Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 090368   Estimate Number: 0015 , Final     Spec Year: 1999
Primary JP: 22657(04)   Residency: CIRCUIT ENGR. DISTRICT # 8 (04009)     Contract No: 411231
Date Created: 03/24/2011   Contractor FEI: 480531159     Account No: 432400

Project Number(s): BRO-STIM(228)CO
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD (EW-13): OVER SAND CREEK, 1.0 MILE NORTH AND 1.5 MILES EAST OF SH-11/SH-132 JCT. PROJECT LENGTH = 0.207 MILES.
Primary County: GRANT              
Name of Road: COUNTY ROAD              
Prime Contractor: BEACHNER CONSTRUCTION CO., INC.           Time Charged: 368.00
    P. O. BOX 128           Time Allowed: 381.00
    SAINT PAUL , KS   66771           Percent Time: 96.59 %

  Paid To Date: $511,357.28 Payable This Statement: $0.00

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.                                
BEACHNER CONSTRUCTION CO., 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:    03/24/2011
Contract ID: 090368   Estimate Number: 0015     Contract No: 411231
Residency: CIRCUIT ENGR. DISTRICT # 8 (04009)   Estimate Type: Final     Account No: 432400

Project Number(s): BRO-STIM(228)CO
Primary Job Piece No: 22657(04)
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD (EW-13): OVER SAND CREEK, 1.0 MILE NORTH AND 1.5 MILES EAST OF SH-11/SH-132 JCT. PROJECT LENGTH = 0.207 MILES.
Primary County: GRANT              
Name of Road: COUNTY ROAD              
Prime Contractor: BEACHNER CONSTRUCTION CO., INC.              
    P. O. BOX 128              
    SAINT PAUL , KS   66771              
Surety Company: WESTERN SURETY COMPANY              

Date Let: 04/23/2009 NTP Effective Date: 08/03/2009 Pay Period: 02/16/2011  TO  02/17/2011
Date Awarded: 04/27/2009 Date Work Began: 09/01/2009 Original Contract Time: 150
Date Contract Executed: 05/12/2009 Date Time Stopped: Current Time Charged: 368.00
Date NTP Issued: 05/19/2009 Completion Date: Current Time Allowed: 381.00
General Liability Expires: 03/31/2011 Workman's Comp Expires: 03/31/2011 Percent Time Used: 96.59 %
Specification Year: 1999        

Current Contract Amount: $511,357.28 Total to Date Prev to Date This Estimate
Bid Amount: $521,593.75 Participating: $511,357.28 $511,357.28 $0.00
Percent Complete: 100 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $0.00 Non ARRA: $0.00 $0.00 $0.00
Unearned Balance: $10,236.47 Total Earnings: $511,357.28 $511,357.28 $0.00
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $511,357.28 $511,357.28 $0.00
Other Adjustments: $0.00 $0.00 $0.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $511,357.28 $511,357.28 $0.00

Estimate Adjustment Detail

Contract ID: 090368   Estimate Number: 0015     Primary JP: 22657(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 ced8 stim228 fqco Approved 12/20/2010 0.0 $-10,418.72
002 ced8 redo of Final quantiity change order Approved 02/14/2011 0.0 $182.25


STOCKPILE PAYMENT HISTORY
Project Line Nbr Stockpile Description Adjustment Type Estimate Nbr Adjusted Amount
22657(04) 0017 PC BR ITM FABS (AML) Stockpiled Material Adjustment 0005 $-91,400.29
22657(04) 0017 PC BR ITM FABS (AML) Stockpiled Material Initial Payment 0001 $91,400.29
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
No line item adjustments have been created on this contract.
Subtotals For Line Item Adjustments $0.00


