Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 100098   Estimate Number: 0015 , Final     Spec Year: 1999
Primary JP: 27218(04)   Residency: CLAREMORE (08300)     Contract No: 511309
Date Created: 09/14/2011   Contractor FEI: 208746250     Account No: 555800

Project Number(s): STP-STIM(479)EH, STP-STIM(479)PART 3 EH
Contract Description: PEDESTRIAN IMPROVEMENTS/RESURFACE (ASPHALT) US-69A: FROM 4TH STREET, EXTEND NORTH IN THE TOWN OF QUAPAW. PROJECT LENGTH = 0.563 MILES.
Primary County: OTTAWA              
Name of Road: US-69A              
Prime Contractor: GLOVER & ASSOCIATES, INC.           Time Charged: 304.00
    2832 N. COUNTRY CLUB           Time Allowed: 304.00
    MUSKOGEE , OK   74403           Percent Time: 100.00 %

  Paid To Date: $396,625.25 Payable This Statement: $3,197.72

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.                                
GLOVER & ASSOCIATES, 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:    09/14/2011
Contract ID: 100098   Estimate Number: 0015     Contract No: 511309
Residency: CLAREMORE (08300)   Estimate Type: Final     Account No: 555800

Project Number(s): STP-STIM(479)EH, STP-STIM(479)PART 3 EH
Primary Job Piece No: 27218(04)
Contract Description: PEDESTRIAN IMPROVEMENTS/RESURFACE (ASPHALT) US-69A: FROM 4TH STREET, EXTEND NORTH IN THE TOWN OF QUAPAW. PROJECT LENGTH = 0.563 MILES.
Primary County: OTTAWA              
Name of Road: US-69A              
Prime Contractor: GLOVER & ASSOCIATES, INC.              
    2832 N. COUNTRY CLUB              
    MUSKOGEE , OK   74403              
Surety Company: WESTFIELD INSURANCE COMPANY              

Date Let: 04/15/2010 NTP Effective Date: 07/05/2010 Pay Period: 06/01/2011  TO  09/13/2011
Date Awarded: 05/03/2010 Date Work Began: 07/06/2010 Original Contract Time: 90
Date Contract Executed: 05/19/2010 Date Time Stopped: 05/04/2011 Current Time Charged: 304.00
Date NTP Issued: 05/27/2010 Completion Date: 05/04/2011 Current Time Allowed: 304.00
General Liability Expires: 02/01/2012 Workman's Comp Expires: 02/01/2012 Percent Time Used: 100.00 %
Specification Year: 1999        

Current Contract Amount: $398,441.14 Total to Date Prev to Date This Estimate
Bid Amount: $402,763.16 Participating: $392,702.20 $389,504.48 $3,197.72
Percent Complete: 99.54 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $1,815.89 Non ARRA: $5,738.95 $5,738.95 $0.00
Unearned Balance: $6,137.91 Total Earnings: $398,441.15 $395,243.43 $3,197.72
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $398,441.15 $395,243.43 $3,197.72
Other Adjustments: $-1,815.90 $-1,815.90 $0.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $396,625.25 $393,427.53 $3,197.72

Estimate Adjustment Detail

Contract ID: 100098   Estimate Number: 0015     Primary JP: 27218(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Supplemental agreement revising Title Sheet Approved 03/22/2011 0.0 $0.00
002 Supplemental agreement adding time. Approved 12/01/2010 10.0 $0.00
003 Supplemental agreement to remove a tree. Approved 05/02/2011 6.0 $5,738.95
004 Final Contract Item Quantities Approved 08/25/2011 0.0 $-10,060.97


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 -4.0 $500.00 $-2,000.00
System Application of Liquidated Damages 0009 -2.0 $500.00 $-1,000.00
System Application of Liquidated Damages 0010 -0.0 $500.00 $0.00
System Application of Liquidated Damages 0011 -0.0 $500.00 $0.00
System Application of Liquidated Damages 0012 -0.0 $500.00 $0.00
System Application of Liquidated Damages 0013 -0.0 $500.00 $0.00
System Application of Liquidated Damages 0013 -0.0 $500.00 $0.00
System Application of Liquidated Damages 0013 --2.0 $500.00 $1,000.00
System Application of Liquidated Damages 0013 -0.0 $500.00 $0.00
System Application of Liquidated Damages 0013 --4.0 $500.00 $2,000.00


