Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 090682   Estimate Number: 0009 , Final     Spec Year: 1999
Primary JP: 27198(04)   Residency: CLINTON (05100)     Contract No: 510847
Date Created: 10/11/2010   Contractor FEI: 141879794     Account No: 555500

Project Number(s): STP-STIM(459)EH
Contract Description: PEDESTRIAN IMPROVEMENT SH-152/US-283: FROM MAIN STREET, EXTEND NORTH IN THE CITY OF SAYRE. PROJECT LENGTH = 1.248 MILES. PREQUALIFICATION FOR THIS PROJECT HAS BEEN WAIVED.
Primary County: BECKHAM              
Name of Road: SH-152/US-283              
Prime Contractor: SAC SERVICES, INC.           Time Charged: 166.00
    3600 S. ROSS AVE.           Time Allowed: 166.00
    OKLAHOMA CITY , OK   73119           Percent Time: 100.00 %

  Paid To Date: $474,220.24 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.                                
SAC SERVICES, 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:    10/11/2010
Contract ID: 090682   Estimate Number: 0009     Contract No: 510847
Residency: CLINTON (05100)   Estimate Type: Final     Account No: 555500

Project Number(s): STP-STIM(459)EH
Primary Job Piece No: 27198(04)
Contract Description: PEDESTRIAN IMPROVEMENT SH-152/US-283: FROM MAIN STREET, EXTEND NORTH IN THE CITY OF SAYRE. PROJECT LENGTH = 1.248 MILES. PREQUALIFICATION FOR THIS PROJECT HAS BEEN WAIVED.
Primary County: BECKHAM              
Name of Road: SH-152/US-283              
Prime Contractor: SAC SERVICES, INC.              
    3600 S. ROSS AVE.              
    OKLAHOMA CITY , OK   73119              
Surety Company: GRANITE RE, INC.              

Date Let: 12/17/2009 NTP Effective Date: 03/01/2010 Pay Period: 08/14/2010  TO  08/14/2010
Date Awarded: 01/11/2010 Date Work Began: 04/26/2010 Original Contract Time: 60
Date Contract Executed: 01/25/2010 Date Time Stopped: 08/13/2010 Current Time Charged: 166.00
Date NTP Issued: 02/03/2010 Completion Date: 08/13/2010 Current Time Allowed: 166.00
General Liability Expires: 08/30/2011 Workman's Comp Expires: 10/01/2011 Percent Time Used: 100.00 %
Specification Year: 1999        

Current Contract Amount: $474,220.24 Total to Date Prev to Date This Estimate
Bid Amount: $465,076.55 Participating: $474,220.29 $474,220.29 $0.00
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: $-9,143.69 Total Earnings: $474,220.29 $474,220.29 $0.00
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $474,220.29 $474,220.29 $0.00
Other Adjustments: $-0.05 $-0.05 $0.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $474,220.24 $474,220.24 $0.00

Estimate Adjustment Detail

Contract ID: 090682   Estimate Number: 0009     Primary JP: 27198(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 09/29/2010 0.0 $9,143.69


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 $-0.05
Subtotals For Contract Adjustments $-0.05


