Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 100157   Estimate Number: 0003 , Final     Spec Year: 1999
Primary JP: 27213(04)   Residency: ANADARKO (07300)     Contract No: 510984
Date Created: 12/28/2010   Contractor FEI: 201398755     Account No: 555700

Project Number(s): STP-STIM(474)EH
Contract Description: PEDESTRIAN IMPROVEMENTS US-277: FROM 'F' AVENUE WEST TO ONE BLOCK WEST OF MAIN STREET IN THE TOWN OF CEMENT. PROJECT LENGTH = 0.0023 MILES. PREQUALIFICATION FOR THIS PROJECT HAS BEEN WAIVED.
Primary County: CADDO              
Name of Road: US-277              
Prime Contractor: BLACO CONSTRUCTION, LLC           Time Charged: 75.00
    7700 N.W. 3RD ST.           Time Allowed: 113.00
    OKLAHOMA CITY , OK   73127           Percent Time: 66.37 %

  Paid To Date: $119,778.35 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.                                
BLACO 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:    12/28/2010
Contract ID: 100157   Estimate Number: 0003     Contract No: 510984
Residency: ANADARKO (07300)   Estimate Type: Final     Account No: 555700

Project Number(s): STP-STIM(474)EH
Primary Job Piece No: 27213(04)
Contract Description: PEDESTRIAN IMPROVEMENTS US-277: FROM 'F' AVENUE WEST TO ONE BLOCK WEST OF MAIN STREET IN THE TOWN OF CEMENT. PROJECT LENGTH = 0.0023 MILES. PREQUALIFICATION FOR THIS PROJECT HAS BEEN WAIVED.
Primary County: CADDO              
Name of Road: US-277              
Prime Contractor: BLACO CONSTRUCTION, LLC              
    7700 N.W. 3RD ST.              
    OKLAHOMA CITY , OK   73127              
Surety Company: GRANITE RE, INC.              

Date Let: 02/25/2010 NTP Effective Date: 05/03/2010 Pay Period: 07/02/2010  TO  09/22/2010
Date Awarded: 03/01/2010 Date Work Began: 06/01/2010 Original Contract Time: 60
Date Contract Executed: 03/15/2010 Date Time Stopped: 07/16/2010 Current Time Charged: 75.00
Date NTP Issued: 03/23/2010 Completion Date: 07/16/2010 Current Time Allowed: 113.00
General Liability Expires: 09/13/2011 Workman's Comp Expires: 09/13/2011 Percent Time Used: 66.37 %
Specification Year: 1999        

Current Contract Amount: $119,778.34 Total to Date Prev to Date This Estimate
Bid Amount: $66,709.35 Participating: $119,778.35 $119,778.35 $0.00
Percent Complete: 100 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $-0.01 Non ARRA: $0.00 $0.00 $0.00
Unearned Balance: $-53,069.00 Total Earnings: $119,778.35 $119,778.35 $0.00
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $119,778.35 $119,778.35 $0.00
Other Adjustments: $0.00 $0.00 $0.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $119,778.35 $119,778.35 $0.00

Estimate Adjustment Detail

Contract ID: 100157   Estimate Number: 0003     Primary JP: 27213(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Additional Appropriation Major Item Price Reduction Approved 09/08/2010 0.0 $53,744.98
002 Final Quantity Change Order Approved 12/28/2010 0.0 $-675.99


