Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 100079   Estimate Number: 0012 , Final     Spec Year: 1999
Primary JP: 27212(04)   Residency: DUNCAN (07100)     Contract No: 510977
Date Created: 01/30/2012   Contractor FEI: 730799069     Account No: 555700

Project Number(s): STP-STIM(473)EH
Contract Description: PEDESTRIAN IMPROVEMENTS SH-5: FROM COMMERCIAL AVE. TO 4TH ST., IN THE CITY OF HASTINGS. PROJECT LENGTH = 0.192 MILES. PREQUALIFICATION FOR THIS PROJECT HAS BEEN WAIVED.
Primary County: JEFFERSON              
Name of Road: SH-5              
Prime Contractor: T & G CONSTRUCTION, INC.           Time Charged: 232.00
    800 S. E. 1ST STREET           Time Allowed: 167.00
    LAWTON , OK   73501           Percent Time: 138.92 %

  Paid To Date: $235,079.47 Payable This Statement: $1,196.77

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.                                
T & G CONSTRUCTION, 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:    01/30/2012
Contract ID: 100079   Estimate Number: 0012     Contract No: 510977
Residency: DUNCAN (07100)   Estimate Type: Final     Account No: 555700

Project Number(s): STP-STIM(473)EH
Primary Job Piece No: 27212(04)
Contract Description: PEDESTRIAN IMPROVEMENTS SH-5: FROM COMMERCIAL AVE. TO 4TH ST., IN THE CITY OF HASTINGS. PROJECT LENGTH = 0.192 MILES. PREQUALIFICATION FOR THIS PROJECT HAS BEEN WAIVED.
Primary County: JEFFERSON              
Name of Road: SH-5              
Prime Contractor: T & G CONSTRUCTION, INC.              
    800 S. E. 1ST STREET              
    LAWTON , OK   73501              
Surety Company: WESTFIELD INSURANCE COMPANY              

Date Let: 02/25/2010 NTP Effective Date: 05/03/2010 Pay Period: 12/20/2010  TO  12/20/2010
Date Awarded: 03/01/2010 Date Work Began: 05/03/2010 Original Contract Time: 60
Date Contract Executed: 03/17/2010 Date Time Stopped: 12/20/2010 Current Time Charged: 232.00
Date NTP Issued: 03/25/2010 Completion Date: 12/20/2010 Current Time Allowed: 167.00
General Liability Expires: 10/01/2012 Workman's Comp Expires: 10/01/2012 Percent Time Used: 138.92 %
Specification Year: 1999        

Current Contract Amount: $267,167.36 Total to Date Prev to Date This Estimate
Bid Amount: $226,517.00 Participating: $267,167.36 $265,970.61 $1,196.75
Percent Complete: 87.99 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $32,087.89 Non ARRA: $0.00 $0.00 $0.00
Unearned Balance: $-8,562.47 Total Earnings: $267,167.36 $265,970.61 $1,196.75
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $267,167.36 $265,970.61 $1,196.75
Other Adjustments: $412.11 $412.09 $0.02
Liq Dam/Disincentive: $-32,500.00 $-32,500.00 $0.00
TOTAL: $235,079.47 $233,882.70 $1,196.77

Estimate Adjustment Detail

Contract ID: 100079   Estimate Number: 0012     Primary JP: 27212(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Finalizing Contract Item Quanties Approved 10/24/2011 0.0 $40,650.36


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 0003 -9.0 $500.00 $-4,500.00
System Application of Liquidated Damages 0004 -16.0 $500.00 $-8,000.00
System Application of Liquidated Damages 0005 -15.0 $500.00 $-7,500.00
System Application of Liquidated Damages 0006 -16.0 $500.00 $-8,000.00
System Application of Liquidated Damages 0007 -15.0 $500.00 $-7,500.00
System Application of Liquidated Damages 0008 --6.0 $500.00 $3,000.00
System Application of Liquidated Damages 0009 -0.0 $500.00 $0.00
System Application of Liquidated Damages 0010 -0.0 $500.00 $0.00
System Application of Liquidated Damages 0011 -0.0 $500.00 $0.00


CONTRACT ADJUSTMENTS HISTORY
Adjustment Description Estimate Nbr Adjustment Amount
Withhold to Funds Avail(Prog. Est. Only) 0010 $-2,131.39
Withhold to Funds Avail(Prog. Est. Only) 0011 $2,131.39
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
27212(04) 0007 (SP)ASPHALT CONCRETE TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0007 0.00 $0.00 $198.11
27212(04) 0007 (SP)ASPHALT CONCRETE TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0012 -0.12 $0.32 $-0.04
27212(04) 0008 (SP)ASPHALT CONCRETE TYPE S4(PG 70-28 OK) Asphalt Binder Adjustment 0007 0.00 $0.00 $213.98
27212(04) 0008 (SP)ASPHALT CONCRETE TYPE S4(PG 70-28 OK) Asphalt Binder Adjustment 0012 0.16 $0.37 $0.06
Subtotals For Line Item Adjustments $412.11


