Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 090123   Estimate Number: 0006 , Final     Spec Year: 1999
Primary JP: 26277(04)   Residency: JACOBS (AKA - CARTER-BURGESS) (01004)     Contract No: 411309
Date Created: 02/22/2011   Contractor FEI: 208746250     Account No: 400100

Project Number(s): IM-STIM(295)3R
Contract Description: RESURFACE (ASPHALT) I-40: BEG. 0.53 MI. W. OF W. END OF ARKANSAS RIVER BRIDGE, EXT. EAST. SH-10: FROM SOUTH RAMP OF I-40, EXTEND NORTH. PROJECT LENGTH = 4.39 MILES.
Primary County: MUSKOGEE              
Name of Road: I-40              
Prime Contractor: GLOVER & ASSOCIATES, INC.           Time Charged: N/A
    2832 N. COUNTRY CLUB           Time Allowed: N/A
    MUSKOGEE , OK   74403           Percent Time: N/A

  Paid To Date: $2,313,558.72 Payable This Statement: $-21,466.69

CONTRACTOR AFFIDAVIT
STATE OF ___________________ )  
  )      
COUNTY OF __________________ )  
The undersigned contractor or duly authorized agent, of lawful age, being first duly sworn, on oath say that this claim is true and correct.
Affiant further states that the work, services or materials as shown by this claim have been completed or supplied in accordance with the plans, specifications, orders, requests and all other terms of the contract. Affiant further states that (s)he is duly authorized agent of the contractor for the purpose of certifying the facts pertaining to the giving of things of value to government personnel in order to procure the contract or obtain payment; that (s)he is fully aware of the facts and circumstances surrounding the making of the contract and has been personally and directly involved in the proceedings leading to the procurement of the contract and the filing of this claim; and, neither the contractor nor anyone subject to the contractor's direction or control has been paid, given or donated or agreed to pay, give or donate to any officer or employee of the State of Oklahoma any money or other thing of value, either directly or
indirectly, in procuring the contract or obtaining payment. The affiant further certifies that all laborers, mechanics, apprentices and trainees employed by him/her or by any subcontractor performing work under the contract on the project have been paid wages at rates not less than those required by the contract provisions, and that the work performed by each such laborer, mechanic, apprentice or trainee conformed to the classifications set forth in the contract or training program provisions applicable to the wage rate paid.
Affiant hereby agrees that Contractor will accept this estimate as full compensation for all money due Contractor by the Department of Transportation, and hereby relinquish all claims, either in contract or in tort, which have arisen or which might arise out of the construction of said project. That to the best of my knowledge and belief, all indebtedness for labor, materials, fuel, equipment, equipment rental, parts, supplies, insurance premiums, and claims for items not specifically mentioned, which are attributable to performance of the work on this project or which were incorporated therein in any manner, have been paid in full, and that there are not now any presently outstanding, unpaid claims for such indebtedness; that my position with the company is such, that if there were any such outstanding claims of the nature specified herein, I would ordinarily be aware of them.
Further affiant sayeth not.                                
GLOVER & ASSOCIATES, INC.                               
 
_________________________________________________
Affiant Signature
 
_________________________________________________
Affiant Printed Name
                          PE Seal
_________________________________________________
Affiant Company Position
Subscribed and sworn to before me this ______ day of ____________, 20____
My Commission Number: ____________ My Commission Expires: ______________
   
_________________________________________________              
_________________________________________________
                    Professional Engineer Signature
              Oklahoma Department of Transportation
Corporate Seal
Notary Seal                  

Oklahoma Department of Transportation
Final Estimate Summary
Created:    02/22/2011
Contract ID: 090123   Estimate Number: 0006     Contract No: 411309
Residency: JACOBS (AKA - CARTER-BURGESS) (01004)   Estimate Type: Final     Account No: 400100

