Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 100026   Estimate Number: 0007 , Final     Spec Year: 1999
Primary JP: 27214(04)   Residency: ARDMORE (07200)     Contract No: 510921
Date Created: 09/16/2011   Contractor FEI: 731562464     Account No: 555700

Project Number(s): STP-STIM(475)EH
Contract Description: PEDESTRIAN IMPROVEMENTS SH-53A: FROM GRAND STREET, EXTEND NORTH IN THE TOWN OF GENE AUTRY. PROJECT LENGTH = 0.251 MILES.
Primary County: CARTER              
Name of Road: SH-53A              
Prime Contractor: COMMERCIAL CONCRETE           Time Charged: 101.00
    25239 MAY AVE.           Time Allowed: 102.00
    BLANCHARD , OK   73010           Percent Time: 99.02 %

  Paid To Date: $100,043.14 Payable This Statement: $2.25

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.                                
COMMERCIAL CONCRETE                                
 
_________________________________________________
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:    09/16/2011
Contract ID: 100026   Estimate Number: 0007     Contract No: 510921
Residency: ARDMORE (07200)   Estimate Type: Final     Account No: 555700

Project Number(s): STP-STIM(475)EH
Primary Job Piece No: 27214(04)
Contract Description: PEDESTRIAN IMPROVEMENTS SH-53A: FROM GRAND STREET, EXTEND NORTH IN THE TOWN OF GENE AUTRY. PROJECT LENGTH = 0.251 MILES.
Primary County: CARTER              
Name of Road: SH-53A              
Prime Contractor: COMMERCIAL CONCRETE              
    25239 MAY AVE.              
    BLANCHARD , OK   73010              
Surety Company: SURETEC INSURANCE CO.              

Date Let: 01/28/2010 NTP Effective Date: 04/05/2010 Pay Period: 06/12/2010  TO  08/16/2010
Date Awarded: 02/01/2010 Date Work Began: 03/29/2010 Original Contract Time: 60
Date Contract Executed: 02/17/2010 Date Time Stopped: 07/07/2010 Current Time Charged: 101.00
Date NTP Issued: 02/25/2010 Completion Date: 07/07/2010 Current Time Allowed: 102.00
General Liability Expires: 04/27/2011 Workman's Comp Expires: 01/08/2011 Percent Time Used: 99.02 %
Specification Year: 1999        

Current Contract Amount: $100,027.50 Total to Date Prev to Date This Estimate
Bid Amount: $100,387.20 Participating: $100,027.51 $100,025.26 $2.25
Percent Complete: 100 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $-15.64 Non ARRA: $0.00 $0.00 $0.00
Unearned Balance: $344.06 Total Earnings: $100,027.51 $100,025.26 $2.25
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $100,027.51 $100,025.26 $2.25
Other Adjustments: $15.63 $15.63 $0.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $100,043.14 $100,040.89 $2.25

Estimate Adjustment Detail

Contract ID: 100026   Estimate Number: 0007     Primary JP: 27214(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 07/15/2011 0.0 $-359.70


