Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 100312   Estimate Number: 0004 , Final     Spec Year: 1999
Primary JP: 27383(04)   Residency: GARVER, LLC. (08011)     Contract No: 610179
Date Created: 02/09/2012   Contractor FEI: 481131853     Account No: 400850

Project Number(s): STP-STIM(507)IG
Contract Description: INTERSECTION MODIFICATION AND TRAFFIC SIGNAL CITY STREET (86TH STREET): AT THE INTERSECTION OF GARNETT ROAD IN THE CITY OF OWASSO. PROJECT LENGTH = 0.066 MILES.
Primary County: TULSA              
Name of Road: CITY STREET              
Prime Contractor: CROSSLAND HEAVY CONTRACTORS INC.           Time Charged: N/A
    P. O. BOX 350           Time Allowed: N/A
    COLUMBUS , KS   66725           Percent Time: N/A

  Paid To Date: $261,216.91 Payable This Statement: $-5,338.32

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.                                
CROSSLAND HEAVY CONTRACTORS 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:    02/09/2012
Contract ID: 100312   Estimate Number: 0004     Contract No: 610179
Residency: GARVER, LLC. (08011)   Estimate Type: Final     Account No: 400850

Project Number(s): STP-STIM(507)IG
Primary Job Piece No: 27383(04)
Contract Description: INTERSECTION MODIFICATION AND TRAFFIC SIGNAL CITY STREET (86TH STREET): AT THE INTERSECTION OF GARNETT ROAD IN THE CITY OF OWASSO. PROJECT LENGTH = 0.066 MILES.
Primary County: TULSA              
Name of Road: CITY STREET              
Prime Contractor: CROSSLAND HEAVY CONTRACTORS INC.              
    P. O. BOX 350              
    COLUMBUS , KS   66725              
Surety Company: FIDELITY & DEPOSIT INSURANCE COMPANY OF MARYLAND              

Date Let: 06/17/2010 NTP Effective Date: 11/14/2010 Pay Period: 12/01/2010  TO  02/01/2012
Date Awarded: 07/06/2010 Date Work Began: 09/09/2010 Original Contract Time: N/A
Date Contract Executed: 07/16/2010 Date Time Stopped: 12/16/2010 Current Time Charged: N/A
Date NTP Issued: 07/16/2010 Completion Date: 12/16/2010 Current Time Allowed: N/A
General Liability Expires: 04/30/2012 Workman's Comp Expires: 04/30/2012 Percent Time Used: N/A
Specification Year: 1999 FIXED COMPLETION DATE: 12/16/2010    

Current Contract Amount: $264,598.81 Total to Date Prev to Date This Estimate
Bid Amount: $269,000.00 Participating: $264,598.83 $266,824.11 $-2,225.28
Percent Complete: 98.72 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $3,381.90 Non ARRA: $0.00 $0.00 $0.00
Unearned Balance: $7,783.09 Total Earnings: $264,598.83 $266,824.11 $-2,225.28
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $264,598.83 $266,824.11 $-2,225.28
Other Adjustments: $-3,381.92 $-268.88 $-3,113.04
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $261,216.91 $266,555.23 $-5,338.32

Estimate Adjustment Detail

Contract ID: 100312   Estimate Number: 0004     Primary JP: 27383(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Extension of Contract Time Approved 02/03/2011 31.0 $0.00
002 Final Quantity Change Order Approved 08/09/2011 0.0 $-4,401.19


