Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 100035   Estimate Number: 0013 , Final     Spec Year: 1999
Primary JP: 27191(04)   Residency: PERRY (04100)     Contract No: 510987
Date Created: 07/19/2011   Contractor FEI: 731587199     Account No: 555400

Project Number(s): STP-STIM(452)EH
Contract Description: PEDESTRIAN IMPROVEMENTS US-60B & US-77: ON US-60B, FROM MAIN ST. EXTEND EAST. ON US-77, FROM GRAND AVE. EXTEND SOUTH. BOTH IN THE TOWN OF TONKAWA. PROJECT LENGTH = 0.748 MILES. PREQUALIFICATION FOR THIS PROJECT HAS BEEN WAIVED.
Primary County: KAY              
Name of Road: US-60B/US-77              
Prime Contractor: HEMBREE & HODGSON CONSTRUCTION, LLC           Time Charged: 234.00
    4501 N. HWY. 77 ACCESS ROAD           Time Allowed: 235.00
    PONCA CIITY , OK   74601           Percent Time: 99.57 %

  Paid To Date: $339,560.13 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.                                
HEMBREE & HODGSON CONSTRUCTION, LLC                               
 
_________________________________________________
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:    07/19/2011
Contract ID: 100035   Estimate Number: 0013     Contract No: 510987
Residency: PERRY (04100)   Estimate Type: Final     Account No: 555400

Project Number(s): STP-STIM(452)EH
Primary Job Piece No: 27191(04)
Contract Description: PEDESTRIAN IMPROVEMENTS US-60B & US-77: ON US-60B, FROM MAIN ST. EXTEND EAST. ON US-77, FROM GRAND AVE. EXTEND SOUTH. BOTH IN THE TOWN OF TONKAWA. PROJECT LENGTH = 0.748 MILES. PREQUALIFICATION FOR THIS PROJECT HAS BEEN WAIVED.
Primary County: KAY              
Name of Road: US-60B/US-77              
Prime Contractor: HEMBREE & HODGSON CONSTRUCTION, LLC              
    4501 N. HWY. 77 ACCESS ROAD              
    PONCA CIITY , OK   74601              
Surety Company: OKLAHOMA SURETY COMPANY              

Date Let: 02/25/2010 NTP Effective Date: 05/03/2010 Pay Period: 06/14/2011  TO  07/19/2011
Date Awarded: 03/01/2010 Date Work Began: 04/19/2010 Original Contract Time: 60
Date Contract Executed: 03/09/2010 Date Time Stopped: 12/08/2010 Current Time Charged: 234.00
Date NTP Issued: 03/22/2010 Completion Date: 12/08/2010 Current Time Allowed: 235.00
General Liability Expires: 06/12/2012 Workman's Comp Expires: 04/01/2011 Percent Time Used: 99.57 %
Specification Year: 1999        

Current Contract Amount: $339,560.09 Total to Date Prev to Date This Estimate
Bid Amount: $323,564.00 Participating: $335,790.34 $335,790.34 $0.00
Percent Complete: 100 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $-0.04 Non ARRA: $3,769.79 $3,769.79 $0.00
Unearned Balance: $-15,996.13 Total Earnings: $339,560.13 $339,560.13 $0.00
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $339,560.13 $339,560.13 $0.00
Other Adjustments: $0.00 $0.00 $0.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $339,560.13 $339,560.13 $0.00

Estimate Adjustment Detail

Contract ID: 100035   Estimate Number: 0013     Primary JP: 27191(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 PROVIDE FOR OVERRUNS OF HANDRAIL AND CURB & GUTTER Approved 08/09/2010 0.0 $11,518.11
002 ADD SPECIAL GRATING TO DRAINAGE INLET Approved 09/29/2010 0.0 $3,769.79
003 PROVIDE FOR OVERRUN OF SPECIALTY CURB Approved 02/08/2011 0.0 $2,158.00
004 FINAL QUANTITY CHANGE ORDER Approved 07/11/2011 0.0 $-1,449.81


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
No line item adjustments have been created on this contract.
Subtotals For Line Item Adjustments $0.00


