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<br />PENCE/KELLY <br />CONSTRUCTION, INC. <br />P.O. Box 4109 <br />2747 Pence Loop SE <br />Salem, OR 97302-8109 <br />``0 LlN(II/ <br />° ~ `Oi <br />C o <br />~ tia <br />°F ~rtn~~ <br />cce ~ass <br />(503) 399-7223 <br />(503) 585-7477 Fax <br />(503) 224-8681 Portland <br />CONDITIONAL AFFIDAVIT, LIEN WAIVER AND I2ELEASE <br />With reference to construction of the Courthouse Square Project on the site at Court & Higli <br />Streets, Salem, Oregon (the "Project"), the undersigned for value received, acknowledges that, <br />when a check for $ 1,035,532.00 has been properly endorsed and has been paid by the bank <br />upon which it is drawn, it has been paid in full for all labor, services, equipment and materials <br />provided or transported in connecrion with the Project through June 30 , 2000, except <br />retainage, if any, and hereby fully and unconditionally waives and releases any and all right to <br />payment, liens, claims of lien, rights to lien, bond claim rights, or any other claims or demands for <br />labor, services, equipment, materials provided or transported in connecrion with the Project <br />through said date except retainage, if any, and except: <br />2. The affiant below does hereby swear and attest that he/she has full authority to sign this document <br />on behalf of the undersigned company and that the undersigned company will pay in full all of its <br />subcontractors, suppliers and consultants for labor, services, equipment, materials provided or <br />transported in connection with the Project through the date referenced in paragraph 1 above. The <br />undersigned affiant and company further acknowledge that Owner and its lenders or financing <br />sources are relying on this Conditional Affidavit, Lien Waiver and Release in connection with <br />processing and authorizing funding requests for payment. <br />Dated this 26th day of June 2000. <br />Company: ~ Penc /Kel( struction Inc. <br />By: <br />Title: Dave HaVS - Project Mana~er <br />STATE OF OREGON) <br />) ss. <br />County of Marion ) <br />The foregoing instrument was acknowledged befare me this 26th day of June , 2000, by Dave <br />Hays : of Pence/Kelly Construction, Inc. a corporation on behalf of the corporation . <br />'~ ~~ '~ 4~ OFFIC!AL SEAL <br />~ hZATTHEVY L. SMITH <br />1,,St ~yO~~RRY PUBi1C - OREGON Notary Public for Oregon <br />COPAMISSIO~ t~0. 3~3013 <br />h~Y CO`~ .-.F#>31flN EaTI~FS JULY 14, 2d0~ . My commission expires: July 14, 2001 <br />Form E.1 <br />"Creating Landmarks of Excellence" <br />