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
27383(04) 0011 (SP)ASPHALT CONCRETE TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0002 0.00 $0.00 $-121.00
27383(04) 0011 (SP)ASPHALT CONCRETE TYPE S3(PG 64-22 OK) * HMA Deduction as per Sec. 411 0004 -27.46 $77.00 $-2,114.42
27383(04) 0012 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0002 0.00 $0.00 $-147.88
27383(04) 0012 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) * HMA Deduction as per Sec. 411 0004 -11.22 $89.00 $-998.58
27383(04) 0029 REMOVAL OF CONCRETE PAVEMENT * Rounding Error Correction 0004 0.00 $0.00 $-0.01
27383(04) 0031 REMOVAL OF SIDEWALK * Rounding Error Correction 0004 0.00 $0.00 $-0.01
27383(04) 0033 SOLID SLAB SODDING * Rounding Error Correction 0004 0.00 $0.00 $-0.01
27383(04) 0079 MOBILIZATION * Rounding Error Correction 0004 0.00 $0.00 $-0.01
Subtotals For Line Item Adjustments $-3,381.92
* = 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: 100312   Estimate Number: 0004     Primary JP: 27383(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(507)IG Project:    27383(04) Category:    0100/ROADWAY
0001 CLEARING AND GRUBBING 201 0102 LSUM 1.000 1.000   1.000 $1,597.00 $0.00 $1,597.00
0002 EARTHWORK 202(G) 0185 LSUM 1.000 1.000   1.000 $9,500.00 $0.00 $9,500.00
0003 TEMPORARY SILT FENCE 223 2801 LF 680.000 634.000   634.000 $1.00 $0.00 $634.00
0004 TEMPORARY SEDIMENT FILTER 224 2803 EA 1.000 0.000   0.000 $85.00 $0.00 $0.00
0005 SOLID SLAB SODDING 230(A) 2806 SY 434.000 1,962.650 0.550 1,962.650 $3.35 $1.84 $6,574.87
0006 SEEDING METHOD A 232(A) 2813 AC 0.100 0.000   0.000 $350.00 $0.00 $0.00
0007 VEGETATIVE MULCHING 233(A) 2817 AC 0.100 0.000   0.000 $575.00 $0.00 $0.00
0008 AGGREGATE BASE 303 0192 CY 219.000 219.000   219.000 $51.00 $0.00 $11,169.00
0009 SUBGRADE, METHOD B 310(B) 0149 SY 1,355.000 1,355.000   1,355.000 $0.90 $0.00 $1,219.50
0010 SEPARATOR FABRIC 325 5271 SY 1,355.000 1,355.000   1,355.000 $2.50 $0.00 $3,387.50
0011 (SP)ASPHALT CONCRETE TYPE S3(PG 64-22 OK) 411(S3) 5945 TON 102.000 113.530 0.000 113.530 $77.00 $0.00 $8,741.81
0012 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) 411(S4) 5960 TON 174.000 121.410 0.000 121.410 $89.00 $0.00 $10,805.49
0013 9" P.C. DOWEL JOINTED CONCRETE PAVEMENT 414(A1) 5754 SY 973.000 973.000   973.000 $63.00 $0.00 $61,299.00
0014 COLD MILLING BITUMINOUS PAVEMENT 417 4267 SY 256.000 182.260   182.260 $23.00 $0.00 $4,191.98
0015 CONCRETE CURB (6" BARRIER-INTEGRAL) 609(A) 0300 LF 488.000 477.000   477.000 $15.50 $0.00 $7,393.50
0016 COMBINED CURB & GUTTER (6" BARRIER) 609(B) 0383 LF 190.000 189.000 -9.000 189.000 $26.50 $-238.50 $5,008.50
0017 4" CONCRETE SIDEWALK 610(A) 0602 SY 192.000 204.590 -23.820 204.590 $31.00 $-738.42 $6,342.29
0018 (PL)4" DECORATIVE CONCRETE SIDEWALK 610(A) 0650 SY 17.000 13.320 2.220 13.320 $150.00 $333.00 $1,998.00
0019 (PL)TACTILE WARNING DEVICE-NEW 610(I) 4610 SF 24.000 24.000   24.000 $41.00 $0.00 $984.00
0020 INLET CICI DES. 1 (STD) 611(E) 5100 EA 1.000 1.000   1.000 $1,800.00 $0.00 $1,800.00
0021 INLET CICI DES. 2 (STD) 611(E) 5112 EA 1.000 0.000   0.000 $1,900.00 $0.00 $0.00
0022 INLET FRM&GRT (SSIF-FRM,CIG-GRT-RVG-F) 611(G) 4489 EA 3.000 1.000   1.000 $410.00 $0.00 $410.00
