Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 100200   Estimate Number: 0011 , Final     Spec Year: 1999
Primary JP: 14960(04)   Residency: ENID (04300)     Contract No: 511173
Date Created: 05/10/2012   Contractor FEI: 730731258     Account No: 400400

Project Number(s): NH-STIM(528)
Contract Description: GRADE, DRAIN AND SURFACE US-81: FROM THE KINGFISHER/GARFIELD COUNTY LINE, EXTEND NORTH. PROJECT LENGTH = 7.00 MILES.
Primary County: GARFIELD              
Name of Road: US-81              
Prime Contractor: HASKELL LEMON CONSTRUCTION CO.           Time Charged: 314.00
    P. O. BOX 75608           Time Allowed: 395.00
    OKLAHOMA CITY , OK   73147-0608           Percent Time: 79.49 %

  Paid To Date: $3,912,674.82 Payable This Statement: $-7,323.30

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.                                
HASKELL LEMON CONSTRUCTION CO.                               
 
_________________________________________________
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:    05/10/2012
Contract ID: 100200   Estimate Number: 0011     Contract No: 511173
Residency: ENID (04300)   Estimate Type: Final     Account No: 400400

Project Number(s): NH-STIM(528)
Primary Job Piece No: 14960(04)
Contract Description: GRADE, DRAIN AND SURFACE US-81: FROM THE KINGFISHER/GARFIELD COUNTY LINE, EXTEND NORTH. PROJECT LENGTH = 7.00 MILES.
Primary County: GARFIELD              
Name of Road: US-81              
Prime Contractor: HASKELL LEMON CONSTRUCTION CO.              
    P. O. BOX 75608              
    OKLAHOMA CITY , OK   73147-0608              
Surety Company: WESTERN SURETY COMPANY              

Date Let: 03/18/2010 NTP Effective Date: 08/02/2010 Pay Period: 04/01/2011  TO  05/10/2012
Date Awarded: 04/12/2010 Date Work Began: 07/29/2010 Original Contract Time: 180
Date Contract Executed: 04/21/2010 Date Time Stopped: 06/07/2011 Current Time Charged: 314.00
Date NTP Issued: 04/27/2010 Completion Date: 06/07/2011 Current Time Allowed: 395.00
General Liability Expires: 07/01/2012 Workman's Comp Expires: 07/01/2012 Percent Time Used: 79.49 %
Specification Year: 1999        

Current Contract Amount: $3,915,746.37 Total to Date Prev to Date This Estimate
Bid Amount: $4,496,190.84 Participating: $3,881,299.94 $3,892,370.54 $-11,070.60
Percent Complete: 99.92 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $3,071.55 Non ARRA: $34,446.47 $31,651.97 $2,794.50
Unearned Balance: $583,516.02 Total Earnings: $3,915,746.41 $3,924,022.51 $-8,276.10
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $3,915,746.41 $3,924,022.51 $-8,276.10
Other Adjustments: $-3,071.59 $-4,024.39 $952.80
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $3,912,674.82 $3,919,998.12 $-7,323.30

Estimate Adjustment Detail

Contract ID: 100200   Estimate Number: 0011     Primary JP: 14960(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Addition of pay item for rem. of Conc. Pave. Approved 11/08/2010 0.0 $9,865.20
002 Pay plan quantity excavation and AC Deductions Approved 02/13/2012 0.0 $-9,053.87
003 Final Quantity Change Order Approved 04/20/2012 0.0 $-581,255.80


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.
Subtotals For Liquidated Damages $


