Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 100082   Estimate Number: 0010 , Final     Spec Year: 1999
Primary JP: 27202(04)   Residency: ALTUS (05200)     Contract No: 511305
Date Created: 10/24/2011   Contractor FEI: 730776271     Account No: 555500

Project Number(s): STP-STIM(463)EH, STP-STIM(463) PART 3 EH
Contract Description: PEDESTRIAN IMPROVEMENTS/RESURFACE (ASPHALT) US-183: FROM 5TH ST., EXTEND NORTH IN THE TOWN OF HOBART. PROJECT LENGTH = 1.38 MILES.
Primary County: KIOWA              
Name of Road: US-183              
Prime Contractor: SEWELL BROS., INC.           Time Charged: 364.00
    1220 E. MAIN           Time Allowed: 365.00
    CORDELL , OK   73632           Percent Time: 99.73 %

  Paid To Date: $564,723.88 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.                                
SEWELL BROS., 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:    10/24/2011
Contract ID: 100082   Estimate Number: 0010     Contract No: 511305
Residency: ALTUS (05200)   Estimate Type: Final     Account No: 555500

Project Number(s): STP-STIM(463)EH, STP-STIM(463) PART 3 EH
Primary Job Piece No: 27202(04)
Contract Description: PEDESTRIAN IMPROVEMENTS/RESURFACE (ASPHALT) US-183: FROM 5TH ST., EXTEND NORTH IN THE TOWN OF HOBART. PROJECT LENGTH = 1.38 MILES.
Primary County: KIOWA              
Name of Road: US-183              
Prime Contractor: SEWELL BROS., INC.              
    1220 E. MAIN              
    CORDELL , OK   73632              
Surety Company: WESTFIELD INSURANCE COMPANY              

Date Let: 04/15/2010 NTP Effective Date: 07/05/2010 Pay Period: 09/16/2011  TO  10/15/2011
Date Awarded: 05/03/2010 Date Work Began: 07/06/2010 Original Contract Time: 90
Date Contract Executed: 05/19/2010 Date Time Stopped: 06/30/2011 Current Time Charged: 364.00
Date NTP Issued: 05/26/2010 Completion Date: 06/30/2011 Current Time Allowed: 365.00
General Liability Expires: 07/01/2012 Workman's Comp Expires: 07/01/2012 Percent Time Used: 99.73 %
Specification Year: 1999        

Current Contract Amount: $569,156.39 Total to Date Prev to Date This Estimate
Bid Amount: $517,232.50 Participating: $564,690.22 $564,690.22 $0.00
Percent Complete: 99.22 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $4,432.51 Non ARRA: $4,466.18 $4,466.18 $0.00
Unearned Balance: $-47,491.38 Total Earnings: $569,156.40 $569,156.40 $0.00
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $569,156.40 $569,156.40 $0.00
Other Adjustments: $-4,432.52 $-4,432.52 $0.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $564,723.88 $564,723.88 $0.00

Estimate Adjustment Detail

Contract ID: 100082   Estimate Number: 0010     Primary JP: 27202(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Handrail Approved 09/14/2011 0.0 $67,678.82
002 Final Quantity Change Order Approved 10/12/2011 0.0 $-15,754.93


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 -42.0 $500.00 $-21,000.00
System Application of Liquidated Damages 0009 --42 $500.00 $21,000.00


