Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 090561   Estimate Number: 0003 , Final     Spec Year: 1999
Primary JP: 26758(04)   Residency: ENGINEERING SERVICES & TESTING (04001)     Contract No: 510318
Date Created: 07/08/2010   Contractor FEI: 731084433     Account No: 400400

Project Number(s): STP-STIM(420)AG
Contract Description: RESURFACE (ASPHALT) CITY STREET (NW 63RD ST): BEGIN JUST EAST OF MCARTHUR BLVD, EXTEND EAST. PROJECT LENGTH = 0.417 MILES
Primary County: OKLAHOMA              
Name of Road: CITY STREET              
Prime Contractor: T.J. CAMPBELL CONSTRUCTION CO.           Time Charged: 78.00
    P. O. BOX 15129           Time Allowed: 82.00
    OKLA. CITY , OK   73155           Percent Time: 95.12 %

  Paid To Date: $116,329.68 Payable This Statement: $-1,199.99

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.                                
T.J. CAMPBELL 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:    07/08/2010
Contract ID: 090561   Estimate Number: 0003     Contract No: 510318
Residency: ENGINEERING SERVICES & TESTING (04001)   Estimate Type: Final     Account No: 400400

Project Number(s): STP-STIM(420)AG
Primary Job Piece No: 26758(04)
Contract Description: RESURFACE (ASPHALT) CITY STREET (NW 63RD ST): BEGIN JUST EAST OF MCARTHUR BLVD, EXTEND EAST. PROJECT LENGTH = 0.417 MILES
Primary County: OKLAHOMA              
Name of Road: CITY STREET              
Prime Contractor: T.J. CAMPBELL CONSTRUCTION CO.              
    P. O. BOX 15129              
    OKLA. CITY , OK   73155              
Surety Company: TRAVELERS INDEMNITY COMPANY              

Date Let: 08/20/2009 NTP Effective Date: 02/01/2010 Pay Period: 04/16/2010  TO  07/08/2010
Date Awarded: 09/08/2009 Date Work Began: 02/01/2010 Original Contract Time: 30
Date Contract Executed: 09/18/2009 Date Time Stopped: 04/19/2010 Current Time Charged: 78.00
Date NTP Issued: 09/24/2009 Completion Date: 04/19/2010 Current Time Allowed: 82.00
General Liability Expires: 04/01/2011 Workman's Comp Expires: 07/01/2011 Percent Time Used: 95.12 %
Specification Year: 1999        

Current Contract Amount: $116,329.68 Total to Date Prev to Date This Estimate
Bid Amount: $118,722.34 Participating: $111,969.01 $113,169.00 $-1,199.99
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: $2,392.66 Total Earnings: $111,969.01 $113,169.00 $-1,199.99
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $111,969.01 $113,169.00 $-1,199.99
Other Adjustments: $4,360.67 $4,360.67 $0.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $116,329.68 $117,529.67 $-1,199.99

Estimate Adjustment Detail

Contract ID: 090561   Estimate Number: 0003     Primary JP: 26758(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 07/07/2010 0.0 $-2,392.66


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
26758(04) 0003 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0001 0.00 $0.00 $3,211.83
26758(04) 0014 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0001 0.00 $0.00 $1,148.84
Subtotals For Line Item Adjustments $4,360.67


