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PENCE/KELLY CONSTRUCTiON, tNC. P.O. Box 4109 2747 Pence loop SE Salem, OR 97302-8109 ~~,~ u~~,,,~,e ~ ~t ~ ~~~ ~9'7~3 ' ~f fNEt~~~ ~` (503) 585-7477 Fax (503) 2248681 Po~tland ccs ~5 CONDITIONAL AFFIDAVIT, LIEN WAIVER AND RELEASE With reference to construcrion of the Courthouse Square Project on the site at Court & Higl~ Streets, Salem, Oregon (the "ProjecP'), the undersigned for value received, acknowledges tliat, when a check for $ 1,035,532.00 has been properly endorsed and has been paid by the bank upon which it is drawn, it has b~cn paid in full for all labor, services, equipment and materials provided or transported in connection with the Project through June 30 , 2000, except retainage, if any, and hereby fully and unconditionally waives and releases any and all right to payment, liens, claims of licn, rights to lien, bond claim rights, or any other claims or demands for labor, services, equipment, materials provided or transported in connecrion with the Project through said date except retainage, if any, and except: The affiant below does hereby swear and attest that he/she has full authority to sign this document on behalf of the undersigned company and that the undersigned company will pay in full all of its subcontractors, suppliers and consultants for labor, services, equipment, materials provided or transported in connection with the Project through the date referenced in paragraph 1 above. The undersigned affiant and company further aclrnowledge that Owner and its lenders or financing sources are relying on this Conditional Affidavit, Lien Waiver and Release in connection with processing and authorizing funding requests for payment. Dated this 26th day of June 2000. Company: / Penc ell truction Inc. By: Title: Dave Hays - Project Mana~er STATE OF OREGON) ) ss. County of Marion ) The foregoing instrument was acknowledged before me this 26th day of June , 2000, by Dave Hays : of Pence/Ketly Construction, Inc. a corporation on behalf of the corporation . OFFIClAL SEAL WIATTHEW t SMITH tiOTARY PUBLIC - OREGON No Public for Ore on COMMlSSIOiJ IvO. 3a3013 ~' g hfY C0~!!! ~SION E>:PiRES JULY 14, 200i My commission expires: July 14, 2001 Form E.1 "Creating Landmarks of Exce/lence"