0023 CAST IRON CURB INLETS 611(K) 4488 EA 3.000 1.000   1.000 $150.00 $0.00 $150.00
0024 4" PERFORATED PIPE UNDERDRAIN ROUND 613(P) 1089 LF 131.000 196.000   196.000 $12.50 $0.00 $2,450.00
0025 PIPE UNDERDRAIN COVER MAT'L. 613(R) 1100 CY 20.000 16.840 -7.260 16.840 $33.00 $-239.58 $555.72
0026 18" DUCTILE IRON PIPE 616(A) 5125 LF 10.000 10.000   10.000 $225.00 $0.00 $2,250.00
0027 REMOVAL OF STRUCTURES & OBSTRUCTIONS 619(A) 0920 LSUM 1.000 1.000   1.000 $3,500.00 $0.00 $3,500.00
0028 REMOVAL OF CURB AND GUTTER 619(B) 4726 LF 372.000 377.600   377.600 $5.50 $0.00 $2,076.80
0029 REMOVAL OF CONCRETE PAVEMENT 619(B) 4727 SY 329.000 387.470 0.000 387.470 $12.25 $0.00 $4,746.51
0030 REMOVAL OF ASPHALT PAVEMENT 619(B) 4728 SY 121.000 0.000   0.000 $4.00 $0.00 $0.00
0031 REMOVAL OF SIDEWALK 619(B) 4792 SY 252.000 247.930 -4.810 247.930 $2.75 $-13.23 $681.81
0032 SAWING PAVEMENT 619(C) 0924 LF 357.000 339.000 -28.000 339.000 $3.75 $-105.00 $1,271.25
Subtotals For Category     0100/ROADWAY    $-999.89 $160,738.53
Fed/State Project Number:    STP-STIM(507)IG Project:    27383(04) Category:    0101/ROADWAY - ADD ALT
0033 SOLID SLAB SODDING 230(A) 2806 SY 277.000 277.780 0.010 277.780 $3.50 $0.04 $972.24
0034 SEEDING METHOD A 232(A) 2813 AC 0.100 0.000   0.000 $350.00 $0.00 $0.00
0035 VEGETATIVE MULCHING 233(A) 2817 AC 0.100 0.000   0.000 $575.00 $0.00 $0.00
0036 9" P.C. DOWEL JOINTED CONCRETE PAVEMENT 414(A1) 5754 SY 10.000 8.330   8.330 $84.00 $0.00 $699.72
0037 CLASS A CONCRETE FOR SMALL STRUCTURES 509(C) 0322 CY 0.800 0.860 0.020 0.860 $550.00 $11.00 $473.00
0038 4" CONCRETE SIDEWALK 610(A) 0602 SY 80.000 127.220   127.220 $31.50 $0.00 $4,007.43
0039 MANHOLE FRAME & COVER 611(D) 4215 EA 1.000 1.000   1.000 $325.00 $0.00 $325.00
0040 INLET CICI DES. 2 (STD) 611(E) 5112 EA 1.000 1.000   1.000 $1,900.00 $0.00 $1,900.00
0041 INLET FRM&GRT (SSIF-FRM,CIG-GRT-RVG-F) 611(G) 4489 EA 2.000 2.000   2.000 $825.00 $0.00 $1,650.00
0042 JUNCTION BOXES 611(J) 0487 CF 35.000 15.800 0.290 15.800 $65.00 $18.85 $1,027.00
0043 CAST IRON CURB INLETS 611(K) 4488 EA 2.000 2.000   2.000 $155.00 $0.00 $310.00
0044 18" R.C.PIPE CLASS III 613(B) 0491 LF 250.000 250.000   250.000 $70.00 $0.00 $17,500.00
Subtotals For Category     0101/ROADWAY - ADD ALT    $29.89 $28,864.39
Fed/State Project Number:    STP-STIM(507)IG Project:    27383(04) Category:    0300/TRAFFIC SIGNALS
0045 (PL)REMOVE & RELOCATE TRAFFIC SIGNAL 612(O) 0673 LSUM 1.000 1.000   1.000 $4,800.00 $0.00 $4,800.00
0046 2" PVC SCH.40 PLASTIC CONDUIT TRENCHED 802(B) 8342 LF 10.000 10.000   10.000 $11.80 $0.00 $118.00
0047 STRUCTURAL CONCRETE 804(A) 2915 CY 6.500 6.500 0.300 6.500 $580.00 $174.00 $3,770.00
0048 REINFORCING STEEL 804(B) 2916 LB 956.200 956.200 22.300 956.200 $1.40 $31.22 $1,338.68
0049 32'MH POLE,55'TS & 10'LMA(G.STL.) 806(A) 8353 EA 1.000 1.000   1.000 $10,500.00 $0.00 $10,500.00
0050 8' MTG.HT.TS PED.POLE(G.STL.) 806(B) 8892 EA 1.000 1.000   1.000 $650.00 $0.00 $650.00
0051 (PL)ROADWAY LUMINAIRE 809(A) 8090 EA 1.000 1.000   1.000 $400.00 $0.00 $400.00
0052 1/C NO.10 ELECTRICAL CONDUCTOR 811 8044 LF 157.000 288.000 -94.000 288.000 $0.75 $-70.50 $216.00
0053 SIGNAL SYSTEM CONTROLLER UPGRADE 825 8559 EA 1.000 1.000   1.000 $3,500.00 $0.00 $3,500.00