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

Line Item Detail

Contract ID: 090561   Estimate Number: 0003     Primary JP: 26758(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(420)AG Project:    26758(04) Category:    0100/ROADWAY
0001 SOLID SLAB SODDING 230(A) 2806 SY 200.000 243.710   243.710 $3.00 $0.00 $731.13
0002 TACK COAT 407 0250 GAL 359.000 281.750 -281.750 281.750 $3.00 $-845.25 $845.25
0003 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) 411(S4) 5960 TON 1,003.000 1,055.830   1,055.830 $55.00 $0.00 $58,070.65
0004 COLD MILLING PAVEMENT 417 5267 SY 7,162.000 7,455.720 0.010 7,455.720 $0.85 $0.01 $6,337.36
0005 2'-8" COMB. CURB & GUTTER (8" BARRIER) 609(B) 1526 LF 141.000 0.000   0.000 $22.00 $0.00 $0.00
0006 4" CONCRETE SIDEWALK 610(A) 0602 SY 92.000 267.980   267.980 $40.00 $0.00 $10,719.20
0007 (PL)TACTILE WARNING DEVICE-NEW 610(I) 4610 SF 145.000 40.000   40.000 $22.00 $0.00 $880.00
0008 REMOVAL OF CURB AND GUTTER 619(B) 4726 LF 141.000 0.000   0.000 $8.00 $0.00 $0.00
0009 REMOVAL OF ASPHALT PAVEMENT 619(B) 4728 SY 100.000 0.000   0.000 $3.50 $0.00 $0.00
0010 SAWING PAVEMENT 619(C) 0924 LF 18.000 0.000   0.000 $3.50 $0.00 $0.00
0011 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $2,000.00 $0.00 $2,000.00
8099 ASPHALT BINDER PRICE ADJUSTMENT 109 1150 LSUM 0.000 1.000   0.000 $4,360.67 $0.00 $0.00
Subtotals For Category     0100/ROADWAY    $-845.24 $79,583.59
Fed/State Project Number:    STP-STIM(420)AG Project:    26758(04) Category:    0101/ROADWAY ADD ALTERNATE
0012 SOLID SLAB SODDING 230(A) 2806 SY 100.000 0.000   0.000 $3.00 $0.00 $0.00
0013 TACK COAT 407 0250 GAL 152.000 118.250 -118.250 118.250 $3.00 $-354.75 $354.75
0014 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) 411(S4) 5960 TON 425.000 377.660   377.660 $58.00 $0.00 $21,904.28
0015 COLD MILLING PAVEMENT 417 5267 SY 3,034.000 3,174.830   3,174.830 $1.00 $0.00 $3,174.83
0016 2'-8" COMB. CURB & GUTTER (8" BARRIER) 609(B) 1526 LF 70.000 0.000   0.000 $22.00 $0.00 $0.00
0017 4" CONCRETE SIDEWALK 610(A) 0602 SY 30.000 0.000   0.000 $40.00 $0.00 $0.00
0018 (PL)TACTILE WARNING DEVICE-NEW 610(I) 4610 SF 9.000 0.000   0.000 $22.00 $0.00 $0.00
0019 REMOVAL OF CURB AND GUTTER 619(B) 4726 LF 40.000 0.000   0.000 $8.00 $0.00 $0.00
0020 REMOVAL OF ASPHALT PAVEMENT 619(B) 4728 SY 50.000 0.000   0.000 $3.50 $0.00 $0.00
0021 SAWING PAVEMENT 619(C) 0924 LF 6.000 0.000   0.000 $3.50 $0.00 $0.00
0022 LOOP DETECTOR WIRE(PREFORMED) 828(B) 8141 LF 144.000 0.000   0.000 $5.80 $0.00 $0.00
0023 TRAFFIC STRIPE(PAINT)(4" WIDE) 854(A) 8800 LF 1,974.000 2,126.000   2,126.000 $0.26 $0.00 $552.76
0024 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $2,000.00 $0.00 $2,000.00
Subtotals For Category     0101/ROADWAY ADD ALTERNATE    $-354.75 $27,986.62
Fed/State Project Number:    STP-STIM(420)AG Project:    26758(04) Category:    0300/TRAFFIC
0025 LOOP DETECTOR WIRE(PREFORMED) 828(B) 8141 LF 480.000 0.000   0.000 $5.80 $0.00 $0.00
0026 TRAFFIC STRIPE(PAINT)(4" WIDE) 854(A) 8800 LF 4,820.000 5,380.000   5,380.000 $0.26 $0.00 $1,398.80
Subtotals For Category     0300/TRAFFIC    $0.00 $1,398.80
Fed/State Project Number:    STP-STIM(420)AG Project:    26758(04) Category:    0640/CONSTRUCTION
0027 MOBILIZATION 641 1552 LSUM 1.000 1.000   1.000 $3,000.00 $0.00 $3,000.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $3,000.00
Subtotals For Project STP-STIM(420)AG /26758(04) $-1,199.99 $111,969.01


1 CURRENT QUANTITIES DO NOT MATCH THE QUANTITY PAID TO DATE