Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 090370   Estimate Number: 0013 , Final     Spec Year: 1999
Primary JP: 21415(04)   Residency: CIRCUIT ENGR. DISTRICT # 8 (04009)     Contract No: 510058
Date Created: 12/17/2010   Contractor FEI: 730776271     Account No: 432400

Project Number(s): BRF-STIM(230)CO
Contract Description: GRADE, DRAIN, SURFACE, AND BRIDGE COUNTY ROAD(EW-84): OVER TRIBUTARY OF CAMPBELL CREEK, 4.5 MILES WEST OF SH-74F IN CASHION. PROJECT LENGTH = 0.151 MILES.
Primary County: KINGFISHER              
Name of Road: COUNTY ROAD(EW-84)              
Prime Contractor: SEWELL BROS., INC.           Time Charged: 339.00
    1220 E. MAIN           Time Allowed: 362.00
    CORDELL , OK   73632           Percent Time: 93.65 %

  Paid To Date: $565,014.32 Payable This Statement: $3,631.67

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.                                
SEWELL BROS., 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:    12/17/2010
Contract ID: 090370   Estimate Number: 0013     Contract No: 510058
Residency: CIRCUIT ENGR. DISTRICT # 8 (04009)   Estimate Type: Final     Account No: 432400

Project Number(s): BRF-STIM(230)CO
Primary Job Piece No: 21415(04)
Contract Description: GRADE, DRAIN, SURFACE, AND BRIDGE COUNTY ROAD(EW-84): OVER TRIBUTARY OF CAMPBELL CREEK, 4.5 MILES WEST OF SH-74F IN CASHION. PROJECT LENGTH = 0.151 MILES.
Primary County: KINGFISHER              
Name of Road: COUNTY ROAD(EW-84)              
Prime Contractor: SEWELL BROS., INC.              
    1220 E. MAIN              
    CORDELL , OK   73632              
Surety Company: WESTFIELD INSURANCE COMPANY              

Date Let: 04/23/2009 NTP Effective Date: 08/03/2009 Pay Period: 07/01/2010  TO  07/08/2010
Date Awarded: 06/22/2009 Date Work Began: 09/08/2009 Original Contract Time: 150
Date Contract Executed: 06/30/2009 Date Time Stopped: 07/07/2010 Current Time Charged: 339.00
Date NTP Issued: 07/02/2009 Completion Date: 07/07/2010 Current Time Allowed: 362.00
General Liability Expires: 07/01/2011 Workman's Comp Expires: 07/01/2011 Percent Time Used: 93.65 %
Specification Year: 1999        

Current Contract Amount: $564,424.38 Total to Date Prev to Date This Estimate
Bid Amount: $577,319.00 Participating: $564,424.37 $560,847.77 $3,576.60
Percent Complete: 100 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $-589.94 Non ARRA: $0.00 $0.00 $0.00
Unearned Balance: $12,304.68 Total Earnings: $564,424.37 $560,847.77 $3,576.60
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $564,424.37 $560,847.77 $3,576.60
Other Adjustments: $589.95 $534.88 $55.07
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $565,014.32 $561,382.65 $3,631.67

Estimate Adjustment Detail

Contract ID: 090370   Estimate Number: 0013     Primary JP: 21415(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 CED8 Request for 30 additional days Approved 11/04/2009 30.0 $0.00
002 ced08 change in asphalt mix de Approved 06/04/2010 0.0 $0.00
003 CED8 FQCO on 230 Approved 12/06/2010 0.0 $-12,894.62


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
21415(04) 0013 (SP)ASPHALT CONCRETE TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0010 0.00 $0.00 $336.13
21415(04) 0014 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0010 0.00 $0.00 $198.75
21415(04) 0014 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0013 11.93 $4.61 $55.07
Subtotals For Line Item Adjustments $589.95