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
14960(04) 0016 (SP)ASPHALT CONCRETE TYPE S3(PG 76-28 OK) Asphalt Binder Adjustment 0004 0.00 $0.00 $-116.58
14960(04) 0016 (SP)ASPHALT CONCRETE TYPE S3(PG 76-28 OK) Asphalt Binder Adjustment 0005 0.00 $0.00 $-247.60
14960(04) 0017 (SP)ASPHALT CONCRETE TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0004 0.00 $0.00 $-174.91
14960(04) 0017 (SP)ASPHALT CONCRETE TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0005 0.00 $0.00 $-776.33
14960(04) 0017 (SP)ASPHALT CONCRETE TYPE S3(PG 64-22 OK) * Asphalt Binder Adjustment 0011 0.00 $0.00 $952.80
14960(04) 0018 (SP)ASPHALT CONCRETE TYPE S4(PG 76-28 OK) Asphalt Binder Adjustment 0005 0.00 $0.00 $-1,747.82
14960(04) 0019 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0005 0.00 $0.00 $-961.15
Subtotals For Line Item Adjustments $-3,071.59
* = User applied Line Item Adjustments


MILESTONE INFORMATION
Milestone Number Milestone Description Start Date End Date Current Time Allowed Rate Milestone Closed
No milestones exist for this contract.


MILESTONE ADJUSTMENTS
Milestone Number Milestone Adjustment Description Estimate Nbr Total
No milestones adjustments exist for this contract.
Subtotals For Milestones $