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

Line Item Detail

Contract ID: 090368   Estimate Number: 0015     Primary JP: 22657(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:    BRO-STIM(228)CO Project:    22657(04) Category:    0100/ROADWAY
0001 CLEARING AND GRUBBING 201 0102 LSUM 1.000 1.000   1.000 $5,000.00 $0.00 $5,000.00
0002 EARTHWORK 202(G) 0185 LSUM 1.000 1.000   1.000 $15,000.00 $0.00 $15,000.00
0003 TYPE A-SALVAGED TOPSOIL 205 4229 LSUM 1.000 1.000 0.000 1.000 $6,000.00 $0.00 $6,000.00
0004 TEMPORARY SILT FENCE 223 2801 LF 250.000 375.000   375.000 $0.40 $0.00 $150.00
0005 TEMPORARY SILT DIKE 227 0100 LF 800.000 763.000   763.000 $4.50 $0.00 $3,433.50
0006 SOLID SLAB SODDING 230(A) 2806 SY 6,117.000 6,744.560   6,744.560 $1.75 $0.00 $11,802.98
0007 VEGETATIVE MULCHING 233(A) 2817 AC 1.260 0.000   0.000 $400.00 $0.00 $0.00
0008 TRAFFIC BOUND SURFACE COURSE TYPE E 403(E) 0225 TON 524.000 527.200   527.200 $37.50 $0.00 $19,770.00
0009 CLASS C CONCRETE 509(D) 0325 CY 20.000 0.000   0.000 $200.00 $0.00 $0.00
0010 TYPE A4 CULVERT END TREATMENT 613(CC) 7186 EA 2.000 2.000   2.000 $1,000.00 $0.00 $2,000.00
0011 TYPE B4 CULVERT END TREATMENT 613(CC) 7187 EA 4.000 4.000   4.000 $1,000.00 $0.00 $4,000.00
0012 24" CORR. GALV. STEEL PIPE 613(D) 0690 LF 44.000 44.000   44.000 $23.50 $0.00 $1,034.00
0013 21" X 15" CORR. GALV. STEEL PIPE ARCH 613(D) 4527 LF 38.000 38.000   38.000 $21.50 $0.00 $817.00
0014 28" X 20" CORR. GALV. STEEL PIPE ARCH 613(D) 4528 LF 40.000 40.000   40.000 $27.00 $0.00 $1,080.00
Subtotals For Category     0100/ROADWAY    $0.00 $70,087.48
Fed/State Project Number:    BRO-STIM(228)CO Project:    22657(04) Category:    0200/BRIDGE 'A'
0015 SUBSTRUCTURE EXCAVATION COMMON 501(B) 1307 CY 60.000 60.000   60.000 $20.00 $0.00 $1,200.00
0016 UNCLASSIFIED BACKFILL 501(D) 6353 CY 40.000 40.000   40.000 $50.00 $0.00 $2,000.00
0017 PRESTRESSED CONCRETE DOUBLE TEE 503(B) 6144 LF 554.000 554.000   554.000 $235.00 $0.00 $130,190.00
0018 CONCRETE RAIL (TR1) 504(E) 1380 LF 325.000 325.000   325.000 $60.00 $0.00 $19,500.00
0019 CLASS AA CONCRETE 509(A) 1326 CY 98.000 98.000   98.000 $500.00 $0.00 $49,000.00
0020 CLASS A CONCRETE 509(B) 1328 CY 61.000 61.000   61.000 $500.00 $0.00 $30,500.00
0021 REINFORCING STEEL 511(A) 1332 LB 25,880.000 25,880.000   25,880.000 $0.80 $0.00 $20,704.00
0022 PILES, FURNISHED (HP 10X42) 514(A) 6010 LF 465.000 465.000   465.000 $25.00 $0.00 $11,625.00
0023 PILES, DRIVEN (HP 10X42) 514(B) 6292 LF 465.000 430.920   430.920 $15.00 $0.00 $6,463.80
0024 DRILLED SHAFTS 48" DIAMETER 516(A) 6094 LF 182.000 182.050   182.500 $405.00 $0.00 $73,912.50
0025 TYPE I-A PLAIN RIPRAP 601(A-1)1353 TON 598.000 489.590   489.590 $50.00 $0.00 $24,479.50
0026 TYPE I-A FILTER BLANKET 601(A-2)1355 TON 144.000 121.900   121.900 $50.00 $0.00 $6,095.00
0027 REMOVAL OF EXISTING BRIDGE STRUCTURE 619(D) 1397 LSUM 1.000 1.000   1.000 $3,000.00 $0.00 $3,000.00
0028 GUARD RAIL ANCHOR UNIT (TYPE II) 623(F) 6033 EA 4.000 4.000   4.000 $2,150.00 $0.00 $8,600.00
0029 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $2,500.00 $0.00 $2,500.00
8000 DRILLED SHAFTS 48" DIAMETER 516(A) 6094 LF 0.000 0.450   0.000 $405.00 $0.00 $0.00
Subtotals For Category     0200/BRIDGE 'A'    $0.00 $389,769.80
Fed/State Project Number:    BRO-STIM(228)CO Project:    22657(04) Category:    0600/STAKING
0030 STAKING 642 0098 LSUM 1.000 1.000   1.000 $4,500.00 $0.00 $4,500.00
Subtotals For Category     0600/STAKING    $0.00 $4,500.00
Fed/State Project Number:    BRO-STIM(228)CO Project:    22657(04) Category:    0640/CONSTRUCTION
0031 (SP)SWPPP DOCUMENTATION AND MANAGEMENT 220 2800 LSUM 1.000 1.000   1.000 $3,000.00 $0.00 $3,000.00
0032 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $44,000.00 $0.00 $44,000.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $47,000.00
Subtotals For Project BRO-STIM(228)CO /22657(04) $0.00 $511,357.28


2 CURRENT QUANTITIES DO NOT MATCH THE QUANTITY PAID TO DATE