Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 090548   Estimate Number: 0009 , Final     Spec Year: 1999
Primary JP: 26726(04)   Residency: ENGINEERING SERVICES & TESTING (04001)     Contract No: 510888
Date Created: 01/26/2011   Contractor FEI: 730731258     Account No: 400400

Project Number(s): STP-STIM(297)AG
Contract Description: RESURFACE (ASPHALT) CITY STREETS (36TH ST. AND ROCKWELL AVE.): 36TH STREET FROM ROCKWELL TO HAMMOND. ROCKWELL AVE. FROM 16TH ST. TO 23RD ST. PROJECT LENGTH = 1.28 MILES.
Primary County: OKLAHOMA              
Name of Road: 36TH ST, ROCKWELL AV              
Prime Contractor: HASKELL LEMON CONSTRUCTION CO.           Time Charged: N/A
    P. O. BOX 75608           Time Allowed: N/A
    OKLAHOMA CITY , OK   73147-0608           Percent Time: N/A

  Paid To Date: $419,462.91 Payable This Statement: $7.07

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.                                
HASKELL LEMON CONSTRUCTION CO.                               
 
_________________________________________________
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:    01/26/2011
Contract ID: 090548   Estimate Number: 0009     Contract No: 510888
Residency: ENGINEERING SERVICES & TESTING (04001)   Estimate Type: Final     Account No: 400400

Project Number(s): STP-STIM(297)AG
Primary Job Piece No: 26726(04)
Contract Description: RESURFACE (ASPHALT) CITY STREETS (36TH ST. AND ROCKWELL AVE.): 36TH STREET FROM ROCKWELL TO HAMMOND. ROCKWELL AVE. FROM 16TH ST. TO 23RD ST. PROJECT LENGTH = 1.28 MILES.
Primary County: OKLAHOMA              
Name of Road: 36TH ST, ROCKWELL AV              
Prime Contractor: HASKELL LEMON CONSTRUCTION CO.              
    P. O. BOX 75608              
    OKLAHOMA CITY , OK   73147-0608              
Surety Company: WESTERN SURETY COMPANY              

Date Let: 01/28/2010 NTP Effective Date: 06/28/2010 Pay Period: 12/16/2010  TO  01/15/2011
Date Awarded: 02/01/2010 Date Work Began: 03/23/2010 Original Contract Time: N/A
Date Contract Executed: 02/10/2010 Date Time Stopped: 06/22/2010 Current Time Charged: N/A
Date NTP Issued: 02/18/2010 Completion Date: 06/22/2010 Current Time Allowed: N/A
General Liability Expires: 07/01/2011 Workman's Comp Expires: 07/01/2011 Percent Time Used: N/A
Specification Year: 1999 FIXED COMPLETION DATE: 06/30/2010    

Current Contract Amount: $419,462.91 Total to Date Prev to Date This Estimate
Bid Amount: $418,420.78 Participating: $401,986.34 $401,981.69 $4.65
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: $-1,042.13 Total Earnings: $401,986.34 $401,981.69 $4.65
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $401,986.34 $401,981.69 $4.65
Other Adjustments: $17,476.57 $17,474.15 $2.42
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $419,462.91 $419,455.84 $7.07

Estimate Adjustment Detail

Contract ID: 090548   Estimate Number: 0009     Primary JP: 26726(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Final quantity change order Approved 12/10/2010 0.0 $1,035.06
002 Binder adjustment Approved 01/12/2011 0.0 $4.65
003 Binder adjustment #2 Approved 01/25/2011 0.0 $2.42


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
Withhold to Funds Avail(Prog. Est. Only) 0008 $-2.42
Withhold to Funds Avail(Prog. Est. Only) 0009 $2.42
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
26726(04) 0002 (SP)ASPHALT CONCRETE TYPE S3(PATCHING)(PG 64-22 OK) Asphalt Binder Adjustment 0002 0.00 $0.00 $6.65
26726(04) 0003 (SP)ASPHALT CONCRETE TYPE S4(PG 70-28 OK) Asphalt Binder Adjustment 0002 0.00 $0.00 $4,813.16
26726(04) 0003 (SP)ASPHALT CONCRETE TYPE S4(PG 70-28 OK) Asphalt Binder Adjustment 0003 0.00 $0.00 $12,654.35
26726(04) 0003 (SP)ASPHALT CONCRETE TYPE S4(PG 70-28 OK) Asphalt Binder Adjustment 0008 1.62 $1.48 $2.41
Subtotals For Line Item Adjustments $17,476.57