LINE ITEM ADJUSTMENT HISTORY
Project Item Nbr Line Item Description Adjustment Type Estimate Nbr Adj Quantity Unit Price Adjusted Amount
27198(04) 0005 CLASS A CONCRETE FOR SMALL STRUCTURES * Material Discrepancy Adjustments 0007 -4.24 $625.00 $-2,650.00
27198(04) 0005 CLASS A CONCRETE FOR SMALL STRUCTURES * Material Discrepancy Adjustments 0008 4.24 $625.00 $2,650.00
27198(04) 0008 4" CONCRETE SIDEWALK * Material Discrepancy Adjustments 0007 -24.53 $44.25 $-1,085.45
27198(04) 0008 4" CONCRETE SIDEWALK * Material Discrepancy Adjustments 0008 24.53 $44.25 $1,085.45
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: 090682   Estimate Number: 0009     Primary JP: 27198(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(459)EH Project:    27198(04) Category:    0100/ROADWAY
0001 SELECTIVE CLEARING 201 0181 LSUM 1.000 1.000   1.000 $5,150.00 $0.00 $5,150.00
0002 TEMPORARY SILT DIKE 227 0100 LF 60.000 0.000   0.000 $10.00 $0.00 $0.00
0003 SOLID SLAB SODDING 230(A) 2806 SY 1,496.000 1,036.300 0.000 1,036.300 $2.80 $0.00 $2,901.64
0004 HANDRAILING 504(G) 6006 LF 65.000 36.000   36.000 $100.00 $0.00 $3,600.00
0005 CLASS A CONCRETE FOR SMALL STRUCTURES 509(C) 0322 CY 6.000 22.810 0.000 22.810 $625.00 $0.00 $14,256.25
0006 REINFORCING STEEL 511(A) 0332 LB 34.000 2,141.510 0.000 2,141.510 $2.00 $0.00 $4,283.02
0007 2'-8" COMB. CURB & GUTTER (6" BARRIER) 609(B) 1525 LF 1,200.000 2,956.120 0.000 2,956.120 $19.00 $0.00 $56,166.28
0008 4" CONCRETE SIDEWALK 610(A) 0602 SY 4,461.000 3,862.760 0.000 3,862.760 $44.25 $0.00 $170,927.13
0009 8" CONCRETE DRIVEWAY (H.E.S.) 610(B) 0400 SY 813.000 979.060 0.000 979.060 $62.50 $0.00 $61,191.26
0010 (PL)TACTILE WARNING DEVICE-NEW 610(I) 4610 SF 1,231.000 684.000   684.000 $30.00 $0.00 $20,520.00
0011 INLET FRM&GRT (SSIF-FRM,CIG-GRT-VG-F) 611(G) 4488 EA 28.000 28.000   28.000 $367.00 $0.00 $10,276.00
0012 VALVE BOXES ADJUST TO GRADE 612(G) 0647 EA 9.000 12.000   12.000 $75.00 $0.00 $900.00
0013 METER BOXES ADJUST TO GRADE 612(H) 0648 EA 13.000 19.000   19.000 $120.00 $0.00 $2,280.00
0014 REMOVAL OF STRUCTURES & OBSTRUCTIONS 619(A) 0920 LSUM 1.000 1.000   1.000 $5,800.00 $0.00 $5,800.00
0015 REMOVAL OF ASPHALT PAVEMENT 619(B) 4728 SY 646.000 106.320   106.320 $8.50 $0.00 $903.72
0016 REMOVAL OF CONCRETE DRIVEWAY 619(B) 4766 SY 859.000 928.200   928.200 $8.50 $0.00 $7,889.72
0017 REMOVAL OF CURB 619(B) 4791 LF 2,441.000 2,827.570   2,827.570 $4.50 $0.00 $12,724.08
0018 REMOVAL OF SIDEWALK 619(B) 4792 SY 3,202.000 3,711.800   3,711.800 $7.50 $0.00 $27,838.51
0019 SAWING PAVEMENT 619(C) 0924 LF 4,690.000 4,183.840   4,183.840 $2.00 $0.00 $8,367.68
0020 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $15,500.00 $0.00 $15,500.00
0021 (PL)REMOVE & RESET GROUND MOUNTED SIGN 890A/B 8760 EA 6.000 0.000   0.000 $525.00 $0.00 $0.00
Subtotals For Category     0100/ROADWAY    $0.00 $431,475.29
Fed/State Project Number:    STP-STIM(459)EH Project:    27198(04) Category:    0600/STAKING
0022 STAKING 642 0098 LSUM 1.000 1.000   1.000 $12,895.00 $0.00 $12,895.00
Subtotals For Category     0600/STAKING    $0.00 $12,895.00
Fed/State Project Number:    STP-STIM(459)EH Project:    27198(04) Category:    0640/CONSTRUCTION
0023 (SP)SWPPP DOCUMENTATION AND MANAGEMENT 220 2800 LSUM 1.000 1.000   1.000 $4,750.00 $0.00 $4,750.00
0024 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $25,100.00 $0.00 $25,100.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $29,850.00
Subtotals For Project STP-STIM(459)EH /27198(04) $0.00 $474,220.29