Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 090375   Estimate Number: 0013 , Final     Spec Year: 1999
Primary JP: 22754(04)   Residency: CLAREMORE (08300)     Contract No: 510086
Date Created: 02/09/2012   Contractor FEI: 480531159     Account No: 432800

Project Number(s): BRO-149D(058)CO, BRO-STIM(184)CO
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD: OVER BRUSHY CREEK, 2.2 MILES SOUTH & 2.5 MILES WEST OF US-412/US-69 JUNCTION. COUNTY ROAD: OVER ELM CREEK, 1.0 MILE EAST AND 1.0 MILE NORTH OF PENSACOLA. PROJECT LENGTH = 0.238 MILES.
Primary County: MAYES              
Name of Road: COUNTY ROAD              
Prime Contractor: BEACHNER CONSTRUCTION CO., INC.           Time Charged: 277.00
    P. O. BOX 128           Time Allowed: 250.00
    SAINT PAUL , KS   66771           Percent Time: 110.80 %

  Paid To Date: $593,558.50 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:    02/09/2012
Contract ID: 090375   Estimate Number: 0013     Contract No: 510086
Residency: CLAREMORE (08300)   Estimate Type: Final     Account No: 432800

Project Number(s): BRO-149D(058)CO, BRO-STIM(184)CO
Primary Job Piece No: 22754(04)
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD: OVER BRUSHY CREEK, 2.2 MILES SOUTH & 2.5 MILES WEST OF US-412/US-69 JUNCTION. COUNTY ROAD: OVER ELM CREEK, 1.0 MILE EAST AND 1.0 MILE NORTH OF PENSACOLA. PROJECT LENGTH = 0.238 MILES.
Primary County: MAYES              
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: 06/18/2009 NTP Effective Date: 09/08/2009 Pay Period: 09/16/2011  TO  02/08/2012
Date Awarded: 06/22/2009 Date Work Began: 10/05/2009 Original Contract Time: 120
Date Contract Executed: 07/02/2009 Date Time Stopped: 06/11/2010 Current Time Charged: 277.00
Date NTP Issued: 07/30/2009 Completion Date: 06/11/2010 Current Time Allowed: 250.00
General Liability Expires: 03/31/2012 Workman's Comp Expires: 03/31/2012 Percent Time Used: 110.80 %
Specification Year: 1999        

Current Contract Amount: $607,058.49 Total to Date Prev to Date This Estimate
Bid Amount: $616,116.35 Participating: $606,708.50 $606,708.50 $0.00
Percent Complete: 97.78 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $13,499.99 Non ARRA: $350.00 $350.00 $0.00
Unearned Balance: $22,557.85 Total Earnings: $607,058.50 $607,058.50 $0.00
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $607,058.50 $607,058.50 $0.00
Other Adjustments: $0.00 $0.00 $0.00
Liq Dam/Disincentive: $-13,500.00 $-13,500.00 $0.00
TOTAL: $593,558.50 $593,558.50 $0.00

Estimate Adjustment Detail

Contract ID: 090375   Estimate Number: 0013     Primary JP: 22754(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Change Order for Steel Piling Slices Approved 03/29/2010 0.0 $350.00
002 Supplemental Agreement to change Pay Quantity Approved 09/06/2011 0.0 $0.00
003 Final Contract Item Quantities Approved 02/07/2012 0.0 $-9,407.86


STOCKPILE PAYMENT HISTORY
Project Line Nbr Stockpile Description Adjustment Type Estimate Nbr Adjusted Amount
22754(04) 0014 PC BR ITM FABS (AML) Stockpiled Material Adjustment 0002 $-43,241.41
22754(04) 0014 PC BR ITM FABS (AML) Stockpiled Material Initial Payment 0001 $43,241.41
Subtotals For Stockpile Payments $0.00


LIQUIDATED DAMAGES HISTORY
Adjustment Description Estimate Nbr Time Units Rate Adjustment Amount
System Application of Liquidated Damages 0008 -2.0 $500.00 $-1,000.00
System Application of Liquidated Damages 0009 -15.0 $500.00 $-7,500.00
System Application of Liquidated Damages 0010 -5.0 $500.00 $-2,500.00
System Application of Liquidated Damages 0011 -5.0 $500.00 $-2,500.00
System Application of Liquidated Damages 0012 -0.0 $500.00 $0.00