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

Line Item Detail

Contract ID: 100035   Estimate Number: 0013     Primary JP: 27191(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(452)EH Project:    27191(04) Category:    0100/ROADWAY
0001 UNCLASSIFIED EXCAVATION 202(A) 0183 CY 100.000 10.260   10.260 $29.30 $0.00 $300.62
0002 TEMPORARY SILT FENCE 223 2801 LF 1,075.000 0.000   0.000 $1.88 $0.00 $0.00
0003 TEMPORARY SEDIMENT FILTER 224 2803 EA 1.000 0.000   0.000 $650.00 $0.00 $0.00
0004 SOLID SLAB SODDING 230(A) 2806 SY 580.000 512.860   512.860 $5.00 $0.00 $2,564.30
0005 AGGREGATE BASE 303 0192 CY 263.000 341.950   341.950 $52.38 $0.00 $17,911.35
0006 H.E.S. CONCRETE (FULL DEPTH PATCHING) 414(B) 5913 SY 253.000 338.500   338.500 $76.00 $0.00 $25,726.00
0007 CLSM BACKFILL 501(G) 6309 CY 60.000 21.000   21.000 $127.00 $0.00 $2,667.00
0008 HANDRAILING 504(G) 6006 LF 76.000 146.000   146.000 $96.50 $0.00 $14,089.00
0009 TYPE IV GROUTED RIPRAP 601(D) 1390 SY 70.000 18.330   18.330 $72.93 $0.00 $1,336.81
0010 2'-8" COMB. CURB & GUTTER (4" MNTBLE) 609(B) 1523 LF 512.000 664.000   664.000 $22.13 $0.00 $14,694.32
0011 2'-8" COMB. CURB & GUTTER (6" MNTBLE) 609(B) 1524 LF 528.000 585.000   585.000 $24.55 $0.00 $14,361.75
0012 (PL)SPECIALTY CURB 609(E) 0150 LF 155.000 220.000   220.000 $33.20 $0.00 $7,304.00
0013 4" CONCRETE SIDEWALK 610(A) 0602 SY 2,603.000 2,131.600   2,131.600 $41.76 $0.00 $89,015.62
0014 6" CONCRETE DRIVEWAY (H.E.S.) 610(B) 0399 SY 1,327.000 1,780.370   1,780.370 $39.50 $0.00 $70,324.63
0015 (PL)TACTILE WARNING DEVICE-NEW 610(I) 4610 SF 376.000 401.000   401.000 $20.45 $0.00 $8,200.45
0016 INLET GPI TYPE 2 (DES. 10) 611(E) 5336 EA 1.000 1.000   1.000 $3,550.00 $0.00 $3,550.00
0017 36" R.C.PIPE CLASS III 613(B) 0494 LF 10.000 12.000   12.000 $147.00 $0.00 $1,764.00
0018 TRENCH EXCAVATION 613(S) 1180 CY 10.000 12.340   12.340 $24.00 $0.00 $296.16
0019 STANDARD BEDDING MATERIAL 613(T) 1181 CY 5.000 9.010   9.010 $82.00 $0.00 $738.82
0020 REMOVAL OF STRUCTURES & OBSTRUCTIONS 619(A) 0920 LSUM 1.000 1.000   1.000 $6,298.00 $0.00 $6,298.00
0021 REMOVAL OF CONCRETE DRIVEWAY 619(B) 4766 SY 1,327.000 1,776.190   1,776.190 $7.76 $0.00 $13,783.25
0022 REMOVAL OF CURB 619(B) 4791 LF 900.000 413.000   413.000 $6.81 $0.00 $2,812.53
0023 REMOVAL OF SIDEWALK 619(B) 4792 SY 2,074.000 2,117.840   2,117.840 $4.75 $0.00 $10,059.73
0024 SAWING PAVEMENT 619(C) 0924 LF 100.000 0.000   0.000 $4.00 $0.00 $0.00
Subtotals For Category     0100/ROADWAY    $0.00 $307,798.34
Fed/State Project Number:    STP-STIM(452)EH Project:    27191(04) Category:    0300/TRAFFIC
0025 TRAFFIC STRIPE(PLASTIC)(4" WIDE) 855(A) 8812 LF 888.000 1,712.000   1,712.000 $3.50 $0.00 $5,992.00
0026 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $6,000.00 $0.00 $6,000.00
Subtotals For Category     0300/TRAFFIC    $0.00 $11,992.00
Fed/State Project Number:    STP-STIM(452)EH Project:    27191(04) Category:    0600/STAKING
0027 STAKING 642 0098 LSUM 1.000 1.000   1.000 $6,500.00 $0.00 $6,500.00
Subtotals For Category     0600/STAKING    $0.00 $6,500.00
Fed/State Project Number:    STP-STIM(452)EH Project:    27191(04) Category:    0640/CONSTRUCTION
0028 MOBILIZATION 641 1552 LSUM 1.000 1.000   1.000 $9,500.00 $0.00 $9,500.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $9,500.00
Fed/State Project Number:    STP-STIM(452)EH Project:    27191(04) Category:    0850/NON ARRA FUNDING
0029 CONSTRUCTION MISCELLANEOUS 104 0700 LSUM 0.000 1.000   1.000 $3,769.79 $0.00 $3,769.79
Subtotals For Category     0850/NON ARRA FUNDING    $0.00 $3,769.79
Subtotals For Project STP-STIM(452)EH /27191(04) $0.00 $339,560.13