Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 100159   Estimate Number: 0008 , Final     Spec Year: 1999
Primary JP: 27177(04)   Residency: SALLISAW (01200)     Contract No: 510899
Date Created: 09/30/2011   Contractor FEI: 208746250     Account No: 555100

Project Number(s): STP-STIM(439)EH
Contract Description: PEDESTRIAN IMPROVEMENTS SH-2/SH-31: SH-2 FROM 4TH STREET TO NORTH OF 2ND STREET, AND SH-31 FROM HOYT TO MAIN IN THE CITY OF KINTA. PROJECT LENGTH = 0.253 MILES.
Primary County: HASKELL              
Name of Road: SH-2/SH-31              
Prime Contractor: GLOVER & ASSOCIATES, INC.           Time Charged: 328.00
    2832 N. COUNTRY CLUB           Time Allowed: 328.00
    MUSKOGEE , OK   74403           Percent Time: 100.00 %

  Paid To Date: $169,603.40 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.                                
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:    09/30/2011
Contract ID: 100159   Estimate Number: 0008     Contract No: 510899
Residency: SALLISAW (01200)   Estimate Type: Final     Account No: 555100

Project Number(s): STP-STIM(439)EH
Primary Job Piece No: 27177(04)
Contract Description: PEDESTRIAN IMPROVEMENTS SH-2/SH-31: SH-2 FROM 4TH STREET TO NORTH OF 2ND STREET, AND SH-31 FROM HOYT TO MAIN IN THE CITY OF KINTA. PROJECT LENGTH = 0.253 MILES.
Primary County: HASKELL              
Name of Road: SH-2/SH-31              
Prime Contractor: GLOVER & ASSOCIATES, INC.              
    2832 N. COUNTRY CLUB              
    MUSKOGEE , OK   74403              
Surety Company: WESTFIELD INSURANCE COMPANY              

Date Let: 01/28/2010 NTP Effective Date: 04/05/2010 Pay Period: 08/12/2011  TO  09/01/2011
Date Awarded: 02/01/2010 Date Work Began: 04/05/2010 Original Contract Time: 60
Date Contract Executed: 02/17/2010 Date Time Stopped: 02/25/2011 Current Time Charged: 328.00
Date NTP Issued: 02/24/2010 Completion Date: 02/25/2011 Current Time Allowed: 328.00
General Liability Expires: 02/01/2012 Workman's Comp Expires: 02/01/2012 Percent Time Used: 100.00 %
Specification Year: 1999        

Current Contract Amount: $169,603.36 Total to Date Prev to Date This Estimate
Bid Amount: $169,815.40 Participating: $169,364.86 $169,364.86 $0.00
Percent Complete: 100 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $-0.04 Non ARRA: $0.00 $0.00 $0.00
Unearned Balance: $212.00 Total Earnings: $169,364.86 $169,364.86 $0.00
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $169,364.86 $169,364.86 $0.00
Other Adjustments: $238.54 $238.54 $0.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $169,603.40 $169,603.40 $0.00

Estimate Adjustment Detail

Contract ID: 100159   Estimate Number: 0008     Primary JP: 27177(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 FINAL QUANTITY CHANGE ORDER Approved 09/13/2011 0.0 $-212.04


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
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
27177(04) 0006 (SP)ASPHALT CONCRETE, TYPE S4(PATCHING)(PG 64-22 OK) Asphalt Binder Adjustment 0003 0.00 $0.00 $130.71
27177(04) 0006 (SP)ASPHALT CONCRETE, TYPE S4(PATCHING)(PG 64-22 OK) Asphalt Binder Adjustment 0005 51.70 $2.08 $107.83
Subtotals For Line Item Adjustments $238.54