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
20159(04) 0004 TEMPORARY SILT DIKE * Material Discrepancy Adjustments 0006 -6.00 $4.50 $-27.00
20159(04) 0004 TEMPORARY SILT DIKE * Material Discrepancy Adjustments 0009 6.00 $4.50 $27.00
22754(04) 0005 TEMPORARY SILT FENCE * Material Discrepancy Adjustments 0001 -910.00 $0.50 $-455.00
22754(04) 0005 TEMPORARY SILT FENCE * Material Discrepancy Adjustments 0005 -243.00 $0.50 $-121.50
22754(04) 0005 TEMPORARY SILT FENCE * Material Discrepancy Adjustments 0009 1,153.00 $0.50 $576.50
22754(04) 0006 TEMPORARY SILT DIKE * Material Discrepancy Adjustments 0001 -30.00 $4.50 $-135.00
22754(04) 0006 TEMPORARY SILT DIKE * Material Discrepancy Adjustments 0002 30.00 $4.50 $135.00
22754(04) 0006 TEMPORARY SILT DIKE * Material Discrepancy Adjustments 0006 -5.00 $4.50 $-22.50
22754(04) 0006 TEMPORARY SILT DIKE * Material Discrepancy Adjustments 0009 5.00 $4.50 $22.50
20159(04) 0022 TYPE I-A FILTER BLANKET * Material Discrepancy Adjustments 0003 -22.50 $25.00 $-562.50
20159(04) 0022 TYPE I-A FILTER BLANKET * Material Discrepancy Adjustments 0005 22.50 $25.00 $562.50
Subtotals For Line Item Adjustments $0.00
* = 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: 090375   Estimate Number: 0013     Primary JP: 22754(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-149D(058)CO Project:    20159(04) Category:    0100/ROADWAY BRO-149D(058)CO
0001 CLEARING AND GRUBBING 201 0102 LSUM 1.000 1.000   1.000 $4,000.00 $0.00 $4,000.00
0002 EARTHWORK 202(G) 0185 LSUM 1.000 1.000   1.000 $31,500.00 $0.00 $31,500.00
0003 TEMPORARY SILT FENCE 223 2801 LF 150.000 109.000   109.000 $0.50 $0.00 $54.50
0004 TEMPORARY SILT DIKE 227 0100 LF 30.000 46.000   46.000 $4.50 $0.00 $207.00
0005 SOLID SLAB SODDING 230(A) 2806 SY 2,200.000 2,578.170   2,578.170 $1.70 $0.00 $4,382.89
0006 VEGETATIVE MULCHING 233(A) 2817 AC 0.500 0.000   0.000 $400.00 $0.00 $0.00
0007 TRAFFIC BOUND SURFACE COURSE TYPE E 403(E) 0225 TON 340.000 339.000   339.000 $23.00 $0.00 $7,797.00
0008 CLASS C CONCRETE 509(D) 0325 CY 10.000 0.000   0.000 $200.00 $0.00 $0.00
Subtotals For Category     0100/ROADWAY BRO-149D(058)CO    $0.00 $47,941.39
Fed/State Project Number:    BRO-149D(058)CO Project:    20159(04) Category:    0200/BRIDGE 'A' BRO-149D(058)CO
0009 SUBSTRUCTURE EXCAVATION COMMON 501(B) 1307 CY 78.000 78.000   78.000 $30.00 $0.00 $2,340.00