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
27214(04) 0005 (SP)ASPHALT CONCRETE TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0004 0.00 $0.00 $82.40
27214(04) 0005 (SP)ASPHALT CONCRETE TYPE S3(PG 64-22 OK) * Asphalt Binder Adjustment 0004 0.00 $0.00 $-82.40
27214(04) 0005 (SP)ASPHALT CONCRETE TYPE S3(PG 64-22 OK) * Asphalt Binder Adjustment 0005 0.00 $0.00 $-19.94
27214(04) 0005 (SP)ASPHALT CONCRETE TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0005 0.00 $0.00 $19.94
27214(04) 0005 (SP)ASPHALT CONCRETE TYPE S3(PG 64-22 OK) * Asphalt Binder Adjustment 0006 0.00 $0.00 $-41.06
27214(04) 0005 (SP)ASPHALT CONCRETE TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0006 0.00 $0.00 $41.06
27214(04) 0006 (SP)ASPHALT CONCRETE TYPE S4(PG 70-28 OK) * Asphalt Binder Adjustment 0004 0.00 $0.00 $-47.06
27214(04) 0006 (SP)ASPHALT CONCRETE TYPE S4(PG 70-28 OK) Asphalt Binder Adjustment 0004 0.00 $0.00 $47.06
27214(04) 0006 (SP)ASPHALT CONCRETE TYPE S4(PG 70-28 OK) Asphalt Binder Adjustment 0005 0.00 $0.00 $11.44
27214(04) 0006 (SP)ASPHALT CONCRETE TYPE S4(PG 70-28 OK) * Asphalt Binder Adjustment 0005 0.00 $0.00 $-11.44
27214(04) 0006 (SP)ASPHALT CONCRETE TYPE S4(PG 70-28 OK) Asphalt Binder Adjustment 0006 0.00 $0.00 $15.63
Subtotals For Line Item Adjustments $15.63
* = 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: 100026   Estimate Number: 0007     Primary JP: 27214(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(475)EH Project:    27214(04) Category:    0100/ROADWAY
0001 TEMPORARY SILT FENCE 223 2801 LF 1,200.000 0.000   0.000 $3.25 $0.00 $0.00
0002 SOLID SLAB SODDING 230(A) 2806 SY 220.000 219.730   219.730 $3.50 $0.00 $769.06
0003 AGGREGATE BASE 303 5912 TON 264.000 149.790   149.790 $45.00 $0.00 $6,740.55
0004 TRAFFIC BOUND SURFACE COURSE TYPE E 403(E) 0225 TON 25.000 0.000   0.000 $45.00 $0.00 $0.00
0005 (SP)ASPHALT CONCRETE TYPE S3(PG 64-22 OK) 411(S3) 5945 TON 44.000 37.540   37.540 $135.00 $0.00 $5,067.90
0006 (SP)ASPHALT CONCRETE TYPE S4(PG 70-28 OK) 411(S4) 5955 TON 25.000 16.980   16.980 $145.00 $0.00 $2,462.10
0007 HANDRAILING 504(G) 6006 LF 6.000 0.000   0.000 $235.00 $0.00 $0.00
0008 REMOVAL OF CULVERT END 508(A) 6335 EA 1.000 1.000   1.000 $2,000.00 $0.00 $2,000.00
0009 CLASS A CONCRETE 509(B) 0321 CY 6.000 4.580   4.580 $293.00 $0.00 $1,341.94
0010 REINFORCING STEEL 511(A) 0332 LB 260.000 255.000   255.000 $3.92 $0.00 $999.60
0011 TYPE IV GROUTED RIPRAP 601(D) 1390 SY 60.000 68.050   68.050 $140.00 $0.00 $9,527.00
0012 COMBINED CURB & GUTTER (6" BARRIER) 609(B) 0383 LF 184.000 0.000   0.000 $22.00 $0.00 $0.00
0013 4" CONCRETE SIDEWALK 610(A) 0602 SY 633.000 700.110   700.110 $36.00 $0.00 $25,203.96
0014 6" CONCRETE DRIVEWAY (H.E.S.) 610(B) 0399 SY 30.000 287.830   287.830 $39.00 $0.00 $11,225.37
0015 8" CONCRETE DRIVEWAY (H.E.S.) 610(B) 0400 SY 74.000 114.110   114.110 $40.00 $0.00 $4,564.40
0016 (PL)TACTILE WARNING DEVICE-NEW 610(I) 4610 SF 48.000 56.000   56.000 $40.00 $0.00 $2,240.00
0017 MANHOLES ADJUST TO GRADE 612(A) 0641 EA 2.000 1.000   1.000 $350.00 $0.00 $350.00
0018 36" R.C.PIPE CLASS III 613(B) 0494 LF 51.000 51.000   51.000 $93.00 $0.00 $4,743.00
0019 TYPE A6 CULVERT END TREATMENT 613(CC) 7196 EA 1.000 2.000   2.000 $1,500.00 $0.00 $3,000.00
0020 18" CORR. GALV. STEEL PIPE 613(D) 0689 LF 12.000 12.000   12.000 $63.00 $0.00 $756.00
0021 REMOVAL OF CONCRETE PAVEMENT 619(B) 4727 SY 2.000 1.890 0.090 1.890 $25.00 $2.25 $47.25
0022 REMOVAL OF ASPHALT PAVEMENT 619(B) 4728 SY 258.000 311.020   311.020 $4.00 $0.00 $1,244.08
0023 REMOVAL OF EXISTING STRUCTURES 619(B) 4778 EA 1.000 1.000   1.000 $3,758.00 $0.00 $3,758.00
0024 REMOVAL OF SIDEWALK 619(B) 4792 SY 225.000 246.660   246.660 $5.00 $0.00 $1,233.30
0025 SAWING PAVEMENT 619(C) 0924 LF 245.000 617.000   617.000 $2.00 $0.00 $1,234.00
0026 REMOVE AND RECONSTRUCT FENCE 625(B) 1252 LF 28.000 28.000   28.000 $15.00 $0.00 $420.00
Subtotals For Category     0100/ROADWAY    $2.25 $88,927.51
Fed/State Project Number:    STP-STIM(475)EH Project:    27214(04) Category:    0300/TRAFFIC
0027 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $3,000.00 $0.00 $3,000.00
0028 (PL)REMOVE & RESET GROUND MOUNTED SIGN 890A/B 8760 EA 1.000 1.000   1.000 $100.00 $0.00 $100.00
Subtotals For Category     0300/TRAFFIC    $0.00 $3,100.00
Fed/State Project Number:    STP-STIM(475)EH Project:    27214(04) Category:    0600/STAKING
0029 STAKING 642 0098 LSUM 1.000 1.000   1.000 $3,000.00 $0.00 $3,000.00
Subtotals For Category     0600/STAKING    $0.00 $3,000.00
Fed/State Project Number:    STP-STIM(475)EH Project:    27214(04) Category:    0640/CONSTRUCTION
0030 MOBILIZATION 641 1552 LSUM 1.000 1.000   1.000 $5,000.00 $0.00 $5,000.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $5,000.00
Subtotals For Project STP-STIM(475)EH /27214(04) $2.25 $100,027.51