Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 100169   Estimate Number: 0009 , Final     Spec Year: 1999
Primary JP: 27248(04)   Residency: CLAREMORE (08300)     Contract No: 510877
Date Created: 12/14/2011   Contractor FEI: 731452899     Account No: 555800

Project Number(s): STP-STIM(489)EH
Contract Description: PEDESTRIAN IMPROVEMENTS SH-10: FROM 'C' STREET, EXTEND EAST IN THE CITY OF MIAMI. PROJECT LENGTH = 0.282 MILES.
Primary County: OTTAWA              
Name of Road: SH-10              
Prime Contractor: PBX CORPORATION           Time Charged: 354.00
    P.O. BOX 644           Time Allowed: 347.00
    SAPULPA , OK   74067           Percent Time: 102.02 %

  Paid To Date: $496,630.54 Payable This Statement: $5,000.00

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.                                
PBX CORPORATION                                
 
_________________________________________________
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:    12/14/2011
Contract ID: 100169   Estimate Number: 0009     Contract No: 510877
Residency: CLAREMORE (08300)   Estimate Type: Final     Account No: 555800

Project Number(s): STP-STIM(489)EH
Primary Job Piece No: 27248(04)
Contract Description: PEDESTRIAN IMPROVEMENTS SH-10: FROM 'C' STREET, EXTEND EAST IN THE CITY OF MIAMI. PROJECT LENGTH = 0.282 MILES.
Primary County: OTTAWA              
Name of Road: SH-10              
Prime Contractor: PBX CORPORATION              
    P.O. BOX 644              
    SAPULPA , OK   74067              
Surety Company: WESTFIELD INSURANCE COMPANY              

Date Let: 01/28/2010 NTP Effective Date: 04/05/2010 Pay Period: 06/08/2011  TO  09/23/2011
Date Awarded: 02/01/2010 Date Work Began: 05/05/2010 Original Contract Time: 60
Date Contract Executed: 02/16/2010 Date Time Stopped: 03/24/2011 Current Time Charged: 354.00
Date NTP Issued: 02/20/2010 Completion Date: 03/24/2011 Current Time Allowed: 347.00
General Liability Expires: 10/05/2012 Workman's Comp Expires: 10/05/2012 Percent Time Used: 102.02 %
Specification Year: 1999        

Current Contract Amount: $500,055.00 Total to Date Prev to Date This Estimate
Bid Amount: $484,614.50 Participating: $500,055.00 $500,055.00 $0.00
Percent Complete: 99.32 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $3,424.46 Non ARRA: $0.00 $0.00 $0.00
Unearned Balance: $-12,016.04 Total Earnings: $500,055.00 $500,055.00 $0.00
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $500,055.00 $500,055.00 $0.00
Other Adjustments: $75.54 $-4,924.46 $5,000.00
Liq Dam/Disincentive: $-3,500.00 $-3,500.00 $0.00
TOTAL: $496,630.54 $491,630.54 $5,000.00

Estimate Adjustment Detail

Contract ID: 100169   Estimate Number: 0009     Primary JP: 27248(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Additional appropriation on contract items. Approved 06/06/2011 0.0 $11,940.59
002 Final Contract Item Quantities Approved 08/09/2011 0.0 $3,499.91


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 0005 -5.0 $500.00 $-2,500.00
System Application of Liquidated Damages 0006 -0.0 $500.00 $0.00
System Application of Liquidated Damages 0007 -0.0 $500.00 $0.00
System Application of Liquidated Damages 0008 -2.0 $500.00 $-1,000.00


