Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 100057   Estimate Number: 0011 , Final     Spec Year: 1999
Primary JP: 27206(04)   Residency: BUFFALO (06100)     Contract No: 610010
Date Created: 05/18/2012   Contractor FEI: 731587199     Account No: 555600

Project Number(s): STP-STIM(467)EH, STP-STIM(467) PART 3 EH
Contract Description: PEDESTRIAN IMPROVEMENTS/RESURFACE (ASPHALT) SH-45: FROM MC CLURE AVENUE, EXTEND EAST IN THE TOWN OF GOLTRY. PROJECT LENGTH = 0.863 MILES.
Primary County: ALFALFA              
Name of Road: SH-45              
Prime Contractor: HEMBREE & HODGSON CONSTRUCTION, LLC           Time Charged: 409.00
    4501 N. HWY. 77 ACCESS ROAD           Time Allowed: 408.00
    PONCA CIITY , OK   74601           Percent Time: 100.25 %

  Paid To Date: $518,566.24 Payable This Statement: $2,269.55

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:    05/18/2012
Contract ID: 100057   Estimate Number: 0011     Contract No: 610010
Residency: BUFFALO (06100)   Estimate Type: Final     Account No: 555600

Project Number(s): STP-STIM(467)EH, STP-STIM(467) PART 3 EH
Primary Job Piece No: 27206(04)
Contract Description: PEDESTRIAN IMPROVEMENTS/RESURFACE (ASPHALT) SH-45: FROM MC CLURE AVENUE, EXTEND EAST IN THE TOWN OF GOLTRY. PROJECT LENGTH = 0.863 MILES.
Primary County: ALFALFA              
Name of Road: SH-45              
Prime Contractor: HEMBREE & HODGSON CONSTRUCTION, LLC              
    4501 N. HWY. 77 ACCESS ROAD              
    PONCA CIITY , OK   74601              
Surety Company: OKLAHOMA SURETY COMPANY              

Date Let: 04/15/2010 NTP Effective Date: 07/19/2010 Pay Period: 04/01/2011  TO  03/07/2012
Date Awarded: 05/03/2010 Date Work Began: 08/16/2010 Original Contract Time: 90
Date Contract Executed: 05/26/2010 Date Time Stopped: 09/28/2011 Current Time Charged: 409.00
Date NTP Issued: 06/08/2010 Completion Date: 09/28/2011 Current Time Allowed: 408.00
General Liability Expires: 06/12/2012 Workman's Comp Expires: 04/01/2012 Percent Time Used: 100.25 %
Specification Year: 1999        

Current Contract Amount: $521,797.64 Total to Date Prev to Date This Estimate
Bid Amount: $491,607.33 Participating: $521,098.54 $519,528.10 $1,570.44
Percent Complete: 99.38 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $3,231.40 Non ARRA: $699.11 $0.00 $699.11
Unearned Balance: $-26,958.91 Total Earnings: $521,797.65 $519,528.10 $2,269.55
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $521,797.65 $519,528.10 $2,269.55
Other Adjustments: $-2,731.41 $-2,731.41 $0.00
Liq Dam/Disincentive: $-500.00 $-500.00 $0.00
TOTAL: $518,566.24 $516,296.69 $2,269.55

Estimate Adjustment Detail

Contract ID: 100057   Estimate Number: 0011     Primary JP: 27206(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Pedestrain improvements in Goltry Approved 08/04/2010 0.0 $0.00
002 Additional Appropriations Approved 03/15/2011 0.0 $27,732.89
003 Finalizing Contr. Item Quantities Approved 03/05/2012 0.0 $2,457.42


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
System Application of Liquidated Damages 0008 --1.0 $500.00 $-500.00
Subtotals For Liquidated Damages $-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
27206(06) 0030 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0008 1,251.17 $-2.17 $-2,725.05
27206(06) 0030 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0009 4.03 $-1.57 $-6.36
Subtotals For Line Item Adjustments $-2,731.41


MILESTONE INFORMATION
Milestone Number Milestone Description Start Date End Date Current Time Allowed Rate Milestone Closed
No milestones exist for this contract.


MILESTONE ADJUSTMENTS
Milestone Number Milestone Adjustment Description Estimate Nbr Total
No milestones adjustments exist for this contract.
Subtotals For Milestones $