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
27218(04) 0004 (SP)ASPHALT CONCRETE TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0010 27.70 $-1.90 $-52.79
27218(04) 0004 (SP)ASPHALT CONCRETE TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0012 5.23 $-1.38 $-7.22
27218(04) 0019 18" R.C.PIPE CLASS III * Material Discrepancy Adjustments 0007 -15.00 $44.00 $-660.00
27218(04) 0019 18" R.C.PIPE CLASS III * Material Discrepancy Adjustments 0008 15.00 $44.00 $660.00
27218(04) 0020 18" PREFAB. CULVERT END SECTION, ROUND * Material Discrepancy Adjustments 0007 -2.00 $700.00 $-1,400.00
27218(04) 0020 18" PREFAB. CULVERT END SECTION, ROUND * Material Discrepancy Adjustments 0012 2.00 $700.00 $1,400.00
27218(06) 0033 (SP)ASPHALT CONCRETE TYPE S4(PG 76-28 OK) Asphalt Binder Adjustment 0008 502.78 $-2.17 $-1,095.06
27218(06) 0034 COLD MILLING PAVEMENT * Material Discrepancy Adjustments 0008 -1.00 $660.83 $-660.83
Subtotals For Line Item Adjustments $-1,815.90
* = 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: 100098   Estimate Number: 0015     Primary JP: 27218(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(479)EH Project:    27218(04) Category:    0100/ROADWAY - STP-STIM(479)EH
0001 UNCLASSIFIED EXCAVATION 202(A) 0183 CY 250.000 287.820   287.820 $16.00 $0.00 $4,605.12
0002 UNCLASSIFIED BORROW 202(C) 0184 CY 250.000 287.820   287.820 $22.00 $0.00 $6,332.04
0003 SOLID SLAB SODDING 230(A) 2806 SY 250.000 802.220   802.220 $4.00 $0.00 $3,208.88
0004 (SP)ASPHALT CONCRETE TYPE S3(PG 64-22 OK) 411(S3) 5945 TON 64.000 32.930   32.930 $115.00 $0.00 $3,786.95
0005 H.E.S. CONCRETE CLASS A 509(B) 0295 CY 25.000 25.000   25.000 $385.00 $0.00 $9,625.00
0006 CLASS A CONCRETE FOR SMALL STRUCTURES 509(C) 0322 CY 1.200 4.220 3.020 4.220 $495.00 $1,494.90 $2,088.90
0007 CONCRETE CURB (6" BARRIER-DOWELLED) 609(A) 5864 LF 1,488.000 1,356.950   1,356.950 $18.00 $0.00 $24,425.10
0008 COMBINED CURB & GUTTER (6" BARRIER) 609(B) 0383 LF 2,770.000 2,679.750   2,679.750 $14.75 $0.00 $39,526.31
0009 4" CONCRETE SIDEWALK 610(A) 0602 SY 1,222.000 1,262.610 41.320 1,262.610 $37.00 $1,528.84 $46,716.57
0010 6" CONCRETE DRIVEWAY (H.E.S.) 610(B) 0399 SY 726.000 715.910 14.670 715.910 $37.50 $550.13 $26,846.64
0011 DECORATIVE MEDIAN CONCRETE 610(C) 5824 SY 672.000 424.250 0.770 424.250 $48.98 $37.71 $20,779.76
0012 (PL)TACTILE WARNING DEVICE-NEW 610(I) 4610 SF 317.000 320.340 10.040 320.340 $28.50 $286.14 $9,129.69
0013 MANHOLE FRAME & COVER 611(D) 4215 EA 1.000 1.000   1.000 $550.00 $0.00 $550.00
0014 INLET W/SMALL JCT.BOX,CICI-JB-1,DES.2 611(E) 5970 EA 1.000 1.000   1.000 $1,650.00 $0.00 $1,650.00
0015 INLET FRM&GRT (SSIF-FRM,CIG-GRT-VG-F) 611(G) 4488 EA 2.000 2.000   2.000 $660.00 $0.00 $1,320.00
0016 CAST IRON CURB INLETS 611(K) 4488 EA 2.000 2.000   2.000 $660.00 $0.00 $1,320.00
0017 VALVE BOXES ADJUST TO GRADE 612(G) 0647 EA 4.000 0.000   0.000 $55.00 $0.00 $0.00