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
27248(04) 0003 SOLID SLAB SODDING * Material Discrepancy Adjustments 0003 -200.00 $2.00 $-400.00
27248(04) 0003 SOLID SLAB SODDING * Material Discrepancy Adjustments 0005 -1,063.12 $2.00 $-2,126.24
27248(04) 0003 SOLID SLAB SODDING * Material Discrepancy Adjustments 0007 1,263.12 $2.00 $2,526.24
27248(04) 0005 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0006 0.00 $0.00 $75.54
27248(04) 0012 (PL)TACTILE WARNING DEVICE-NEW * Material Discrepancy Adjustments 0003 -300.00 $75.00 $-22,500.00
27248(04) 0012 (PL)TACTILE WARNING DEVICE-NEW * Material Discrepancy Adjustments 0005 -120.00 $75.00 $-9,000.00
27248(04) 0012 (PL)TACTILE WARNING DEVICE-NEW * Material Discrepancy Adjustments 0007 420.00 $75.00 $31,500.00
27248(04) 0014 INLET FRM&GRT (SSIF-FRM,CIG-GRT-VG-F) * Material Discrepancy Adjustments 0004 -4.00 $750.00 $-3,000.00
27248(04) 0014 INLET FRM&GRT (SSIF-FRM,CIG-GRT-VG-F) * Missing Material Certification 0009 4.00 $750.00 $3,000.00
27248(04) 0015 CAST IRON CURB INLETS * Material Discrepancy Adjustments 0004 -4.00 $500.00 $-2,000.00
27248(04) 0015 CAST IRON CURB INLETS * Missing Material Certification 0009 4.00 $500.00 $2,000.00
Subtotals For Line Item Adjustments $75.54
* = 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: 100169   Estimate Number: 0009     Primary JP: 27248(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(489)EH Project:    27248(04) Category:    0100/ROADWAY
0001 UNCLASSIFIED EXCAVATION 202(A) 0183 CY 250.000 638.880   638.880 $5.00 $0.00 $3,194.40
0002 UNCLASSIFIED BORROW 202(C) 0184 CY 250.000 638.880   638.880 $13.00 $0.00 $8,305.44
0003 SOLID SLAB SODDING 230(A) 2806 SY 426.900 1,266.990   1,266.990 $2.00 $0.00 $2,533.98
0004 AGGREGATE BASE 303 0192 CY 477.800 507.820   507.820 $37.00 $0.00 $18,789.34
0005 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) 411(S4) 5960 TON 68.720 30.890   30.890 $95.00 $0.00 $2,934.55
0006 9" H.E.S. CONCRETE (PATCHING) 414(B) 5072 SY 613.600 610.440   610.440 $125.00 $0.00 $76,305.00
0007 CONCRETE CURB (6" BARRIER-INTEGRAL) 609(A) 0300 LF 430.600 832.800   832.800 $18.00 $0.00 $14,990.40
0008 2'-8" COMB. CURB & GUTTER (6" BARRIER) 609(B) 1525 LF 27.300 41.000   41.000 $18.00 $0.00 $738.00
0009 CONCRETE HEADER CURB (8"X 18") 609(C) 4810 LF 1,424.900 1,599.500   1,599.500 $10.00 $0.00 $15,995.00
0010 4" CONCRETE SIDEWALK 610(A) 0602 SY 1,430.100 1,524.420   1,524.420 $55.00 $0.00 $83,843.10
0011 6" CONCRETE DRIVEWAY (H.E.S.) 610(B) 0399 SY 823.000 927.800   927.800 $95.00 $0.00 $88,141.00
0012 (PL)TACTILE WARNING DEVICE-NEW 610(I) 4610 SF 506.200 420.000   420.000 $75.00 $0.00 $31,500.00
0013 INLET CICI DES. 2 (STD) 611(E) 5112 EA 1.000 1.000   1.000 $1,500.00 $0.00 $1,500.00