0010 UNCLASSIFIED BACKFILL 501(D) 6353 CY 64.000 64.000   64.000 $65.00 $0.00 $4,160.00
0011 PRESTRESSED CONCRETE BEAMS (TYPE III) 503(A) 1312 LF 276.670 276.670   276.670 $195.00 $0.00 $53,950.65
0012 CONCRETE RAIL (TR1) 504(E) 1380 LF 197.000 197.000   197.000 $70.00 $0.00 $13,790.00
0013 STRUCTURAL STEEL 506(A) 1322 LB 1,620.000 1,572.000   1,572.000 $3.25 $0.00 $5,109.00
0014 CLASS AA CONCRETE 509(A) 1326 CY 54.700 51.080   51.080 $655.00 $0.00 $33,457.40
0015 CLASS A CONCRETE 509(B) 1328 CY 48.800 49.280   49.280 $655.00 $0.00 $32,278.40
0016 REINFORCING STEEL 511(A) 1332 LB 19,181.000 21,243.000   21,243.000 $0.90 $0.00 $19,118.70
0017 PILES, FURNISHED (HP 10X42) 514(A) 6010 LF 80.000 80.000   80.000 $28.00 $0.00 $2,240.00
0018 PILES, FURNISHED (HP 12X53) 514(A) 6011 LF 150.000 150.000   150.000 $35.50 $0.00 $5,325.00
0019 PILES, DRIVEN (HP 10X42) 514(B) 6292 LF 80.000 79.370   79.370 $101.00 $0.00 $8,016.37
0020 PILES, DRIVEN (HP 12X53) 514(B) 6294 LF 150.000 132.900   132.900 $105.00 $0.00 $13,954.50
0021 TYPE I-A PLAIN RIPRAP 601(A-1)1353 TON 550.000 531.430   531.430 $30.00 $0.00 $15,942.90
0022 TYPE I-A FILTER BLANKET 601(A-2)1355 TON 120.000 118.930   118.930 $25.00 $0.00 $2,973.25
0023 REMOVAL OF EXISTING BRIDGE STRUCTURE 619(D) 1397 LSUM 1.000 1.000   1.000 $4,000.00 $0.00 $4,000.00
0024 GUARD RAIL ANCHOR UNIT (TYPE II) 623(F) 6033 EA 4.000 4.000   4.000 $1,975.00 $0.00 $7,900.00
0025 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $1,425.00 $0.00 $1,425.00
Subtotals For Category     0200/BRIDGE 'A' BRO-149D(058)CO    $0.00 $225,981.17
Fed/State Project Number:    BRO-149D(058)CO Project:    20159(04) Category:    0600/STAKING BRO-149D(058)CO
0026 STAKING 642 0098 LSUM 1.000 1.000   1.000 $3,500.00 $0.00 $3,500.00
Subtotals For Category     0600/STAKING BRO-149D(058)CO    $0.00 $3,500.00
Fed/State Project Number:    BRO-149D(058)CO Project:    20159(04) Category:    0640/CONSTRUCTION BRO-149D(058)CO
0027 (SP)SWPPP DOCUMENTATION AND MANAGEMENT 220 2800 LSUM 1.000 1.000   1.000 $2,000.00 $0.00 $2,000.00
0028 FIELD OFFICE 640 1398 EA 1.000 0.000   0.000 $4,500.00 $0.00 $0.00
0029 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $27,500.00 $0.00 $27,500.00
Subtotals For Category     0640/CONSTRUCTION BRO-149D(058)CO    $0.00 $29,500.00
Subtotals For Project BRO-149D(058)CO /20159(04) $0.00 $306,922.56