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

Line Item Detail

Contract ID: 090370   Estimate Number: 0013     Primary JP: 21415(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:    BRF-STIM(230)CO Project:    21415(04) Category:    0100/ROADWAY
0001 CLEARING AND GRUBBING 201 0102 LSUM 1.000 1.000   1.000 $15,000.00 $0.00 $15,000.00
0002 EARTHWORK 202(G) 0185 LSUM 1.000 1.000   1.000 $25,000.00 $0.00 $25,000.00
0003 TYPE A-SALVAGED TOPSOIL 205 4229 LSUM 1.000 1.000   1.000 $3,300.00 $0.00 $3,300.00
0004 TEMPORARY SILT FENCE 223 2801 LF 739.000 529.000   529.000 $1.50 $0.00 $793.50
0005 TEMPORARY SILT DIKE 227 0100 LF 120.000 105.000   105.000 $7.00 $0.00 $735.00
0006 SOLID SLAB SODDING 230(A) 2806 SY 2,726.000 6,486.560 -17.500 6,486.556 $2.00 $-35.00 $12,973.11
0007 VEGETATIVE MULCHING 233(A) 2817 AC 0.570 0.000   0.000 $250.00 $0.00 $0.00
0008 (SP)FLY ASH 327(A) 4200 TON 79.000 68.690   68.690 $60.00 $0.00 $4,121.40
0009 (SP)CEMENTITIOUS STABILIZED SUBGRADE 327(E) 4240 SY 1,622.000 1,754.530 -13.470 1,754.530 $2.50 $-33.68 $4,386.32
0010 TRAFFIC BOUND SURFACE COURSE TYPE E 403(E) 0225 TON 20.000 0.000   0.000 $50.00 $0.00 $0.00
0011 TACK COAT 407 0250 GAL 99.000 25.000   25.000 $4.00 $0.00 $100.00
0012 PRIME COAT 408 5774 GAL 303.000 0.000   0.000 $5.00 $0.00 $0.00
0013 (SP)ASPHALT CONCRETE TYPE S3(PG 64-22 OK) 411(S3) 5945 TON 442.000 428.520   428.520 $81.50 $0.00 $34,924.38
0014 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) 411(S4) 5960 TON 225.000 233.650 11.930 233.650 $96.00 $1,145.28 $22,430.40
0015 CLASS C CONCRETE 509(D) 0325 CY 10.000 0.000   0.000 $300.00 $0.00 $0.00
0016 REMOVAL OF ASPHALT PAVEMENT 619(B) 4728 SY 1,628.000 1,739.490   1,739.490 $3.00 $0.00 $5,218.47
0017 SAWING PAVEMENT 619(C) 0924 LF 44.000 44.000   44.000 $5.00 $0.00 $220.00
0018 TRAFFIC STRIPE(PAINT)(4" WIDE) 854(A) 8800 LF 1,600.000 1,596.000   1,596.000 $0.42 $0.00 $670.32
Subtotals For Category     0100/ROADWAY    $1,076.60 $129,872.90
Fed/State Project Number:    BRF-STIM(230)CO Project:    21415(04) Category:    0200/BRIDGE 'A'
0019 SUBSTRUCTURE EXCAVATION COMMON 501(B) 1307 CY 68.000 68.000   68.000 $10.00 $0.00 $680.00
0020 UNCLASSIFIED BACKFILL 501(D) 6353 CY 50.000 50.000   50.000 $10.00 $0.00 $500.00
0021 PRESTRESSED CONCRETE DOUBLE TEE 503(B) 6144 LF 817.500 817.500   817.500 $162.00 $0.00 $132,435.00
0022 CONCRETE RAIL (TR1) 504(E) 1380 LF 387.000 387.000   387.000 $45.00 $0.00 $17,415.00
0023 CLASS AA CONCRETE 509(A) 1326 CY 112.000 112.000   112.000 $500.00 $0.00 $56,000.00
0024 CLASS A CONCRETE 509(B) 1328 CY 71.200 71.200   71.200 $550.00 $0.00 $39,160.00
0025 REINFORCING STEEL 511(A) 1332 LB 30,630.000 30,630.000   30,630.000 $0.70 $0.00 $21,441.00
0026 PILES, FURNISHED (HP 10X42) 514(A) 6010 LF 260.000 260.000   260.000 $25.00 $0.00 $6,500.00
0027 PILES, DRIVEN (HP 10X42) 514(B) 6292 LF 260.000 217.530   217.530 $15.00 $0.00 $3,262.95
0028 DRILLED SHAFTS 48" DIAMETER 516(A) 6094 LF 132.000 132.000   132.000 $545.00 $0.00 $71,940.00
0029 TYPE I-A PLAIN RIPRAP 601(A-1)1353 TON 790.000 471.890   471.890 $38.00 $0.00 $17,931.82
0030 TYPE I-A FILTER BLANKET 601(A-2)1355 TON 180.000 144.700   144.700 $31.00 $0.00 $4,485.70
0031 REMOVAL OF EXISTING BRIDGE STRUCTURE 619(D) 1397 LSUM 1.000 1.000   1.000 $20,000.00 $0.00 $20,000.00
0032 GUARD RAIL ANCHOR UNIT (TYPE II) 623(F) 6033 EA 4.000 4.000   4.000 $2,200.00 $0.00 $8,800.00
0033 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $2,400.00 $0.00 $2,400.00
Subtotals For Category     0200/BRIDGE 'A'    $0.00 $402,951.47
Fed/State Project Number:    BRF-STIM(230)CO Project:    21415(04) Category:    0600/STAKING
0034 STAKING 642 0098 LSUM 1.000 1.000   1.000 $3,600.00 $0.00 $3,600.00
Subtotals For Category     0600/STAKING    $0.00 $3,600.00
Fed/State Project Number:    BRF-STIM(230)CO Project:    21415(04) Category:    0640/CONSTRUCTION
0035 (SP)SWPPP DOCUMENTATION AND MANAGEMENT 220 2800 LSUM 1.000 1.000 0.250 1.000 $10,000.00 $2,500.00 $10,000.00
0036 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $18,000.00 $0.00 $18,000.00
Subtotals For Category     0640/CONSTRUCTION    $2,500.00 $28,000.00
Fed/State Project Number:    BRF-STIM(230)CO Project:    21415(04) Category:    0900/FEDERAL NON PARTICIPATING
Subtotals For Category     0900/FEDERAL NON PARTICIPATING    $0.00 $0.00
Subtotals For Project BRF-STIM(230)CO /21415(04) $3,576.60 $564,424.37