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UNCONDITTONAL AFFIDAVIT, LIEN WAIVER AND RELEASE <br />t~ 1. With reference to construction of the Courthousc Square Project on the site at Court & ffigh <br />Strceti, Salem, O~gon (the "Projed"), the tmdersiguod for value rooeivod, acknowledges that it <br />has bcen paid in full for all labor~ saviocs, equiPment and maiaials pmvidod or t~anspoctcd in <br />conncction with the Projxt through /'~'p D i~ 199~, excePt t~ainage, if any, and <br />hemby fully and unconditionally waives and releases any and all ri8ht to PaYment, liens, claims of <br />lieu, rights to liea, bond claim riglits, or any otha claims or demands for labor, secvic~s, <br />«iwP~~, mateiials provided or transported in conuection with the Projax through said date <br />~Pt ~~g0. ~ aII}', and except~ <br />The affiant below does hereby swear and atf~t that he/she has full a~ori~, ~~~ ~S docun~ent <br />on bebalf of the undersigned company and that the undersigned company bas paid in full all of its <br />subcontractors, suppliers and consultants for labor, scrvices, equiPm~nt, n~ateiials pmvided or <br />transported in connection with the P~ject through the date re,ferenced in paragraph 1 above. The <br />undersigned affiant and company further aclmowiedge that Owner and its lendecs or financing <br />soui~rs ane relying on this Uncondidonal Affidavit, Lieu Waivcr and Relrase in connection with <br />Processing and authorizing funding requests for payment <br />Dated this ~~ ~y of ~ 199~, <br />Company: <br />By: <br />Title: <br />~-- STATE OF ORE( <br />County of Marion <br />The foregoing insiniment was aci~owledged before me this o~~ day of O(~' <br />199g, by [if sigaed on behalf ogan entity, oomplete e following: of <br />Cmsert name of Company) a (insert type of entity, eg <br />corporation) on behalf of the (type of entity).] <br />~ <br />N Public for Orcgon <br />My commission ex~ires:~ n~~ l~ ~,2CO~. <br />/~~~~ <br />- <br />~ <br />r <br />~ <br />~ <br />~~/`;~'~~ <br />~;~ `~...1~. <br />~\ •`1`>_ - ~-~'~ <br />r1 <br />R <br />r~' <br />~ <br />rti <br />ar <br />, <br />{,~ ~~~...~.:y~ <br />~ .~ , <br />~t: <br />E <br />'v <br />~ <br />Nc'~7a~,Y ~t ~ > ~, Yic:,~.T}i 1~1 <br />~i <br />' <br />,(~ <br />t (,{;f~^~~;`i~jJ- <br />r:=Gl)N :j <br />: <br />r~liJ. ~u% J ~ <br />~'+ <br />~ ~.~i~ <br />~i <br />" <br />_ <br />` <br />r <br />_ <br />L' .^~ <br />Y <br />,~~JiL <br />~ ~"/:N:f1: ~ ~~' <br />i <br />n~7~ <br /> - <br />- ~:~G::•~_ _ . i. ~ <br /> _ <br />Form E.2 <br />