0018 FIRE HYDRANT RESET 612(J) 0650 EA 2.000 1.000   1.000 $1,320.00 $0.00 $1,320.00
0019 18" R.C.PIPE CLASS III 613(B) 0491 LF 28.000 161.500   161.500 $44.00 $0.00 $7,106.00
0020 18" PREFAB. CULVERT END SECTION, ROUND 613(M) 5726 EA 2.000 4.000 -1.000 4.000 $700.00 $-700.00 $2,800.00
0021 REMOVAL OF STRUCTURES & OBSTRUCTIONS 619(A) 0920 LSUM 1.000 1.000   1.000 $38,000.00 $0.00 $38,000.00
0022 REMOVAL OF FENCE 619(B) 4725 LF 34.000 34.000   34.000 $15.50 $0.00 $527.00
0023 REMOVAL OF CONCRETE PAVEMENT 619(B) 4727 SY 973.000 988.960   988.960 $9.00 $0.00 $8,900.64
0024 REMOVAL OF ASPHALT PAVEMENT 619(B) 4728 SY 1,032.000 1,032.000   1,032.000 $7.00 $0.00 $7,224.00
0025 REMOVAL OF CURB 619(B) 4791 LF 323.000 323.000   323.000 $7.70 $0.00 $2,487.10
0026 SAWING PAVEMENT 619(C) 0924 LF 3,421.000 3,073.500   3,073.500 $3.00 $0.00 $9,220.50
0027 REMOVE AND RESET MAILBOX 629(E) 5048 EA 4.000 4.000   4.000 $500.00 $0.00 $2,000.00
Subtotals For Category     0100/ROADWAY - STP-STIM(479)EH    $3,197.72 $281,496.20
Fed/State Project Number:    STP-STIM(479)EH Project:    27218(04) Category:    0300/TRAFFIC - STP-STIM(479)EH
0028 TRAFFIC STRIPE(PLASTIC)(24" WIDE) 855(A) 8825 LF 939.000 878.000   878.000 $5.50 $0.00 $4,829.00
0029 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $8,500.00 $0.00 $8,500.00
0030 (PL)REMOVE & RESET EXISTING SIGNS 890A/B 8756 EA 21.000 19.500   19.500 $200.00 $0.00 $3,900.00
Subtotals For Category     0300/TRAFFIC - STP-STIM(479)EH    $0.00 $17,229.00
Fed/State Project Number:    STP-STIM(479)EH Project:    27218(04) Category:    0600/STAKING - STP-STIM(479)EH
0031 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(479)EH    $0.00 $6,500.00
Fed/State Project Number:    STP-STIM(479)EH Project:    27218(04) Category:    0640/CONSTRUCTION - STP-STIM(479)EH
0032 MOBILIZATION 641 1552 LSUM 1.000 1.000   1.000 $30,000.00 $0.00 $30,000.00
Subtotals For Category     0640/CONSTRUCTION - STP-STIM(479)EH    $0.00 $30,000.00
Fed/State Project Number:    STP-STIM(479)EH Project:    27218(04) Category:    0850/NON ARRA FUNDING
8000 TREES 231(A) 4567 EA 0.000 1.000   1.000 $1,558.95 $0.00 $1,558.95
8001 PIPE RAILING 622(A) 4746 LF 0.000 38.000   38.000 $110.00 $0.00 $4,180.00
Subtotals For Category     0850/NON ARRA FUNDING    $0.00 $5,738.95
Subtotals For Project STP-STIM(479)EH /27218(04) $3,197.72 $340,964.15


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(479)PART 3 EH Project:    27218(06) Category:    0100/ROADWAY - STP-STIM(479)PART 3 EH
0033 (SP)ASPHALT CONCRETE TYPE S4(PG 76-28 OK) 411(S4) 5950 TON 500.000 502.780   502.780 $85.00 $0.00 $42,736.30
0034 COLD MILLING PAVEMENT 417 5267 SY 4,800.000 4,405.560   4,405.560 $2.50 $0.00 $11,013.90
0035 TRAFFIC STRIPE(PLASTIC)(4" WIDE) 855(A) 8812 LF 6,000.000 5,324.000   5,324.000 $0.70 $0.00 $3,726.80
Subtotals For Category     0100/ROADWAY - STP-STIM(479)PART 3 EH    $0.00 $57,477.00
Subtotals For Project STP-STIM(479)PART 3 EH /27218(06) $0.00 $57,477.00