Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 090629   Estimate Number: 0024 , Final     Spec Year: 1999
Primary JP: 20709(04)   Residency: SAND SPRINGS (08400)     Contract No: 510672
Date Created: 12/13/2011   Contractor FEI: 480531159     Account No: 432800

Project Number(s): BRF-STIM(432)CO
Contract Description: GRADE, DRAIN, SURFACE, AND BRIDGE COUNTY ROAD (EW-33): OVER CANDY CREEK, 0.2 MILES SOUTH AND 1.3 MILES EAST OF THE CITY OF WOLCO. PROJECT LENGTH = 0.473 MILES.
Primary County: OSAGE              
Name of Road: COUNTY ROAD              
Prime Contractor: BEACHNER CONSTRUCTION CO., INC.           Time Charged: 537.00
    P. O. BOX 128           Time Allowed: 537.00
    SAINT PAUL , KS   66771           Percent Time: 100.00 %

  Paid To Date: $1,056,922.05 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:    12/13/2011
Contract ID: 090629   Estimate Number: 0024     Contract No: 510672
Residency: SAND SPRINGS (08400)   Estimate Type: Final     Account No: 432800

Project Number(s): BRF-STIM(432)CO
Primary Job Piece No: 20709(04)
Contract Description: GRADE, DRAIN, SURFACE, AND BRIDGE COUNTY ROAD (EW-33): OVER CANDY CREEK, 0.2 MILES SOUTH AND 1.3 MILES EAST OF THE CITY OF WOLCO. PROJECT LENGTH = 0.473 MILES.
Primary County: OSAGE              
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: 11/19/2009 NTP Effective Date: 03/22/2010 Pay Period: 12/02/2011  TO  12/13/2011
Date Awarded: 12/07/2009 Date Work Began: 03/08/2010 Original Contract Time: 210
Date Contract Executed: 12/18/2009 Date Time Stopped: 08/25/2011 Current Time Charged: 537.00
Date NTP Issued: 02/09/2010 Completion Date: 08/25/2011 Current Time Allowed: 537.00
General Liability Expires: 03/31/2012 Workman's Comp Expires: 03/31/2012 Percent Time Used: 100.00 %
Specification Year: 1999        

Current Contract Amount: $1,060,093.66 Total to Date Prev to Date This Estimate
Bid Amount: $1,045,619.26 Participating: $1,050,220.81 $1,050,220.81 $0.00
Percent Complete: 99.70 % Non Participating: $9,872.85 $9,872.85 $0.00
Funds Available: $3,171.61 Non ARRA: $0.00 $0.00 $0.00
Unearned Balance: $-11,302.79 Total Earnings: $1,060,093.66 $1,060,093.66 $0.00
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $1,060,093.66 $1,060,093.66 $0.00
Other Adjustments: $-3,171.61 $-3,171.61 $0.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $1,056,922.05 $1,056,922.05 $0.00

Estimate Adjustment Detail

Contract ID: 090629   Estimate Number: 0024     Primary JP: 20709(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Pier Revision Approved 08/04/2010 0.0 $17,339.25
002 Final Quantity Change Order Approved 11/16/2011 0.0 $-2,864.85


STOCKPILE PAYMENT HISTORY
Project Line Nbr Stockpile Description Adjustment Type Estimate Nbr Adjusted Amount
20709(04) 0021 PC BR ITM FABS (AML) Stockpiled Material Adjustment 0008 $-20,034.14
20709(04) 0021 PC BR ITM FABS (AML) Stockpiled Material Initial Payment 0002 $40,068.28
20709(04) 0021 PC BR ITM FABS (AML) Stockpiled Material Adjustment 0009 $-20,034.14
20709(04) 0022 PC BR ITM FABS (AML) Stockpiled Material Initial Payment 0002 $46,405.62
20709(04) 0022 PC BR ITM FABS (AML) Stockpiled Material Adjustment 0007 $-46,405.62
Subtotals For Stockpile Payments $0.00


LIQUIDATED DAMAGES HISTORY
Adjustment Description Estimate Nbr Time Units Rate Adjustment Amount
System Application of Liquidated Damages 0015 -2.0 $750.00 $-1,500.00
System Application of Liquidated Damages 0016 --2.0 $750.00 $1,500.00


