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UNCONDTTIONAL AFFIDAVTT, LIEN WAIVER AND RELEASE <br />With reference to constiuction of the Courthouse Squsu-e Project on ihe site at Court & H'igh <br />Strcet~, Salem, Oregon (the "ProJ~"). ~~ ~ for value rxcivod, acknawlaiges that it <br />has bcen paid in full for all labor, sc7vioes, a~uiPmeut and mataials providcd or transpoctcd in <br />conn~ction with the Project through /')??ti~o ~~ 1995, exccpt retainage, if any, and <br />hereby fully and uncondidonally waives and releases any and all right to paycuent, lieus, claims of <br />lien, righis to lien, bond claim rights, or any otha claims or demands for labor, servic~s, <br />«i~P~~, maierials provided or transpocted in oonuection with the Projxt through said date <br />~Pt ~~g~, if any, and excep~ <br />The affiant below does hereby swear and aLtest thai helshe has full authority to sign this document <br />on behalf of the undersigned company and that the undersigned company has paid in full all of its <br />subcontractors, suppliers and cansultants for labor, services, WuiPment, materials provided or <br />tr'ansported in connection with the Project through the daze referenced in paragzaph 1 above. The <br />undersigned affiant and company further ac]mowledge thai Owner and its lenders or financing <br />sou~es are relying on this Uncondifional Affidavit~ Liw Waiva and Release in conne~tion with <br />processing and authorizing funding requests for payment <br />Dated this ~~ day of l 199~. <br />Company: <br />By: <br />Tifle: <br />STATE OF ORE( <br />County of Marion <br />The foregoing instrument was aci~owledged before me this a~ <br />199~, by jif signed on behalf of an entil <br />C~rt name of Company) a <br />corporation) on behaif of the (type of entity).] <br />day of _ p f~ ~ <br />~, oompleie e following: of <br />(insert type of entity, eg <br />~ <br />N Public for Oregon <br />My commission expires: ~, <br />~~~ <br />~ <br />~ <br />~~._1 `.`~~ <br />1ti; ~ `~ "~ n -~!r'I cC , <br />° <br />~ ,~~..~!~~ <br />~ ~ <br />j <br />~~ ~ 1~ <br />ti, <br />`' REt.c~ tiS~Nf <br />yl~::. <br />~'i \ ~ ~ NO ~ <br />~ <br />7}i ' <br />TacY p~ ~> <br />r~~F~~ ~ ,` ,jL~C;;Gr: <br />U ~-: ~ <br />1 <br />" <br />! r <br />~,~i)N <br />j <br />~ <br />. <br />. <br />h~,~ <br />~, ~. ~ <br />G ~~~~ <br />- - CC~_r~;SSii'^; f ~}':fi~~ <br />' ~' <br />~ <br />,j` <br />` <br />- - - - .~:~•- - - ~ <br />~ ~~~~ <br />~. ~ <br />Form E.2 <br />