or demands for labor, services, eyuipment_ <br />materials provided or transported ui connectioi7 with the Project through said date except <br />retainage, if any, and except: <br />The affiant below does hereby swear and attest that he/she has full authoriry to sign this docwnent <br />on behalf of the undersigned company and that the undersigned company has paid 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 Unconditional Affidavit, Lien Waiver and Release in connection with <br />processing and authorizing funding requests for payment. <br />ted this 28t~ of July 2000 <br />Company: P ce/Ke C tructio 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 28th day of July , 2000, by Dave <br />Hays : of Pence/Kelly Construction, Inc. a corporation on beha of the cor oration . <br />~ OFFIClAL SEAL ~~ ~ <br />r. <br />;; ~14/~lTTHE+111P L SMiTH Notary Public for Oregon <br />MOTARY PU@L!C - OREGON <br />~. C~FAMISSIQ"1 N0. 303013 My commission expires: July 14, 2001 <br />AiY CC1?lh41S~lOh EXP}RE~ JUL'f 44, 2QQ1 <br />Form E.2 <br />"Creating Landmarks of Excellence" <br />
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