0014 INLET FRM&GRT (SSIF-FRM,CIG-GRT-VG-F) 611(G) 4488 EA 2.000 4.000 0.000 4.000 $750.00 $0.00 $3,000.00
0015 CAST IRON CURB INLETS 611(K) 4488 EA 2.000 4.000 0.000 4.000 $500.00 $0.00 $2,000.00
0016 MANHOLES ADJUST TO GRADE 612(A) 0641 EA 1.000 1.000   1.000 $1,000.00 $0.00 $1,000.00
0017 VALVE BOXES ADJUST TO GRADE 612(G) 0647 EA 4.000 4.000   4.000 $450.00 $0.00 $1,800.00
0018 FIRE HYDRANT RESET 612(J) 0650 EA 2.000 0.000   0.000 $750.00 $0.00 $0.00
0019 WATER METERS RESET 612(L) 0652 EA 1.000 1.000   1.000 $250.00 $0.00 $250.00
0020 (PL)RESET LIGHT POLES 612(P) 0674 EA 2.000 0.000   0.000 $1,000.00 $0.00 $0.00
0021 3/4" COPPER WATER SERVICE PIPE 616(C) 0868 LF 90.000 0.000   0.000 $10.00 $0.00 $0.00
0022 REMOVAL OF CONCRETE PAVEMENT 619(B) 4727 SY 602.720 817.230   817.230 $9.00 $0.00 $7,355.07
0023 REMOVAL OF ASPHALT PAVEMENT 619(B) 4728 SY 287.900 0.000   0.000 $6.00 $0.00 $0.00
0024 REMOVAL OF CONCRETE PAVEMENT W/ASPHALT OVERLAY 619(B) 4763 SY 729.200 849.800   849.800 $13.00 $0.00 $11,047.40
0025 REMOVAL OF CURB 619(B) 4791 LF 1,484.000 969.020   969.020 $10.00 $0.00 $9,690.20
0026 REMOVAL OF SIDEWALK 619(B) 4792 SY 1,194.400 1,077.730   1,077.730 $9.00 $0.00 $9,699.57
0027 PIPE RAILING 622(A) 4746 LF 151.500 71.060   71.060 $80.00 $0.00 $5,684.80
Subtotals For Category     0100/ROADWAY    $0.00 $400,297.25
Fed/State Project Number:    STP-STIM(489)EH Project:    27248(04) Category:    0300/TRAFFIC
0028 STRUCTURAL CONCRETE 804(A) 2915 CY 0.900 0.000   0.000 $250.00 $0.00 $0.00
0029 TRAFFIC STRIPE(PLASTIC)(4" WIDE) 855(A) 8812 LF 1,514.000 4,970.000   4,970.000 $1.40 $0.00 $6,958.00
0030 TRAFFIC STRIPE(PLASTIC)(SYMBOLS) 855(B) 8824 EA 2.000 2.000   2.000 $125.00 $0.00 $250.00
0031 PAVEMENT MARKING REMOVAL(TRAFFIC STRIPE) 859(A) 8006 LF 1,935.200 1,445.000   1,445.000 $0.35 $0.00 $505.75
0032 PAVEMENT MARKING REMOVAL(ARROWS) 859(B) 8007 EA 2.000 3.000   3.000 $50.00 $0.00 $150.00
0033 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $29,594.00 $0.00 $29,594.00
0034 (PL)REMOVE & RESET TRAFFIC SIGNAL EQUIPMENT 890A/B 8742 LSUM 1.000 1.000   1.000 $25,000.00 $0.00 $25,000.00
0035 (PL)REMOVE & RESET EXISTING SIGNS 890A/B 8756 EA 14.000 14.000   14.000 $200.00 $0.00 $2,800.00
Subtotals For Category     0300/TRAFFIC    $0.00 $65,257.75
Fed/State Project Number:    STP-STIM(489)EH Project:    27248(04) Category:    0600/STAKING
0036 STAKING 642 0098 LSUM 1.000 1.000   1.000 $4,500.00 $0.00 $4,500.00
Subtotals For Category     0600/STAKING    $0.00 $4,500.00
Fed/State Project Number:    STP-STIM(489)EH Project:    27248(04) Category:    0640/CONSTRUCTION
0037 MOBILIZATION 641 1552 LSUM 1.000 1.000   1.000 $30,000.00 $0.00 $30,000.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $30,000.00
Subtotals For Project STP-STIM(489)EH /27248(04) $0.00 $500,055.00