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
20709(04) 0004 TYPE A-SALVAGED TOPSOIL * Material Discrepancy Adjustments 0007 -0.10 $4,000.00 $-400.00
20709(04) 0004 TYPE A-SALVAGED TOPSOIL * Material Discrepancy Adjustments 0008 0.10 $4,000.00 $400.00
20709(04) 0006 TEMPORARY SILT FENCE * Material Discrepancy Adjustments 0001 -3,538.00 $0.80 $-2,830.40
20709(04) 0006 TEMPORARY SILT FENCE * Material Discrepancy Adjustments 0003 3,538.00 $0.80 $2,830.40
20709(04) 0012 (SP)ASPHALT CONCRETE TYPE S3(PG 70-28 OK) Asphalt Binder Adjustment 0016 1,067.89 $1.40 $1,503.64
20709(04) 0012 (SP)ASPHALT CONCRETE TYPE S3(PG 70-28 OK) * SUBSTANDARD ITEM 0016 1.00 $-7,242.17 $-7,242.17
20709(04) 0012 (SP)ASPHALT CONCRETE TYPE S3(PG 70-28 OK) * QAQC 0020 1.00 $-7,442.17 $-7,442.17
20709(04) 0012 (SP)ASPHALT CONCRETE TYPE S3(PG 70-28 OK) * SUBSTANDARD ITEM 0020 1.00 $7,242.17 $7,242.17
20709(04) 0013 (SP)ASPHALT CONCRETE TYPE S4(PG 70-28 OK) Asphalt Binder Adjustment 0016 1,719.44 $1.60 $2,766.92
20709(04) 0038 CONSTRUCTION TRAFFIC CONTROL * Material Discrepancy Adjustments 0001 -0.10 $2,500.00 $-250.00
20709(04) 0038 CONSTRUCTION TRAFFIC CONTROL * Material Discrepancy Adjustments 0002 -0.10 $2,500.00 $-250.00
20709(04) 0038 CONSTRUCTION TRAFFIC CONTROL * Material Discrepancy Adjustments 0003 0.20 $2,500.00 $500.00
Subtotals For Line Item Adjustments $-3,171.61
* = 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: 090629   Estimate Number: 0024     Primary JP: 20709(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(432)CO Project:    20709(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 UNCLASSIFIED EXCAVATION 202(A) 0183 CY 5,780.000 5,780.000   5,780.000 $3.50 $0.00 $20,230.00
0003 UNCLASSIFIED BORROW 202(C) 0184 CY 18,700.000 18,700.000   18,700.000 $5.00 $0.00 $93,500.00
0004 TYPE A-SALVAGED TOPSOIL 205 4229 LSUM 1.000 1.000   1.000 $4,000.00 $0.00 $4,000.00
0005 OBLITERATING ABANDONED ROAD 210 0121 STA 17.000 17.000   17.000 $200.00 $0.00 $3,400.00
0006 TEMPORARY SILT FENCE 223 2801 LF 4,615.000 3,833.000   3,833.000 $0.80 $0.00 $3,066.40
0007 TEMPORARY SILT DIKE 227 0100 LF 480.000 315.000   315.000 $4.50 $0.00 $1,417.50
0008 SOLID SLAB SODDING 230(A) 2806 SY 12,596.000 21,577.280   21,577.280 $1.61 $0.00 $34,739.42
0009 VEGETATIVE MULCHING 233(A) 2817 AC 8.900 0.000   0.000 $390.00 $0.00 $0.00
0010 AGGREGATE BASE 303 0192 CY 1,456.000 1,167.350   1,167.350 $37.50 $0.00 $43,775.62
0011 TRAFFIC BOUND SURFACE COURSE TYPE E 403(E) 0225 TON 280.000 276.480   276.480 $15.00 $0.00 $4,147.20
0012 (SP)ASPHALT CONCRETE TYPE S3(PG 70-28 OK) 411(S3) 5940 TON 1,647.000 1,067.890   1,067.890 $53.50 $0.00 $57,132.12
0013 (SP)ASPHALT CONCRETE TYPE S4(PG 70-28 OK) 411(S4) 5955 TON 1,177.000 1,719.440   1,719.440 $66.00 $0.00 $113,483.04
0014 CLASS A CONCRETE 509(B) 0321 CY 123.000 123.000   123.000 $310.00 $0.00 $38,130.00
0015 CLASS C CONCRETE 509(D) 0325 CY 10.000 0.000   0.000 $200.00 $0.00 $0.00
0016 REINFORCING STEEL 511(A) 0332 LB 18,870.000 18,870.000   18,870.000 $0.75 $0.00 $14,152.50
0017 28" X 20" CORR. GALV. STEEL PIPE ARCH 613(D) 4528 LF 294.000 228.000   228.000 $20.00 $0.00 $4,560.00