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

Line Item Detail

Contract ID: 100079   Estimate Number: 0012     Primary JP: 27212(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(473)EH Project:    27212(04) Category:    0100/ROADWAY
0001 TEMPORARY SILT FENCE 223 2801 LF 1,600.000 0.000   0.000 $3.00 $0.00 $0.00
0002 TEMPORARY SILT DIKE 227 0100 LF 800.000 0.000   0.000 $8.00 $0.00 $0.00
0003 SOLID SLAB SODDING 230(A) 2806 SY 283.000 55.560 0.000 55.560 $6.00 $0.00 $333.36
0004 SUBGRADE, METHOD B 310(B) 0149 SY 266.000 0.000   0.000 $2.50 $0.00 $0.00
0005 TRAFFIC BOUND SURFACE COURSE TYPE E 403(E) 0225 TON 23.000 4.000 0.000 4.000 $75.00 $0.00 $300.00
0006 TACK COAT 407 0250 GAL 9.000 0.000   0.000 $8.00 $0.00 $0.00
0007 (SP)ASPHALT CONCRETE TYPE S3(PG 64-22 OK) 411(S3) 5945 TON 33.000 110.150 -0.120 110.150 $125.00 $-15.00 $13,768.75
0008 (SP)ASPHALT CONCRETE TYPE S4(PG 70-28 OK) 411(S4) 5955 TON 21.000 104.380 0.160 104.380 $275.00 $44.00 $28,704.50
0009 (SP)ASPHALT CONCRETE, TYPE S4(PATCHING)(PG 64-22 OK) 411(S4) 6310 TON 22.000 0.000   0.000 $200.00 $0.00 $0.00
0010 HANDRAILING 504(G) 6006 LF 64.000 114.990 0.000 114.990 $160.00 $0.00 $18,398.40
0011 CLASS A CONCRETE 509(B) 0321 CY 6.000 9.830 0.000 9.830 $1,500.00 $0.00 $14,745.00
0012 REINFORCING STEEL 511(A) 0332 LB 442.000 401.000 0.000 401.000 $1.00 $0.00 $401.00
0013 CONCRETE CURB (4" MNTBLE-INTEGRAL) 609(A) 0287 LF 58.000 0.000   0.000 $15.00 $0.00 $0.00
0014 CONCRETE CURB (6" BARRIER-DOWELLED) 609(A) 5864 LF 444.000 104.990   104.990 $15.00 $0.00 $1,574.85
0015 COMBINED CURB & GUTTER (6" BARRIER) 609(B) 0383 LF 1,120.000 1,143.000 0.000 1,143.000 $18.00 $0.00 $20,574.00
0016 2'-8" COMB. CURB & GUTTER (4" MNTBLE) 609(B) 1523 LF 608.000 667.000 0.000 667.000 $20.00 $0.00 $13,340.00
0017 4" CONCRETE SIDEWALK 610(A) 0602 SY 1,487.000 1,617.380 0.480 1,617.380 $40.00 $19.20 $64,695.20
0018 6" CONCRETE SIDEWALK 610(A) 0605 SY 18.000 359.030 3.750 359.030 $55.00 $206.25 $19,746.65
0019 6" CONCRETE DRIVEWAY (H.E.S.) 610(B) 0399 SY 35.000 42.650   42.650 $70.00 $0.00 $2,985.50
0020 8" CONCRETE DRIVEWAY (H.E.S.) 610(B) 0400 SY 38.000 0.000   0.000 $85.00 $0.00 $0.00
0021 (PL)TACTILE WARNING DEVICE-NEW 610(I) 4610 SF 192.000 192.000 0.000 192.000 $37.50 $0.00 $7,200.00
0022 VALVE BOXES ADJUST TO GRADE 612(G) 0647 EA 1.000 0.000   0.000 $200.00 $0.00 $0.00
0023 REMOVAL OF STRUCTURES & OBSTRUCTIONS 619(A) 0920 LSUM 1.000 1.000 0.000 1.000 $5,000.00 $0.00 $5,000.00
0024 REMOVAL OF FENCE 619(B) 4725 LF 48.000 0.000   0.000 $5.00 $0.00 $0.00
0025 REMOVAL OF CONCRETE PAVEMENT 619(B) 4727 SY 15.000 60.600 0.000 60.600 $10.00 $0.00 $606.00
0026 REMOVAL OF ASPHALT PAVEMENT 619(B) 4728 SY 1,225.000 1,121.780 1.000 1,121.780 $10.00 $10.00 $11,217.80
0027 REMOVAL OF CURB 619(B) 4791 LF 115.000 116.000 0.000 116.000 $5.00 $0.00 $580.00
0028 REMOVAL OF SIDEWALK 619(B) 4792 SY 700.000 729.270 186.460 729.270 $5.00 $932.30 $3,646.35
0029 SAWING PAVEMENT 619(C) 0924 LF 2,142.000 1,960.000   1,960.000 $5.00 $0.00 $9,800.00
Subtotals For Category     0100/ROADWAY    $1,196.75 $237,617.36
Fed/State Project Number:    STP-STIM(473)EH Project:    27212(04) Category:    0300/TRAFFIC
0030 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000 0.000 1.000 $3,950.00 $0.00 $3,950.00
0031 (PL)REMOVE & RESET LIGHT POLE 890A/B 8744 EA 2.000 1.500 0.000 1.500 $3,600.00 $0.00 $5,400.00
0032 (PL)REMOVE & RESET GROUND MOUNTED SIGN 890A/B 8760 EA 10.000 10.000 0.000 10.000 $120.00 $0.00 $1,200.00
Subtotals For Category     0300/TRAFFIC    $0.00 $10,550.00
Fed/State Project Number:    STP-STIM(473)EH Project:    27212(04) Category:    0600/STAKING
0033 STAKING 642 0098 LSUM 1.000 1.000 0.000 1.000 $4,000.00 $0.00 $4,000.00
Subtotals For Category     0600/STAKING    $0.00 $4,000.00
Fed/State Project Number:    STP-STIM(473)EH Project:    27212(04) Category:    0640/CONSTRUCTION
0034 MOBILIZATION 641 1552 LSUM 1.000 1.000 0.000 1.000 $15,000.00 $0.00 $15,000.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $15,000.00
Subtotals For Project STP-STIM(473)EH /27212(04) $1,196.75 $267,167.36