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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 />UNCONDITIONAL AFFIDAVIT, LIEN WAIVER AND RELEASE <br />``~ LIM(II/ <br />• r <br />o e\~s <br />`. C <br />~ ~a° <br />~~ /Ml~~~~ <br />CCB ~63435 <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, acknowledges that it <br />has been paid in full for all labor, seivices, equipment and materials provided or transported in <br />connection with the Project through Au~ust 31 , 2000, except retainage, if any, and hereby <br />fully and unconditionally waives and releases any and all right to paynleut, liens, ciaims of lieu, <br />rights to lien, bond claim rights, or any other claims or demands for labor, services, equipment, <br />materials provided or transported in connection with the Project through said date except <br />retainage, if any, and except: <br />The af~ant below does hereby swear and attest that he/she has full authority to si~n this document <br />on behalf of the undersigned company and that the undersigned coinpany has paid in full all of its <br />subcontractors, suppliers and consultants for labor, services, equipment, materials provided or <br />transported in connecrion 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 connectioii with <br />processing and authorizing funding requests for payment. <br />Dated this 26th day of September 2000. <br />Company: (` P_T e__nce/ ell~ onstruction, 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 26th day of September , 2000, by <br />Dave Ha.ys : of Pence/Kelly Construction, Inc. a_ corporation on behalf of the corporation . <br />OFFICIAL SEAL <br />MATTHEW L SMITH ~ <br />- NOTARY PUBLIC - OREGON <br />COMEAlSSIOt~ t~0. 303013 Notary Public for Oregon <br />MY COI~MISSIOCd EY,P{RES JULY i4, 200i My commission expires: July 14, 2001 <br />Form ~.2 <br />"Creating Landmarks of Excellence" <br />