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

Line Item Detail

Contract ID: 090548   Estimate Number: 0009     Primary JP: 26726(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:    STP-STIM(297)AG Project:    26726(04) Category:    0100/ROADWAY - STP-STIM(297)AG
0001 TACK COAT 407 0250 GAL 1,887.000 1,800.000   1,800.000 $2.00 $0.00 $3,600.00
0002 (SP)ASPHALT CONCRETE TYPE S3(PATCHING)(PG 64-22 OK) 411(S3) 6210 TON 332.000 1.740   1.740 $85.75 $0.00 $149.21
0003 (SP)ASPHALT CONCRETE TYPE S4(PG 70-28 OK) 411(S4) 5955 TON 4,537.000 4,002.790   4,002.790 $64.65 $0.00 $258,780.37
0004 COLD MILLING BITUMINOUS PAVEMENT 417 4267 SY 37,743.000 34,304.960   34,304.960 $0.75 $0.00 $25,728.73
0005 1'-8" COMB. CURB & GUTTER (6" BARRIER) 609(B) 1513 LF 30.000 11.300   11.300 $50.00 $0.00 $565.00
0006 4" CONCRETE SIDEWALK 610(A) 0602 SY 419.000 1,173.070   1,173.070 $55.00 $0.00 $64,518.85
0007 (PL)TACTILE WARNING DEVICE-NEW 610(I) 4610 SF 426.000 492.630   492.630 $15.00 $0.00 $7,389.45
0008 MANHOLES ADJUST TO GRADE 612(A) 0641 EA 10.000 5.000   5.000 $100.00 $0.00 $500.00
0009 VALVE BOXES ADJUST TO GRADE 612(G) 0647 EA 9.000 12.000   12.000 $100.00 $0.00 $1,200.00
0010 REMOVAL OF CURB AND GUTTER 619(B) 4726 LF 339.000 613.300   613.300 $5.00 $0.00 $3,066.50
0011 LOOP DETECTOR WIRE 828(B) 8138 LF 554.000 3,076.000   3,076.000 $4.00 $0.00 $12,304.00
0012 TRAFFIC STRIPE(PLASTIC)(4" WIDE) 855(A) 8812 LF 29,993.000 19,915.500   19,915.500 $0.36 $0.00 $7,169.58
0013 TRAFFIC STRIPE(PLASTIC)(ARROWS) 855(B) 8818 EA 6.000 6.000   6.000 $105.00 $0.00 $630.00
0014 TRAFFIC STRIPE(PLASTIC)(WORDS) 855(B) 8821 EA 3.000 3.000   3.000 $210.00 $0.00 $630.00
0015 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $12,000.00 $0.00 $12,000.00
8010 ASPHALT BINDER PRICE ADJUSTMENT 109 1150 LSUM 0.000 1.000   0.000 $17,474.16 $0.00 $0.00
8011 ASPHALT BINDER PRICE ADJUSTMENT 109 1150 LSUM 0.000 1.000 1.000 1.000 $4.65 $4.65 $4.65
8090 ASPHALT BINDER PRICE ADJUSTMENT 109 1150 LSUM 0.000 1.000   0.000 $2.42 $0.00 $0.00
Subtotals For Category     0100/ROADWAY - STP-STIM(297)AG    $4.65 $398,236.34
Fed/State Project Number:    STP-STIM(297)AG Project:    26726(04) Category:    0640/CONSTRUCTION - STP-STIM(297)AG
0016 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $3,750.00 $0.00 $3,750.00
Subtotals For Category     0640/CONSTRUCTION - STP-STIM(297)AG    $0.00 $3,750.00
Subtotals For Project STP-STIM(297)AG /26726(04) $4.65 $401,986.34


2 CURRENT QUANTITIES DO NOT MATCH THE QUANTITY PAID TO DATE