Project Number(s): IM-STIM(295)3R
Primary Job Piece No: 26277(04)
Contract Description: RESURFACE (ASPHALT) I-40: BEG. 0.53 MI. W. OF W. END OF ARKANSAS RIVER BRIDGE, EXT. EAST. SH-10: FROM SOUTH RAMP OF I-40, EXTEND NORTH. PROJECT LENGTH = 4.39 MILES.
Primary County: MUSKOGEE              
Name of Road: I-40              
Prime Contractor: GLOVER & ASSOCIATES, INC.              
    2832 N. COUNTRY CLUB              
    MUSKOGEE , OK   74403              
Surety Company: WESTFIELD INSURANCE COMPANY              

Date Let: 05/14/2009 NTP Effective Date: 10/30/2009 Pay Period: 11/01/2009  TO  02/17/2011
Date Awarded: 05/19/2009 Date Work Began: 08/24/2009 Original Contract Time: N/A
Date Contract Executed: 06/01/2009 Date Time Stopped: 12/31/2009 Current Time Charged: N/A
Date NTP Issued: 06/05/2009 Completion Date: 12/31/2009 Current Time Allowed: N/A
General Liability Expires: 02/01/2011 Workman's Comp Expires: 02/01/2011 Percent Time Used: N/A
Specification Year: 1999 FIXED COMPLETION DATE: 12/31/2009    

Current Contract Amount: $2,338,590.71 Total to Date Prev to Date This Estimate
Bid Amount: $2,484,866.65 Participating: $2,338,590.74 $2,338,655.41 $-64.67
Percent Complete: 98.93 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $25,031.99 Non ARRA: $0.00 $0.00 $0.00
Unearned Balance: $171,307.93 Total Earnings: $2,338,590.74 $2,338,655.41 $-64.67
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $2,338,590.74 $2,338,655.41 $-64.67
Other Adjustments: $-25,032.02 $-3,630.00 $-21,402.02
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $2,313,558.72 $2,335,025.41 $-21,466.69

Estimate Adjustment Detail

Contract ID: 090123   Estimate Number: 0006     Primary JP: 26277(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Change Order for Completion Date Approved 03/18/2010 61.0 $0.00
002 Final Quantity Change Order Approved 11/05/2010 0.0 $-146,275.94


STOCKPILE PAYMENT HISTORY
Project Line Nbr Stockpile Description Adjustment Type Estimate Nbr Adjusted Amount
No material stockpiles have been created for this contract.
Subtotals For Stockpile Payments $0.00


LIQUIDATED DAMAGES HISTORY
Adjustment Description Estimate Nbr Time Units Rate Adjustment Amount
No liquidated damages have been assessed on this contract.


CONTRACT ADJUSTMENTS HISTORY
Adjustment Description Estimate Nbr Adjustment Amount
No general contract adjustments have been created on this contract.
Subtotals For Contract Adjustments $0.00


LINE ITEM ADJUSTMENT HISTORY
Project Item Nbr Line Item Description Adjustment Type Estimate Nbr Adj Quantity Unit Price Adjusted Amount
26277(04) 0004 (SP)ASPHALT CONCRETE TYPE S4(PG 76-28 OK) * SUBSTANDARD ITEM 0006 0.00 $0.00 $-15,565.88
26277(04) 0004 (SP)ASPHALT CONCRETE TYPE S4(PG 76-28 OK) * Asphalt Binder Adjustment 0006 0.00 $0.00 $-0.44
26277(04) 0005 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) * SUBSTANDARD ITEM 0002 0.00 $0.00 $-3,630.00
26277(04) 0005 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) * SUBSTANDARD ITEM 0006 0.00 $0.00 $-5,836.14
26277(04) 0005 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0006 0.18 $2.45 $0.44
Subtotals For Line Item Adjustments $-25,032.02
* = User applied Line Item Adjustments


MILESTONE ADJUSTMENTS
Milestone Number Milestone Description Time Allowed Time Used Rate Total
No milestones exist for this contract.