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
Withhold to Funds Avail(Prog. Est. Only) 0001 $-3,985.37
Withhold to Funds Avail(Prog. Est. Only) 0002 $3,985.37
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
27213(04) 0004 (SP)ASPHALT CONCRETE TYPE S3(PG 70-28 OK) Asphalt Binder Adjustment 0001 0.00 $0.00 $477.46
27213(04) 0004 (SP)ASPHALT CONCRETE TYPE S3(PG 70-28 OK) Asphalt Binder Adjustment 0002 0.00 $0.00 $680.99
27213(04) 0004 (SP)ASPHALT CONCRETE TYPE S3(PG 70-28 OK) * Asphalt Binder Adjustment 0002 0.00 $0.00 $-1,158.45
27213(04) 0005 (SP)ASPHALT CONCRETE TYPE S4(PG 70-28 OK) Asphalt Binder Adjustment 0002 0.00 $0.00 $365.96
27213(04) 0005 (SP)ASPHALT CONCRETE TYPE S4(PG 70-28 OK) * Asphalt Binder Adjustment 0002 0.00 $0.00 $-365.96
Subtotals For Line Item Adjustments $0.00
* = 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: 100157   Estimate Number: 0003     Primary JP: 27213(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(474)EH Project:    27213(04) Category:    0100/ROADWAY
0001 TEMPORARY SILT FENCE 223 2801 LF 120.000 0.000   0.000 $2.50 $0.00 $0.00
0002 SOLID SLAB SODDING 230(A) 2806 SY 336.000 120.310   120.310 $3.10 $0.00 $372.96
0003 TRAFFIC BOUND SURFACE COURSE TYPE E 403(E) 0225 TON 62.000 211.370   211.370 $30.15 $0.00 $6,372.81
0004 (SP)ASPHALT CONCRETE TYPE S3(PG 70-28 OK) 411(S3) 5940 TON 68.000 416.120   416.120 $112.15 $0.00 $46,667.86
0005 (SP)ASPHALT CONCRETE TYPE S4(PG 70-28 OK) 411(S4) 5955 TON 45.000 116.800   116.800 $109.80 $0.00 $12,824.64
0006 CONCRETE CURB (6" BARRIER-INTEGRAL) 609(A) 0300 LF 56.000 74.500   74.500 $14.00 $0.00 $1,043.00
0007 COMBINED CURB & GUTTER (6" BARRIER) 609(B) 0383 LF 94.000 224.750   224.750 $18.00 $0.00 $4,045.50
0008 4" CONCRETE SIDEWALK 610(A) 0602 SY 91.000 79.880   79.880 $43.00 $0.00 $3,434.84
0009 6" CONCRETE DRIVEWAY (H.E.S.) 610(B) 0399 SY 220.000 229.200   229.200 $56.70 $0.00 $12,995.64
0010 (PL)TACTILE WARNING DEVICE-NEW 610(I) 4610 SF 64.000 64.000   64.000 $22.00 $0.00 $1,408.00
0011 REMOVAL OF ASPHALT PAVEMENT 619(B) 4728 SY 1,074.000 1,160.670   1,160.670 $6.50 $0.00 $7,544.36
0012 REMOVAL OF CONCRETE DRIVEWAY 619(B) 4766 SY 56.000 78.240   78.240 $13.00 $0.00 $1,017.12
0013 REMOVAL OF CURB 619(B) 4791 LF 14.000 14.000   14.000 $26.00 $0.00 $364.00
0014 REMOVAL OF SIDEWALK 619(B) 4792 SY 39.000 9.330   9.330 $18.00 $0.00 $167.94
0015 SAWING PAVEMENT 619(C) 0924 LF 730.000 767.000   767.000 $4.00 $0.00 $3,068.00
8000 ASPHALT BINDER PRICE ADJUSTMENT 109 1150 LSUM 0.000 1.000   1.000 $1,524.41 $0.00 $1,524.41
8001 CONSTRUCTION MISCELLANEOUS 104 0150 TON 0.000 416.120   416.120 $-2.01 $0.00 $-836.40
8002 CONSTRUCTION MISCELLANEOUS 104 0150 TON 0.000 116.800   116.800 $-6.21 $0.00 $-725.33
Subtotals For Category     0100/ROADWAY    $0.00 $101,289.35
Fed/State Project Number:    STP-STIM(474)EH Project:    27213(04) Category:    0300/TRAFFIC
0016 SHEET ALUMINUM SIGNS 850(A) 8110 SF 3.000 0.000   0.000 $14.00 $0.00 $0.00
0017 2"@3.65 GALV.STEEL PIPE POST 851(B) 3216 LF 15.000 0.000   0.000 $9.00 $0.00 $0.00
0018 TRAFFIC STRIPE(PLASTIC)(4" WIDE) 855(A) 8812 LF 861.000 796.000   796.000 $1.25 $0.00 $995.00
0019 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $4,590.00 $0.00 $4,590.00
0020 (PL)REMOVE & RESET GROUND MOUNTED SIGN 890A/B 8760 EA 4.000 3.000   3.000 $218.00 $0.00 $654.00
Subtotals For Category     0300/TRAFFIC    $0.00 $6,239.00
Fed/State Project Number:    STP-STIM(474)EH Project:    27213(04) Category:    0600/STAKING
0021 STAKING 642 0098 LSUM 1.000 1.000   1.000 $5,750.00 $0.00 $5,750.00
Subtotals For Category     0600/STAKING    $0.00 $5,750.00
Fed/State Project Number:    STP-STIM(474)EH Project:    27213(04) Category:    0640/CONSTRUCTION
0022 MOBILIZATION 641 1552 LSUM 1.000 1.000   1.000 $6,500.00 $0.00 $6,500.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $6,500.00
Subtotals For Project STP-STIM(474)EH /27213(04) $0.00 $119,778.35