CONTRACT ADJUSTMENTS HISTORY
Adjustment Description Estimate Nbr Adjustment Amount
Withhold to Funds Avail(Prog. Est. Only) 0008 $-5,000.00
Withhold to Funds Avail(Prog. Est. Only) 0009 $5,000.00
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
27202(04) 0007 (PL)TACTILE WARNING DEVICE-NEW * Material Discrepancy Adjustments 0002 -40.00 $30.00 $-1,200.00
27202(04) 0007 (PL)TACTILE WARNING DEVICE-NEW * Material Discrepancy Adjustments 0003 40.00 $30.00 $1,200.00
27202(04) 0021 CONSTRUCTION TRAFFIC CONTROL * Material Discrepancy Adjustments 0001 -0.10 $4,450.00 $-445.00
27202(04) 0021 CONSTRUCTION TRAFFIC CONTROL * Material Discrepancy Adjustments 0003 0.10 $4,450.00 $445.00
27202(06) 0025 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0008 0.00 $0.00 $-4,432.52
27202(06) 0027 TRAFFIC STRIPE(PLASTIC)(4" WIDE) * Material Discrepancy Adjustments 0008 -766.00 $0.75 $-574.50
27202(06) 0027 TRAFFIC STRIPE(PLASTIC)(4" WIDE) * Material Discrepancy Adjustments 0009 766.00 $0.75 $574.50
27202(06) 0028 TRAFFIC STRIPE(PLASTIC)(ARROWS) * Material Discrepancy Adjustments 0008 -9.00 $90.00 $-810.00
27202(06) 0028 TRAFFIC STRIPE(PLASTIC)(ARROWS) * Material Discrepancy Adjustments 0009 9.00 $90.00 $810.00
Subtotals For Line Item Adjustments $-4,432.52
* = 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: 100082   Estimate Number: 0010     Primary JP: 27202(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(463)EH Project:    27202(04) Category:    0100/ROADWAY STP-STIM(463)EH
0001 TEMPORARY SILT FENCE 223 2801 LF 200.000 0.000   0.000 $3.00 $0.00 $0.00
0002 AGGREGATE BASE 303 5912 TON 1,854.000 1,522.440   1,522.440 $20.00 $0.00 $30,448.80
0003 TRAFFIC BOUND SURFACE COURSE TYPE A 403(A) 0217 TON 40.500 0.000   0.000 $22.00 $0.00 $0.00
0004 COMBINED CURB & GUTTER (6" BARRIER) 609(B) 0383 LF 1,937.500 2,651.420   2,651.420 $25.00 $0.00 $66,285.50
0005 4" CONCRETE SIDEWALK 610(A) 0602 SY 2,199.000 2,220.180   2,220.180 $40.00 $0.00 $88,807.20
0006 6" CONCRETE DRIVEWAY (H.E.S.) 610(B) 0399 SY 2,128.500 1,454.490   1,454.490 $50.00 $0.00 $72,724.50
0007 (PL)TACTILE WARNING DEVICE-NEW 610(I) 4610 SF 208.000 304.000   304.000 $30.00 $0.00 $9,120.00
0008 MANHOLES ADJUST TO GRADE 612(A) 0641 EA 1.000 1.000   1.000 $500.00 $0.00 $500.00
0009 INLETS ADJUST TO GRADE 612(E) 0645 EA 5.000 0.000   0.000 $1,500.00 $0.00 $0.00
0010 VALVE BOXES ADJUST TO GRADE 612(G) 0647 EA 11.000 0.000   0.000 $150.00 $0.00 $0.00
0011 METER BOXES ADJUST TO GRADE 612(H) 0648 EA 13.000 13.000   13.000 $150.00 $0.00 $1,950.00
0012 (PL)RESET LIGHT POLES 612(P) 0674 EA 1.000 0.000   0.000 $2,750.00 $0.00 $0.00
0013 REMOVAL OF STRUCTURES & OBSTRUCTIONS 619(A) 0920 LSUM 1.000 1.000   1.000 $3,500.00 $0.00 $3,500.00
0014 REMOVAL OF CURB AND GUTTER 619(B) 4726 LF 1,898.000 2,597.020   2,597.020 $5.00 $0.00 $12,985.10
0015 REMOVAL OF ASPHALT PAVEMENT 619(B) 4728 SY 716.000 822.870   822.870 $3.00 $0.00 $2,468.61
0016 REMOVAL OF CONCRETE DRIVEWAY 619(B) 4766 SY 789.000 903.890   903.890 $4.00 $0.00 $3,615.56
0017 REMOVAL OF SIDEWALK 619(B) 4792 SY 1,240.000 1,630.630   1,630.630 $2.00 $0.00 $3,261.26
0018 REMOVAL OF RAILROAD 619(B) 4822 LF 30.000 0.000   0.000 $20.00 $0.00 $0.00
0019 SAWING PAVEMENT 619(C) 0924 LF 2,281.000 2,809.350   2,809.350 $4.00 $0.00 $11,237.40
Subtotals For Category     0100/ROADWAY STP-STIM(463)EH    $0.00 $306,903.93
Fed/State Project Number:    STP-STIM(463)EH Project:    27202(04) Category:    0300/TRAFFIC STP-STIM(463)EH
0020 2 1/4" SQUARE TUBE POST 851(C) 8327 LF 176.000 0.000   0.000 $3.50 $0.00 $0.00
0021 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $4,450.00 $0.00 $4,450.00
0022 (PL)REMOVE & RESET EXISTING SIGNS 890A/B 8756 EA 14.000 3.000   3.000 $170.00 $0.00 $510.00
Subtotals For Category     0300/TRAFFIC STP-STIM(463)EH    $0.00 $4,960.00
Fed/State Project Number:    STP-STIM(463)EH Project:    27202(04) Category:    0600/STAKING STP-STIM(463)EH
0023 STAKING 642 0098 LSUM 1.000 1.000   1.000 $6,500.00 $0.00 $6,500.00
Subtotals For Category     0600/STAKING STP-STIM(463)EH    $0.00 $6,500.00
Fed/State Project Number:    STP-STIM(463)EH Project:    27202(04) Category:    0640/CONSTRUCTION STP-STIM(463)EH
0024 MOBILIZATION 641 1552 LSUM 1.000 1.000   1.000 $15,000.00 $0.00 $15,000.00
Subtotals For Category     0640/CONSTRUCTION STP-STIM(463)EH    $0.00 $15,000.00
Fed/State Project Number:    STP-STIM(463)EH Project:    27202(04) Category:    0850/NON ARRA FUNDING
8001 HANDRAILING 504(G) 6006 LF 0.000 52.500   52.500 $85.07 $0.00 $4,466.18
Subtotals For Category     0850/NON ARRA FUNDING    $0.00 $4,466.18
Subtotals For Project STP-STIM(463)EH /27202(04) $0.00 $337,830.11


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(463) PART 3 EH Project:    27202(06) Category:    0100/ROADWAY STP-STIM(463)PT. 3 EH
0025 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) 411(S4) 5960 TON 1,487.000 2,287.160   2,287.160 $79.00 $0.00 $180,685.64
0026 COLD MILLING PAVEMENT 417 5267 SY 16,205.000 21,000.510   21,000.510 $2.00 $0.00 $42,001.02
0027 TRAFFIC STRIPE(PLASTIC)(4" WIDE) 855(A) 8812 LF 6,936.000 10,439.500   10,439.500 $0.75 $0.00 $7,829.63
0028 TRAFFIC STRIPE(PLASTIC)(ARROWS) 855(B) 8818 EA 8.000 9.000   9.000 $90.00 $0.00 $810.00
Subtotals For Category     0100/ROADWAY STP-STIM(463)PT. 3 EH    $0.00 $231,326.29
Subtotals For Project STP-STIM(463) PART 3 EH /27202(06) $0.00 $231,326.29