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

Line Item Detail

Contract ID: 100159   Estimate Number: 0008     Primary JP: 27177(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(439)EH Project:    27177(04) Category:    0100/ROADWAY
0001 TEMPORARY BALE BARRIER 222 2801 LF 200.000 0.000   0.000 $7.00 $0.00 $0.00
0002 TEMPORARY SILT FENCE 223 2801 LF 250.000 0.000   0.000 $1.20 $0.00 $0.00
0003 TEMPORARY SEDIMENT FILTER 224 2803 EA 1.000 0.000   0.000 $110.00 $0.00 $0.00
0004 SOLID SLAB SODDING 230(A) 2806 SY 1,000.000 1,376.110   1,376.110 $1.65 $0.00 $2,270.59
0005 TRAFFIC BOUND SURFACE COURSE TYPE E 403(E) 0225 TON 80.000 183.440   183.440 $50.00 $0.00 $9,172.00
0006 (SP)ASPHALT CONCRETE, TYPE S4(PATCHING)(PG 64-22 OK) 411(S4) 6310 TON 175.000 81.640   81.640 $145.00 $0.00 $11,837.80
0007 COMBINED CURB & GUTTER (6" BARRIER) 609(B) 0383 LF 620.000 631.850   631.850 $15.40 $0.00 $9,730.49
0008 4" CONCRETE SIDEWALK 610(A) 0602 SY 1,385.000 1,195.340   1,195.340 $37.40 $0.00 $44,705.73
0009 6" CONCRETE SIDEWALK 610(A) 0605 SY 56.000 286.850   286.850 $31.90 $0.00 $9,150.52
0010 6" CONCRETE DRIVEWAY (H.E.S.) 610(B) 0399 SY 200.000 507.100   507.100 $35.20 $0.00 $17,849.93
0011 (PL)TACTILE WARNING DEVICE-NEW 610(I) 4610 SF 210.000 204.000   204.000 $30.80 $0.00 $6,283.20
0012 MANHOLES ADJUST TO GRADE 612(A) 0641 EA 1.000 1.000   1.000 $440.00 $0.00 $440.00
0013 VALVE BOXES ADJUST TO GRADE 612(G) 0647 EA 1.000 1.000   1.000 $385.00 $0.00 $385.00
0014 REMOVAL OF STRUCTURES & OBSTRUCTIONS 619(A) 0920 LSUM 1.000 1.000   1.000 $20,000.00 $0.00 $20,000.00
0015 SAWING PAVEMENT 619(C) 0924 LF 1,255.000 1,260.000   1,260.000 $2.00 $0.00 $2,520.00
0016 1 1/2" PIPE RAILING 622(A) 4743 LF 105.000 68.100   68.100 $66.00 $0.00 $4,494.60
0017 (PL)STATIONARY BOLLARD 623(M) 6500 EA 4.000 4.000   4.000 $137.50 $0.00 $550.00
8000 ASPHALT BINDER PRICE ADJUSTMENT 109 1150 LSUM 0.000 1.000   0.000 $238.54 $0.00 $0.00
Subtotals For Category     0100/ROADWAY    $0.00 $139,389.86
Fed/State Project Number:    STP-STIM(439)EH Project:    27177(04) Category:    0300/TRAFFIC
0018 TRAFFIC STRIPE(PLASTIC)(24" WIDE) 855(A) 8825 LF 352.000 385.000   385.000 $7.00 $0.00 $2,695.00
0019 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $4,400.00 $0.00 $4,400.00
0020 (PL)REMOVE & RESET GROUND MOUNTED SIGN 890A/B 8760 EA 3.000 4.000   4.000 $220.00 $0.00 $880.00
Subtotals For Category     0300/TRAFFIC    $0.00 $7,975.00
Fed/State Project Number:    STP-STIM(439)EH Project:    27177(04) Category:    0600/STAKING
0021 STAKING 642 0098 LSUM 1.000 1.000   1.000 $7,000.00 $0.00 $7,000.00
Subtotals For Category     0600/STAKING    $0.00 $7,000.00
Fed/State Project Number:    STP-STIM(439)EH Project:    27177(04) Category:    0640/CONSTRUCTION
0022 MOBILIZATION 641 1552 LSUM 1.000 1.000   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(439)EH /27177(04) $0.00 $169,364.86


1 CURRENT QUANTITIES DO NOT MATCH THE QUANTITY PAID TO DATE