0054 1WAY 3SEC. ADJ. SIG. HD. S-6 831 8231 EA 3.000 4.000   4.000 $600.00 $0.00 $2,400.00
0055 1WAY 3SEC. ADJ. SIG. HD. S-9 831 8252 EA 2.000 2.000   2.000 $595.00 $0.00 $1,190.00
0056 1WAY 5SEC. ADJ. SIG. HD. S-19 831 8286 EA 3.000 3.000   3.000 $1,140.00 $0.00 $3,420.00
0057 1WAY 2SEC. ADJ. PED. SIG. HD. S-20 831 8295 EA 2.000 2.000   2.000 $475.00 $0.00 $950.00
0058 5/C TRAF.SIG.ELECT.CABLE 834(A) 8207 LF 650.000 650.000   650.000 $1.30 $0.00 $845.00
0059 7/C TRAF.SIG.ELECT.CABLE 834(A) 8208 LF 110.000 110.000   110.000 $1.40 $0.00 $154.00
0060 12/C TRAF.SIG.ELECT.CABLE 834(A) 8210 LF 420.000 420.000   420.000 $2.85 $0.00 $1,197.00
0061 15/C TRAF.SIG.EL.CABLE 834(A) 8211 LF 400.000 400.000   400.000 $3.45 $0.00 $1,380.00
0062 (PL)RESET OF PULL BOX 890(B) 8728 EA 1.000 1.000   1.000 $120.00 $0.00 $120.00
0063 (PL)REMOVE & RESET TRAFFIC SIGNAL EQUIPMENT 890A/B 8742 LSUM 1.000 1.000   1.000 $2,900.00 $0.00 $2,900.00
Subtotals For Category     0300/TRAFFIC SIGNALS    $134.72 $39,848.68
Fed/State Project Number:    STP-STIM(507)IG Project:    27383(04) Category:    0310/TRAFFIC STRIPING
0064 TRAFFIC STRIPE(PLASTIC)(4" WIDE) 855(A) 8812 LF 2,686.000 2,471.000   2,471.000 $0.75 $0.00 $1,853.25
0065 TRAFFIC STRIPE(PLASTIC)(8" WIDE) 855(A) 8814 LF 518.000 495.000   495.000 $2.00 $0.00 $990.00
0066 TRAFFIC STRIPE(PLASTIC)(24" WIDE) 855(A) 8825 LF 170.000 158.000   158.000 $5.75 $0.00 $908.50
0067 TRAFFIC STRIPE(PLASTIC)(ARROWS) 855(B) 8818 EA 20.000 20.000   20.000 $101.00 $0.00 $2,020.00
0068 CONSTRUCTION TRAFFIC STRIPE(PAINT)(4" WIDE) 856(A) 8839 LF 2,300.000 0.000   0.000 $0.12 $0.00 $0.00
0069 PAVEMENT MARKING REMOVAL(TRAFFIC STRIPE) 859(A) 8006 LF 1,500.000 1,696.000   1,696.000 $0.55 $0.00 $932.80
0070 PAVEMENT MARKING REMOVAL(ARROWS) 859(B) 8007 EA 10.000 2.000   2.000 $150.00 $0.00 $300.00
0071 PAVEMENT MARKING REMOVAL(WORDS) 859(B) 8008 EA 3.000 1.000   1.000 $150.00 $0.00 $150.00
0072 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $3,800.00 $0.00 $3,800.00
Subtotals For Category     0310/TRAFFIC STRIPING    $0.00 $10,954.55
Fed/State Project Number:    STP-STIM(507)IG Project:    27383(04) Category:    0320/SIGNING
0073 SHEET ALUMINUM SIGNS 850(A) 8110 SF 65.500 65.500   65.500 $17.75 $0.00 $1,162.63
0074 MAST ARM MOUNTED SIGNS(ALUMINUM) 850(C) 8118 SF 36.250 36.250   36.250 $32.50 $0.00 $1,178.13
0075 2"@3.65 GALV.STEEL PIPE POST 851(B) 3216 LF 64.000 64.000   64.000 $21.50 $0.00 $1,376.00
0076 (PL)REMOVE & RESET EXISTING SIGNS 890A/B 8756 EA 4.000 3.000 3.000 3.000 $120.00 $360.00 $360.00
0077 (PL)REMOVE & RESET GROUND MOUNTED SIGN 890A/B 8760 EA 1.000 1.000   1.000 $120.00 $0.00 $120.00
Subtotals For Category     0320/SIGNING    $360.00 $4,196.76
Fed/State Project Number:    STP-STIM(507)IG Project:    27383(04) Category:    0600/STAKING
0078 STAKING 642 0098 LSUM 1.000 1.000 -0.500 1.000 $3,500.00 $-1,750.00 $3,500.00
Subtotals For Category     0600/STAKING    $-1,750.00 $3,500.00
Fed/State Project Number:    STP-STIM(507)IG Project:    27383(04) Category:    0640/CONSTRUCTION
0079 MOBILIZATION 641 1552 LSUM 1.000 1.000 0.000 1.000 $16,495.91 $0.00 $16,495.92
Subtotals For Category     0640/CONSTRUCTION    $0.00 $16,495.92
Subtotals For Project STP-STIM(507)IG /27383(04) $-2,225.28 $264,598.83