Line Item Detail

Contract ID: 100057   Estimate Number: 0011     Primary JP: 27206(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(467)EH Project:    27206(04) Category:    0100/ROADWAY STP-STIM(467)EH
0001 SELECTIVE CLEARING 201 0181 LSUM 1.000 1.000   1.000 $4,960.00 $0.00 $4,960.00
0002 UNCLASSIFIED EXCAVATION 202(A) 0183 CY 563.000 623.290 9.820 623.290 $24.87 $244.22 $15,501.22
0003 SOLID SLAB SODDING 230(A) 2806 SY 239.000 239.720   239.720 $4.25 $0.00 $1,018.81
0004 AGGREGATE BASE 303 0192 CY 476.000 583.470   583.470 $61.26 $0.00 $35,743.36
0005 TRAFFIC BOUND SURFACE COURSE TYPE A 403(A) 0217 TON 25.000 0.000   0.000 $46.00 $0.00 $0.00
0006 STRUCTURAL EXCAVATION UNCLASSIFIED 501(A) 0313 CY 30.000 9.710 9.710 9.710 $38.00 $368.98 $368.98
0007 HANDRAILING 504(G) 6006 LF 44.000 64.000   64.000 $76.80 $0.00 $4,915.20
0008 CLASS A CONCRETE 509(B) 0321 CY 18.000 7.820   7.820 $556.89 $0.00 $4,354.88
0009 CLASS A CONCRETE FOR SMALL STRUCTURES 509(C) 0322 CY 22.000 19.540 -0.380 19.540 $423.85 $-161.06 $8,282.04
0010 CLASS C CONCRETE 509(D) 1331 CY 13.000 30.000   30.000 $369.24 $0.00 $11,077.20
0011 REINFORCING STEEL 511(A) 0332 LB 1,700.000 3,008.000 1,308.000 3,008.000 $1.03 $1,347.24 $3,098.24
0012 COMBINED CURB & GUTTER (8" BARRIER) 609(B) 0384 LF 1,744.000 1,780.500   1,780.500 $20.05 $0.00 $35,699.04
0013 5" CONCRETE SIDEWALK 610(A) 0604 SY 2,114.000 2,191.050   2,191.050 $49.14 $0.00 $107,668.20
0014 6" CONCRETE DRIVEWAY (H.E.S.) 610(B) 0399 SY 353.000 840.780 -14.390 840.780 $56.00 $-805.84 $47,083.68
0015 (PL)TACTILE WARNING DEVICE-NEW 610(I) 4610 SF 64.000 96.000   96.000 $21.50 $0.00 $2,064.00
0016 VALVE BOXES ADJUST TO GRADE 612(G) 0647 EA 3.000 2.000   2.000 $255.00 $0.00 $510.00
0017 METER BOXES ADJUST TO GRADE 612(H) 0648 EA 9.000 9.000   9.000 $255.00 $0.00 $2,295.00
0018 REMOVAL OF CURB AND GUTTER 619(B) 4726 LF 1,472.000 20.000   20.000 $4.08 $0.00 $81.60
0019 REMOVAL OF ASPHALT PAVEMENT 619(B) 4728 SY 220.000 614.470 -0.030 614.470 $5.85 $-0.18 $3,594.64
0020 REMOVAL OF CONCRETE DRIVEWAY 619(B) 4766 SY 353.000 477.350 15.260 477.350 $8.00 $122.08 $3,818.80
0021 REMOVAL OF SIDEWALK 619(B) 4792 SY 1,925.000 1,994.030   1,994.030 $5.95 $0.00 $11,864.48
0022 REMOVAL OF EXISTING RETAINING WALL 619(B) 6068 LF 54.000 54.000   54.000 $10.00 $0.00 $540.00
0023 SAWING PAVEMENT 619(C) 0924 LF 2,011.000 2,449.000   2,449.000 $3.50 $0.00 $8,571.50
Subtotals For Category     0100/ROADWAY STP-STIM(467)EH    $1,115.44 $313,110.87
Fed/State Project Number:    STP-STIM(467)EH Project:    27206(04) Category:    0300/TRAFFIC STP-STIM(467)EH
0024 2 1/4" SQUARE TUBE POST 851(C) 8327 LF 48.000 0.000   0.000 $14.00 $0.00 $0.00
0025 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $7,600.00 $0.00 $7,600.00
Subtotals For Category     0300/TRAFFIC STP-STIM(467)EH    $0.00 $7,600.00
Fed/State Project Number:    STP-STIM(467)EH Project:    27206(04) Category:    0600/STAKING STP-STIM(467)EH
0026 STAKING 642 0098 LSUM 1.000 1.000 0.050 1.000 $9,100.00 $455.00 $9,100.00
Subtotals For Category     0600/STAKING STP-STIM(467)EH    $455.00 $9,100.00
Fed/State Project Number:    STP-STIM(467)EH Project:    27206(04) Category:    0640/CONSTRUCTION STP-STIM(467)EH
0027 MOBILIZATION 641 1552 LSUM 1.000 1.000   1.000 $15,200.00 $0.00 $15,200.00
Subtotals For Category     0640/CONSTRUCTION STP-STIM(467)EH    $0.00 $15,200.00
Fed/State Project Number:    STP-STIM(467)EH Project:    27206(04) Category:    0850/NON ARRA FUNDING
8003 DROP INLET GRATE (42" SPDI) 611(L) 4482 EA 0.000 1.000 1.000 1.000 $699.11 $699.11 $699.11
Subtotals For Category     0850/NON ARRA FUNDING    $699.11 $699.11
Subtotals For Project STP-STIM(467)EH /27206(04) $2,269.55 $345,709.98


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(467) PART 3 EH Project:    27206(06) Category:    0100/ROADWAY STP-STIM(467)PT. 3 EH
0028 SOLID SLAB SODDING 230(A) 2806 SY 1,000.000 1,000.000   1,000.000 $4.25 $0.00 $4,250.00
0029 TACK COAT 407 0250 GAL 710.000 270.500   270.500 $3.20 $0.00 $865.60
0030 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) 411(S4) 5960 TON 1,350.000 1,255.200   1,255.200 $91.57 $0.00 $114,938.67
0031 COLD MILLING PAVEMENT 417 5267 SY 11,805.000 10,796.570   10,796.570 $3.62 $0.00 $39,083.58
0032 (SP)TRAFFIC STRIPE(MULTI-POLYMER)(4" WIDE) 854(C) 8530 LF 6,560.000 8,391.000   8,391.000 $2.02 $0.00 $16,949.82
Subtotals For Category     0100/ROADWAY STP-STIM(467)PT. 3 EH    $0.00 $176,087.67
Subtotals For Project STP-STIM(467) PART 3 EH /27206(06) $0.00 $176,087.67