Line Item Detail

Contract ID: 090123   Estimate Number: 0006     Primary JP: 26277(04)



Line Item Number Item Description Item Number Units Bid Qty Current Quantity Quantity Paid This Est. Quantity Paid To Date Unit Price Amount Paid This Est. Amount Paid To Date
Fed/State Project Number:    IM-STIM(295)3R Project:    26277(04) Category:    0100/ROADWAY
0001 MACHINE GRADING 209 0120 STA 10.000 7.000   7.000 $363.00 $0.00 $2,541.00
0002 TRAFFIC BOUND SURFACE COURSE TYPE E 403(E) 0225 TON 11,250.000 3,318.870 -16.830 3,318.870 $12.00 $-201.96 $39,826.44
0003 TACK COAT 407 0250 GAL 17,600.000 10,612.500   10,612.500 $2.60 $0.00 $27,592.50
0004 (SP)ASPHALT CONCRETE TYPE S4(PG 76-28 OK) 411(S4) 5950 TON 16,900.000 17,133.160 0.000 17,133.160 $69.50 $0.00 $1,190,754.63
0005 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) 411(S4) 5960 TON 16,500.000 15,591.390 0.180 15,591.390 $60.50 $10.89 $943,279.11
0006 RUMBLE STRIP-METHOD AC-CON 413(A) 4861 LF 63,700.000 58,930.000   58,930.000 $0.05 $0.00 $2,946.50
0007 COLD MILLING PAVEMENT 417 5267 SY 18,000.000 22,865.320   22,865.320 $0.80 $0.00 $18,292.26
0008 REMOVAL OF GUARD RAIL 619(B) 4780 LF 1,520.000 1,500.000   1,500.000 $1.58 $0.00 $2,370.00
0009 BEAM GUARD RAIL-W-BEAM-SINGLE 623(A) 0932 LF 500.000 500.000   500.000 $15.75 $0.00 $7,875.00
0010 GUARD RAIL ANCHOR UNIT (TYPE D-BF) 623(F) 5686 EA 8.000 8.000   8.000 $1,286.25 $0.00 $10,290.00
0011 (SP)G.E.T. GUARD RAIL END SECTION 623(H) 8571 EA 12.000 12.000   12.000 $2,152.00 $0.00 $25,824.00
Subtotals For Category     0100/ROADWAY    $-191.07 $2,271,591.44
Fed/State Project Number:    IM-STIM(295)3R Project:    26277(04) Category:    0300/TRAFFIC
0012 TRAFFIC STRIPE(PLASTIC)(4" WIDE) 855(A) 8812 LF 98,800.000 102,566.000   102,566.000 $0.36 $0.00 $36,923.76
0013 TRAFFIC STRIPE(PLASTIC)(6" WIDE) 855(A) 8813 LF 6,800.000 7,932.000   7,932.000 $0.44 $0.00 $3,490.08
0014 TRAFFIC STRIPE(PLASTIC)(8" WIDE) 855(A) 8814 LF 5,100.000 7,030.000   7,030.000 $0.58 $0.00 $4,077.40
0015 TRAFFIC STRIPE(PLASTIC)(24" WIDE) 855(A) 8825 LF 180.000 99.000   99.000 $3.15 $0.00 $311.85
0016 TRAFFIC STRIPE(PLASTIC)(ARROWS) 855(B) 8818 EA 2.000 2.000   2.000 $68.25 $0.00 $136.50
0017 TRAFFIC STRIPE(PLASTIC)(WORDS) 855(B) 8821 EA 1.000 1.000   1.000 $126.00 $0.00 $126.00
0018 TRAFFIC STRIPE(PLASTIC)(SYMBOLS) 855(B) 8824 EA 3.000 3.000   3.000 $236.25 $0.00 $708.75
0019 PAVEMENT MARKING REMOVAL(TRAFFIC STRIPE) 859(A) 8006 LF 10,280.000 13,906.000 790.000 13,906.000 $0.16 $126.40 $2,224.96
0020 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $19,000.00 $0.00 $19,000.00
Subtotals For Category     0300/TRAFFIC    $126.40 $66,999.30
Fed/State Project Number:    IM-STIM(295)3R Project:    26277(04) Category:    0850/Non ARRA Funding
Subtotals For Category     0850/Non ARRA Funding    $0.00 $0.00
Subtotals For Project IM-STIM(295)3R /26277(04) $-64.67 $2,338,590.74