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```~ GIM(~~~! <br />PENCE/kELLY ` <br />o °s <br />CONSTRUCTION, INC. ! e~~~ <br />P.O. Box 4109 (503) 399-7223 °~ ~~«~~` <br />2747 Pence Loop SE (503) 585-7477 Fax <br />Salem, OR 97302-8109 (503) 224-8681 Po~tiand cca ~ass <br />CONDITIONAL AFFIDAVIT, LIEN WAIVER Al\'D RELEASE <br />With reference to construction of the Courtho~se Square Project on the site at Court & High <br />Streets, Salem, Oregon (the "Project"), tl~e undersigned for value received, acknowledges that. <br />when a check for $ 1,128,351.00 has been properiy endorsed and has been paid by the bank <br />upon which it is drawn, it has been paid in full for all labor, services, equip-nent and materials <br />provided or transpo~ted in comiection with the Project through Au~ust 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 comiection wit~h the Project <br />througli said date except retainage, if any, and except: <br />2. 1~he affiant below does hereby swear and attest that he/she has full authority to sign this dvcument <br />on behalt~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 comlection with the Project flirough the date referenced in paragraph 1 above. "I'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 comlection with <br />processing and authorizing funding requests for payment. <br />Dated tllis 29t1i ~ of Au~ust 2000. <br />Company: P ice/K Il Co s ruction Inc. <br />~~~l~C~~ ~ ~'4S~ti <br />By: <br />S EP ~ ~ 200~ <br />Title: Dave Hays - Project Mana~er <br />r,.: ,. <br />STATE OF OREGON) ~~'~ ~'' ~~ ~~ ~~ ~ <br />) ss. <br />County of Marion ) <br />The foregoing insriument was acknowledged before me this 29th day of Au~ust , 2000, by <br />Dave Hays : of Pence/Kelly Construction, Inc. a corporation on behalf of the corporation . <br />' `.~~y~.T~~ OFFICIAL SEAL <br />MATTHEW L SMlTH ~ <br />NOTARY PUBLIC - OREGO~! <br />COMtiISSION N0. 303013 3 <br />A~Y COf~MISSiQN EXPiRES JULY 14, ~:C~ ' <br /> <br />Notary Public for Oregon <br />My commission expires: July 14, 2001 <br />Forni E.1 <br />"Creating Landmarks of ExcelJence" <br />