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(184)CO Project:    22754(04) Category:    0100/ROADWAY BRO-STIM(184)CO
0001 CLEARING AND GRUBBING 201 0102 LSUM 1.000 1.000   1.000 $4,500.00 $0.00 $4,500.00
0002 UNCLASSIFIED EXCAVATION 202(A) 0183 CY 1,953.000 1,953.000   1,953.000 $8.00 $0.00 $15,624.00
0003 UNCLASSIFIED BORROW 202(C) 0184 CY 1,056.000 1,056.000   1,056.000 $10.00 $0.00 $10,560.00
0004 TYPE A-SALVAGED TOPSOIL 205 4229 LSUM 1.000 1.000   1.000 $2,500.00 $0.00 $2,500.00
0005 TEMPORARY SILT FENCE 223 2801 LF 1,350.000 1,397.600   1,397.600 $0.50 $0.00 $698.80
0006 TEMPORARY SILT DIKE 227 0100 LF 150.000 177.000   177.000 $4.50 $0.00 $796.50
0007 SOLID SLAB SODDING 230(A) 2806 SY 4,300.000 6,522.890   6,522.890 $1.70 $0.00 $11,088.92
0008 TRAFFIC BOUND SURFACE COURSE TYPE E 403(E) 0225 TON 640.000 604.440   604.440 $23.00 $0.00 $13,902.12
0009 CLASS C CONCRETE 509(D) 0325 CY 10.000 0.000   0.000 $200.00 $0.00 $0.00
0010 24" CORR. GALV. STEEL PIPE 613(D) 0690 LF 30.000 30.000   30.000 $35.00 $0.00 $1,050.00
0011 24" PREFAB. CULVERT END SECTION, ROUND 613(M) 5730 EA 2.000 2.000   2.000 $300.00 $0.00 $600.00
Subtotals For Category     0100/ROADWAY BRO-STIM(184)CO    $0.00 $61,320.34
Fed/State Project Number:    BRO-STIM(184)CO Project:    22754(04) Category:    0200/BRIDGE 'A' BRO-STIM(184)CO
0012 SUBSTRUCTURE EXCAVATION COMMON 501(B) 1307 CY 68.000 68.000   68.000 $30.00 $0.00 $2,040.00
0013 UNCLASSIFIED BACKFILL 501(D) 6353 CY 50.000 50.000   50.000 $80.00 $0.00 $4,000.00
0014 PRESTRESSED CONCRETE DOUBLE TEE 503(B) 6144 LF 272.500 272.500   272.500 $235.00 $0.00 $64,037.50
0015 CONCRETE RAIL (TR1) 504(E) 1380 LF 167.000 167.000   167.000 $70.00 $0.00 $11,690.00
0016 CLASS AA CONCRETE 509(A) 1326 CY 38.800 38.770   38.770 $680.00 $0.00 $26,363.60
0017 CLASS A CONCRETE 509(B) 1328 CY 34.800 37.110   37.110 $680.00 $0.00 $25,234.80
0018 REINFORCING STEEL 511(A) 1332 LB 12,137.000 11,385.000   11,385.000 $0.90 $0.00 $10,246.50
0019 PILES, FURNISHED (HP 10X42) 514(A) 6010 LF 150.000 155.730   155.730 $29.25 $0.00 $4,555.10
0020 PILES, DRIVEN (HP 10X42) 514(B) 6292 LF 150.000 155.730   155.730 $130.00 $0.00 $20,244.90
0021 TYPE I-A PLAIN RIPRAP 601(A-1)1353 TON 520.000 392.840   392.840 $30.00 $0.00 $11,785.20
0022 TYPE I-A FILTER BLANKET 601(A-2)1355 TON 70.000 83.720   83.720 $25.00 $0.00 $2,093.00
0023 REMOVAL OF EXISTING BRIDGE STRUCTURE 619(D) 1397 LSUM 1.000 1.000   1.000 $4,000.00 $0.00 $4,000.00
0024 GUARD RAIL ANCHOR UNIT (TYPE II) 623(F) 6033 EA 4.000 4.000   4.000 $1,975.00 $0.00 $7,900.00
0025 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $1,425.00 $0.00 $1,425.00
Subtotals For Category     0200/BRIDGE 'A' BRO-STIM(184)CO    $0.00 $195,615.60
Fed/State Project Number:    BRO-STIM(184)CO Project:    22754(04) Category:    0600/STAKING BRO-STIM(184)CO
0026 STAKING 642 0098 LSUM 1.000 1.000   1.000 $3,600.00 $0.00 $3,600.00
Subtotals For Category     0600/STAKING BRO-STIM(184)CO    $0.00 $3,600.00
Fed/State Project Number:    BRO-STIM(184)CO Project:    22754(04) Category:    0640/CONSTRUCTION BRO-STIM(184)CO
0027 (SP)SWPPP DOCUMENTATION AND MANAGEMENT 220 2800 LSUM 1.000 1.000   1.000 $2,000.00 $0.00 $2,000.00
0028 FIELD OFFICE 640 1398 EA 1.000 1.000   1.000 $4,500.00 $0.00 $4,500.00
0029 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $32,750.00 $0.00 $32,750.00
Subtotals For Category     0640/CONSTRUCTION BRO-STIM(184)CO    $0.00 $39,250.00
Fed/State Project Number:    BRO-STIM(184)CO Project:    22754(04) Category:    0850/Non ARRA Funding
8000 SPLICE(10" PILE) 514 6205 EA 0.000 2.000   2.000 $175.00 $0.00 $350.00
Subtotals For Category     0850/Non ARRA Funding    $0.00 $350.00
Subtotals For Project BRO-STIM(184)CO /22754(04) $0.00 $300,135.94