0018 28" X 20" PREFAB. CULVERT END SECTION, ARCH 613(M) 4516 EA 10.000 10.000   10.000 $250.00 $0.00 $2,500.00
Subtotals For Category     0100/ROADWAY    $0.00 $443,233.80
Fed/State Project Number:    BRF-STIM(432)CO Project:    20709(04) Category:    0200/BRIDGE
0019 UNCLASSIFIED BORROW 202(C) 1302 CY 62.000 62.000   62.000 $15.00 $0.00 $930.00
0020 SUBSTRUCTURE EXCAVATION COMMON 501(B) 1307 CY 80.000 80.000   80.000 $25.00 $0.00 $2,000.00
0021 PRESTRESSED CONCRETE BEAMS (TYPE II) 503(A) 1311 LF 353.340 353.340   353.340 $180.00 $0.00 $63,601.20
0022 PRESTRESSED CONCRETE BEAMS (TYPE IV) 503(A) 1313 LF 396.670 396.670   396.670 $190.00 $0.00 $75,367.30
0023 APPROACH SLAB 504(A) 1304 SY 77.000 77.000   77.000 $170.00 $0.00 $13,090.00
0024 SEALED EXPANSION JOINT 504(C) 6250 LF 35.420 35.420   35.420 $200.00 $0.00 $7,084.00
0025 CONCRETE RAIL (TR1) 504(E) 1380 LF 437.000 437.000   437.000 $45.00 $0.00 $19,665.00
0026 STRUCTURAL STEEL 506(A) 1322 LB 4,480.000 4,480.000   4,480.000 $2.75 $0.00 $12,320.00
0027 CLASS AA CONCRETE 509(A) 1326 CY 174.200 174.200   174.200 $435.00 $0.00 $75,777.00
0028 CLASS A CONCRETE 509(B) 1328 CY 101.120 134.370   134.370 $435.00 $0.00 $58,450.95
0029 REINFORCING STEEL 511(A) 1332 LB 56,244.000 60,078.000   60,078.000 $0.75 $0.00 $45,058.50
0030 PILES, FURNISHED (HP 10X42) 514(A) 6010 LF 545.000 545.000   545.000 $24.00 $0.00 $13,080.00
0031 PILES, DRIVEN (HP 10X42) 514(B) 6292 LF 545.000 477.710   477.710 $16.00 $0.00 $7,643.36
0032 DRILLED SHAFTS 48" DIAMETER 516(A) 6094 LF 108.000 108.000   108.000 $435.00 $0.00 $46,980.00
0033 TYPE I-A PLAIN RIPRAP 601(A-1)1353 TON 1,750.000 1,878.610   1,878.610 $30.00 $0.00 $56,358.30
0034 TYPE I-A FILTER BLANKET 601(A-2)1355 TON 750.000 759.380   759.380 $30.00 $0.00 $22,781.40
0035 REMOVAL OF EXISTING BRIDGE STRUCTURE 619(D) 1397 LSUM 1.000 1.000   1.000 $30,000.00 $0.00 $30,000.00
0036 GUARD RAIL ANCHOR UNIT (TYPE D-BF) 623(F) 5686 EA 4.000 4.000   4.000 $1,050.00 $0.00 $4,200.00
0037 GUARD RAIL ANCHOR UNIT (TYPE A) 623(F) 6029 EA 4.000 4.000   4.000 $1,150.00 $0.00 $4,600.00
0038 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $2,500.00 $0.00 $2,500.00
Subtotals For Category     0200/BRIDGE    $0.00 $561,487.01
Fed/State Project Number:    BRF-STIM(432)CO Project:    20709(04) Category:    0600/STAKING
0039 STAKING 642 0098 LSUM 1.000 1.000   1.000 $3,500.00 $0.00 $3,500.00
Subtotals For Category     0600/STAKING    $0.00 $3,500.00
Fed/State Project Number:    BRF-STIM(432)CO Project:    20709(04) Category:    0640/CONSTRUCTION
0040 (SP)SWPPP DOCUMENTATION AND MANAGEMENT 220 2800 LSUM 1.000 1.000   1.000 $2,000.00 $0.00 $2,000.00
0041 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $40,000.00 $0.00 $40,000.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $42,000.00
Fed/State Project Number:    BRF-STIM(432)CO Project:    20709(04) Category:    0901/NON PARTICAPTING
0042 (SP)FENCE-STYLE SWF (5 BARBED WIRE) 624(C) 4459 LF 5,260.000 3,237.000   3,237.000 $3.05 $0.00 $9,872.85
Subtotals For Category     0901/NON PARTICAPTING    $0.00 $9,872.85
Subtotals For Project BRF-STIM(432)CO /20709(04) $0.00 $1,060,093.66