Line Item Detail

Contract ID: 100200   Estimate Number: 0011     Primary JP: 14960(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:    NH-STIM(528) Project:    14960(04) Category:    0100/ROADWAY
0001 CLEARING AND GRUBBING 201 0102 LSUM 1.000 1.000   1.000 $22,000.00 $0.00 $22,000.00
0002 UNCLASSIFIED EXCAVATION 202(A) 0183 CY 9,829.000 9,829.000   9,829.000 $3.15 $0.00 $30,961.35
0003 UNCLASSIFIED BORROW 202(C) 0184 CY 4,181.000 14,810.300   14,810.300 $5.50 $0.00 $81,456.65
0004 TYPE A-SALVAGED TOPSOIL 205 4229 LSUM 1.000 1.000   1.000 $18,000.00 $0.00 $18,000.00
0005 TEMPORARY SEDIMENT FILTER 224 2803 EA 1.000 1.000   1.000 $200.00 $0.00 $200.00
0006 TEMPORARY SILT DIKE 227 0100 LF 266.000 84.000   84.000 $15.00 $0.00 $1,260.00
0007 SOLID SLAB SODDING 230(A) 2806 SY 51,053.000 51,723.220   51,723.220 $1.35 $0.00 $69,826.35
0008 VEGETATIVE MULCHING 233(A) 2817 AC 9.000 0.000   0.000 $300.00 $0.00 $0.00
0009 MOWING 241 2832 AC 18.000 0.000   0.000 $45.00 $0.00 $0.00
0010 AGGREGATE BASE 303 0192 CY 4,969.000 5,682.840 -133.070 5,682.840 $54.00 $-7,185.78 $306,873.36
0011 SEPARATOR FABRIC 325 5271 SY 19,920.000 25,445.530 -625.020 25,445.530 $1.30 $-812.53 $33,079.18
0012 (SP)STABILIZED SUBGRADE 327(K) 4300 SY 23,966.000 28,088.410 669.770 28,088.410 $4.75 $3,181.41 $133,419.95
0013 TRAFFIC BOUND SURFACE COURSE TYPE E 403(E) 0225 TON 4,707.000 2,772.700   2,772.700 $28.65 $0.00 $79,437.86
0014 TACK COAT 407 0250 GAL 14,874.000 12,392.500 317.500 12,392.500 $2.00 $635.00 $24,785.00
0015 PRIME COAT 408 5774 GAL 7,226.000 0.000   0.000 $4.80 $0.00 $0.00
0016 (SP)ASPHALT CONCRETE TYPE S3(PG 76-28 OK) 411(S3) 5935 TON 2,681.000 2,830.290   2,830.290 $61.70 $0.00 $174,628.89
0017 (SP)ASPHALT CONCRETE TYPE S3(PG 64-22 OK) 411(S3) 5945 TON 4,592.000 4,844.080 0.000 4,844.080 $51.70 $0.00 $250,438.94
0018 (SP)ASPHALT CONCRETE TYPE S4(PG 76-28 OK) 411(S4) 5950 TON 37,868.000 27,762.460   27,762.460 $64.50 $0.00 $1,790,678.68
0019 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) 411(S4) 5960 TON 628.000 1,318.220   1,318.220 $59.00 $0.00 $77,774.98
0020 COLD MILLING PAVEMENT 417 5267 SY 253,715.000 247,322.670 0.290 247,322.670 $0.75 $0.22 $185,492.02
0021 STRUCTURAL EXCAVATION UNCLASSIFIED 501(A) 0313 CY 56.000 8.830 -34.980 8.830 $21.00 $-734.58 $185.43
0022 CLASS AA CONCRETE 509(A) 0319 CY 26.000 25.380 2.400 25.380 $475.00 $1,140.00 $12,055.50
0023 CLASS C CONCRETE 509(D) 0325 CY 1,079.000 1,023.830 0.080 1,023.830 $210.00 $16.80 $215,004.30
0024 REINFORCING STEEL 511(A) 0332 LB 3,908.000 3,320.000 -67.000 3,320.000 $0.80 $-53.60 $2,656.00
0025 INLET (SMD-TYPE 2) 611(E) 6002 EA 1.000 1.000   1.000 $1,400.00 $0.00 $1,400.00
0026 18" CORR. GALV. STEEL PIPE 613(D) 0689 LF 126.000 126.000   126.000 $15.00 $0.00 $1,890.00
0027 REMOVAL OF ASPHALT PAVEMENT 619(B) 4728 SY 14,957.000 14,999.890 -0.010 14,999.890 $2.30 $-0.02 $34,499.75
0028 SAWING PAVEMENT 619(C) 0924 LF 1,498.000 0.000   0.000 $2.00 $0.00 $0.00
8001 DEDUCTION FOR FAILING MATERIAL 105 2325 EA 0.000 1.000 1.000 1.000 $-9,053.87 $-9,053.87 $-9,053.87
Subtotals For Category     0100/ROADWAY    $-12,866.95 $3,538,950.32
Fed/State Project Number:    NH-STIM(528) Project:    14960(04) Category:    0300/TRAFFIC
0029 RELOCATION OF RENTED PORTABLE TYPE PRECAST CONCRETE MEDIAN 627(O) 4410 LF 1,587.500 2,225.000 200.000 2,225.000 $5.00 $1,000.00 $11,125.00
