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MRR-02-99 TUE 11~39 AM PENCE KELLY FAX N0, 503 585 7477 P, 07/08 <br />• FINAY. AFRIDAVIT, LIEN WAIVER AND RELEASE <br />Wi~h n.fcrence to consttuction of thc Courthousc Squarc Project on thc sitc al Court & High <br />Strcct~, Salet~ Ore~;on (Ihc "Projcct"), die undersigied for value reccivcd, acknowledgcs tl~at, <br />when a check hhss becn properly endotsed and has been paid by tl~e banlc upon which it is drlwa, it <br />has been paid in fi~ll for all labor, scrvices, equipment and maicrials prorided or tiansportcd in <br />connection wiQ~ tlie Project through , 199_, e~ccept reetainage, if any, and <br />l~ereby h~liy and uncondiaonally w-aivcs and teleases any and all rigtu tn payment, liens, claims of <br />licn, righfs to lien, bond claim rights, or any othcx claims ot demt-~nds for Iabor, scrvices, <br />equipment, matcri~ls provided or ttansported in cotuiection wilh the Pmject duoubh said date <br />except retaina~e, if any, and except: <br />• <br />2. Tl-e afCiant below does hereby swear and a~tcs~ tt~at he/she has full authorily to sign Qus docvment <br />on beh~lf of llic undersigned company and thai the undersigned company bas paid in full all of its <br />subco~itractors, suppliers and wnsultants for Iabor, scrvices, equigment, materials providcd or <br />transported in conne~tion with the Projoci tlvough t~e date referenced ia para~aph 1 abwe. Tt-c <br />uzulersigned atLant aad wmpany fuzther aclrnowledge that Ownet and its lenders or tu~ancing <br />soutces are relying on this Final ~davit, Lien Waiver and Relc;ase in conaeclion with processing <br />and aulhari-r.ing funding requests for payment. <br />3. On condition ltuit final payment in the amaunt of S is received, the <br />widersigncd waives and releases all liens, claims of lien, rigllts to lien, bond claim rights, or any <br />o~hcr claims or dema~ids for payment it may have arising out of or relating ta tl~e Projcct, <br />Company: PencelKelty Construction, Inc <br />By: <br />Tit]c: <br />Datcd diis day of <br />STATE OF OREGOI~ <br />) ss. <br />Counly of Marion ) <br />199 <br />The foreboin~ ins~imerit was ~tcknowlcdgcd bcfore me this day of , <br />199w, by of PcnccJKclty Conytruction, Tne. a Corporalion on behalf of the <br />Cor~~oralion. <br />Notary Public for Orcgon <br />My commission expires: <br />~ <br />LJ <br />