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MAR-02-99 TUE 11;38 RM PENCE KELLY FAX N0, 503 585 7477 P, 04/OS <br />• CONnTTTONAL AFFIDAVI?, LIEN WAlYER AND REL~ASE <br />With reference to conslruction of die Courthouye Sauar~ <br />Prniect on the site at ,Court & HiQh Strcets, Sa]cm, Orcgon (Qie <br />"Project"), the undc;rsigned tor value received, acl~owledges lliat~when a check for <br />~ has bcen m rl,~endorsed a~id has been vaid bys.hc bank uoon wllich it is <br />dnwn, it h<u bccn pvd in full for all labor, services, equipment and niateriafs providcd or <br />transported in connectian wilh the 3'ro}ect lhrough ,] 99 , except retaic~age, <br />if any, and hereby fully and uncandidonally waives and releases any and aIl riglit to paymcnt, <br />liens, elain~s of lien, rights to lien, bond claim rights, or any other claims or demancis for labor. <br />sc[vices, ecluipmcnt, matcrials provided or tr~nspotted in conncction with the Project througli s.~id <br />datc cxccpt retainage, if nny, and except: <br />The affiant below docs hercby sw~ar and attest that he/she has tull aathority to sign this docurncnt <br />on bcl~alf of the undersigied company and that the undersi~ed company i~~wil_ 1 oav in full <br />all of its subcontractors, suppliers and consultants for labor, scrvices, equipment, matcriats <br />pmvidcd or tra~~spor[ed 'ui cannection with the Pcojed through the date referenced in pxr,~grapli 1 <br />above. The undersigned affiant and company further aclrnowledbe th~tt Owner and its lei~decs or <br />financing sourcc;s aze relying on dus Conditional Ai~davit, Licn Waiver u~d Release in <br />conncction widi processing ~tnd auth~rizing funding requests for payment. <br />. ;~'e-~}e~s~i~g~e~ <br />wf-~ves~tu-d-~el , ~tl ~sor• <br />~ .~ekil~e P~sjes~: <br />• <br />Dated tlus d~-y of <br />Company; <br />~y: <br />T~c~~: <br />199 <br />Pence/i:etfv Con!,tn,ctien. Inc <br />STATE OF OREGOI~ <br />) ss. <br />County of Marion ) <br />'I1~e foregoin~ inslnunent was aclrnowledged before mc this <br />199~ by <br />day of <br />__._ __~_.--~...~.r~=~ or ~o=~.~.....Ji ~ -r--- -- ---- <br />'- ~type~o€e~jof Pcncc/Kcl1v Constructinn, Inc. ~ <br />Co~porsitiut~ on bch~lCatl,l~e Cornor$tion~ <br />Notary Public for Ore~on <br />My comtnission expires: <br />~ <br />U <br />