0030 RENTED PORTABLE TYPE PRECAST CONCRETE MEDIAN BARRIER 627(P) 4425 LF 1,875.000 1,850.000 25.000 1,850.000 $30.00 $750.00 $55,500.00
0031 CONSTRUCTION TRAFFIC STRIPE(PAINT)(4" WIDE) 856(A) 8839 LF 9,000.000 9,784.000   9,784.000 $0.11 $0.00 $1,076.24
0032 (PL)CONSTRUCTION ZONE PAVEMENT MARKERS(FLEX TAB)TYPE 2-1 856(G) 8887 EA 9,240.000 8,558.000   8,558.000 $1.00 $0.00 $8,558.00
0033 (PL)SAND FILLED IMPACT ATTENUATION SYSTEM 870(A) 8490 SD 240.000 109.000   109.000 $10.50 $0.00 $1,144.50
0034 (PL)TRUCK MOUNTED ATTENUATOR 876(C) 8482 SD 60.000 0.000   0.000 $75.00 $0.00 $0.00
0035 ARROW DISPLAY(TYPE C) 880(A) 8812 SD 120.000 128.000   128.000 $5.25 $0.00 $672.00
0036 CONSTRUCTION SIGNS 0 TO 6.25 SF 880(B) 8818 SD 8,850.000 8,382.000   8,382.000 $0.11 $0.00 $922.02
0037 CONSTRUCTION SIGNS 6.26 SF TO 15.99 SF 880(B) 8821 SD 4,090.000 4,108.000   4,108.000 $1.05 $0.00 $4,313.40
0038 CONSTRUCTION SIGNS 16.0 SF TO 32.99 SF 880(B) 8824 SD 5,390.000 4,836.000   4,836.000 $1.57 $0.00 $7,592.52
0039 BARRICADES(TYPE III) 880(C) 8842 SD 1,890.000 1,023.000   1,023.000 $0.26 $0.00 $265.98
0040 WING BARRICADES 880(C) 8848 SD 480.000 488.000   488.000 $2.10 $0.00 $1,024.80
0041 WARNING LIGHTS(TYPE A) 880(E) 8860 SD 7,870.000 5,137.000   5,137.000 $0.11 $0.00 $565.07
0042 WARNING LIGHTS(TYPE C) 880(E) 8872 SD 27,000.000 2,917.000   2,917.000 $0.06 $0.00 $175.02
0043 DRUMS 880(F) 8878 SD 16,200.000 3,057.000   3,057.000 $0.11 $0.00 $336.27
0044 CHANNELIZER CONES 880(G) 8890 SD 10,750.000 14,493.000   14,493.000 $0.11 $0.00 $1,594.23
0045 PORT.CHANGEABLE MESSAGE SIGN 882(B) 8306 SD 240.000 0.000   0.000 $13.00 $0.00 $0.00
Subtotals For Category     0300/TRAFFIC    $1,750.00 $94,865.05
Fed/State Project Number:    NH-STIM(528) Project:    14960(04) Category:    0301/SIGNING & STRIPING
0046 SHEET ALUMINUM SIGNS 850(A) 8110 SF 101.600 101.600   101.600 $12.60 $0.00 $1,280.16
0047 2" SQUARE TUBE POST 851(C) 8324 LF 224.000 280.000   280.000 $8.40 $0.00 $2,352.00
0048 TRAFFIC STRIPE(PLASTIC)(4" WIDE) 855(A) 8812 LF 153,958.000 147,287.000 -319.000 147,287.000 $0.35 $-111.65 $51,550.45
0049 TRAFFIC STRIPE(PLASTIC)(6" WIDE) 855(A) 8813 LF 23,568.000 19,776.000 -200.000 19,776.000 $0.46 $-92.00 $9,096.96
0050 TRAFFIC STRIPE(PLASTIC)(ARROWS) 855(B) 8818 EA 28.000 28.000   28.000 $78.75 $0.00 $2,205.00
0051 (PL)REMOVE & RESET EXISTING SIGNS 890A/B 8756 EA 60.000 0.000   0.000 $78.75 $0.00 $0.00
Subtotals For Category     0301/SIGNING & STRIPING    $-203.65 $66,484.57
Fed/State Project Number:    NH-STIM(528) Project:    14960(04) Category:    0600/STAKING
0052 STAKING 642 0098 LSUM 1.000 1.000   1.000 $40,000.00 $0.00 $40,000.00
Subtotals For Category     0600/STAKING    $0.00 $40,000.00
Fed/State Project Number:    NH-STIM(528) Project:    14960(04) Category:    0640/CONSTRUCTION
0053 (SP)SWPPP DOCUMENTATION AND MANAGEMENT 220 2800 LSUM 1.000 1.000 0.250 1.000 $1,000.00 $250.00 $1,000.00
0054 MOBILIZATION 641 1552 LSUM 1.000 1.000   1.000 $140,000.00 $0.00 $140,000.00
Subtotals For Category     0640/CONSTRUCTION    $250.00 $141,000.00
Fed/State Project Number:    NH-STIM(528) Project:    14960(04) Category:    0850/NON ARRA FUNDING
8000 REMOVAL OF CONCRETE PAVEMENT 619(B) 4727 SY 0.000 8,505.300 690.000 8,505.300 $4.05 $2,794.50 $34,446.47
Subtotals For Category     0850/NON ARRA FUNDING    $2,794.50 $34,446.47
Subtotals For Project NH-STIM(528) /14960(04) $-8,276.10 $3,915,746.41