Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 100404   Estimate Number: 0013 , Final     Spec Year: 1999
Primary JP: 27388(04)   Residency: COBB ENGINEERING CO., INC. (08003)     Contract No: 610168
Date Created: 05/10/2013   Contractor FEI: 731079507     Account No: 400850

Project Number(s): STP-STIM(511)IG
Contract Description: PAVEMENT REHABILITATION (P.C. CONCRETE) CITY STREET (RIVERSIDE DRIVE): FROM 68TH STREET, EXTEND SOUTH TO 71ST STREET IN THE CITY OF TULSA. PROJECT LENGTH = 0.15 MILES.
Primary County: TULSA              
Name of Road: CITY STREET              
Prime Contractor: KEYSTONE SERVICES, INC.           Time Charged: 288.00
    P.O. BOX 218           Time Allowed: 320.00
    BIXBY , OK   74008           Percent Time: 90.00 %

  Paid To Date: $457,856.28 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.                                
KEYSTONE SERVICES, 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:    05/10/2013
Contract ID: 100404   Estimate Number: 0013     Contract No: 610168
Residency: COBB ENGINEERING CO., INC. (08003)   Estimate Type: Final     Account No: 400850

Project Number(s): STP-STIM(511)IG
Primary Job Piece No: 27388(04)
Contract Description: PAVEMENT REHABILITATION (P.C. CONCRETE) CITY STREET (RIVERSIDE DRIVE): FROM 68TH STREET, EXTEND SOUTH TO 71ST STREET IN THE CITY OF TULSA. PROJECT LENGTH = 0.15 MILES.
Primary County: TULSA              
Name of Road: CITY STREET              
Prime Contractor: KEYSTONE SERVICES, INC.              
    P.O. BOX 218              
    BIXBY , OK   74008              
Surety Company: MID-CONTINENT CASUALTY COMPANY              

Date Let: 06/17/2010 NTP Effective Date: 10/04/2010 Pay Period: 05/10/2013  TO  05/10/2013
Date Awarded: 07/06/2010 Date Work Began: 10/04/2010 Original Contract Time: 120
Date Contract Executed: 07/26/2010 Date Time Stopped: 07/15/2011 Current Time Charged: 288.00
Date NTP Issued: 07/29/2010 Completion Date: 07/15/2011 Current Time Allowed: 320.00
General Liability Expires: 11/01/2013 Workman's Comp Expires: 11/01/2013 Percent Time Used: 90.00 %
Specification Year: 1999        

Current Contract Amount: $458,025.72 Total to Date Prev to Date This Estimate
Bid Amount: $373,341.05 Participating: $454,145.71 $454,145.71 $0.00
Percent Complete: 99.96 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $169.44 Non ARRA: $3,880.00 $3,880.00 $0.00
Unearned Balance: $-84,515.23 Total Earnings: $458,025.71 $458,025.71 $0.00
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $458,025.71 $458,025.71 $0.00
Other Adjustments: $-169.43 $-169.43 $0.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $457,856.28 $457,856.28 $0.00

Estimate Adjustment Detail

Contract ID: 100404   Estimate Number: 0013     Primary JP: 27388(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Addditional reconstruction of turn ramp Approved 05/02/2011 40.0 $54,613.06
002 Compensation for Quantity Overruns Approved 03/05/2012 0.0 $19,372.66
003 FINAL QUANTITY CHANGE ORDER Approved 05/06/2013 0.0 $10,698.95


STOCKPILE PAYMENT HISTORY
Project Line Nbr Stockpile Description Adjustment Type Estimate Nbr Adjusted Amount
27388(04) 0053 VEH.ACT.SOLST.TRAF.SIGCON.ASM Stockpiled Material Initial Payment 0007 $10,853.00
27388(04) 0053 VEH.ACT.SOLST.TRAF.SIGCON.ASM Stockpiled Material Adjustment 0011 $-5,426.50
27388(04) 0053 VEH.ACT.SOLST.TRAF.SIGCON.ASM Stockpiled Material Adjustment 0008 $-5,426.50
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
27388(04) 0012 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0008 77.79 $-2.17 $-169.43
Subtotals For Line Item Adjustments $-169.43


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: 100404   Estimate Number: 0013     Primary JP: 27388(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(511)IG Project:    27388(04) Category:    0100/ROADWAY
0001 UNCLASSIFIED EXCAVATION 202(A) 0183 CY 748.000 949.430   949.430 $12.00 $0.00 $11,393.16
0002 TYPE A-SALVAGED TOPSOIL 205 4229 LSUM 1.000 1.000   1.000 $4,500.00 $0.00 $4,500.00
0003 TEMPORARY SILT FENCE 223 2801 LF 850.000 870.000   870.000 $1.85 $0.00 $1,609.50
0004 TEMPORARY SEDIMENT FILTER 224 2803 EA 1.000 1.000   1.000 $200.00 $0.00 $200.00
0005 TEMPORARY SILT DIKE 227 0100 LF 30.000 30.000   30.000 $22.00 $0.00 $660.00
0006 SOLID SLAB SODDING 230(A) 2806 SY 1,180.000 2,391.880   2,391.880 $2.95 $0.00 $7,056.05
0007 (PL)TEMPORARY INLET SEDIMENT FILTER 243 0450 EA 3.000 3.000   3.000 $55.00 $0.00 $165.00
0008 AGGREGATE BASE 303 0192 CY 584.000 891.900   891.900 $40.00 $0.00 $35,676.00
0009 SUBGRADE, METHOD B 310(B) 0149 SY 1,752.000 2,543.090   2,543.090 $1.00 $0.00 $2,543.09
0010 SEPARATOR FABRIC 325 5271 SY 2,033.000 3,316.760   3,316.760 $1.00 $0.00 $3,316.76
0011 TACK COAT 407 0250 GAL 14.000 17.500   17.500 $10.00 $0.00 $175.00
0012 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) 411(S4) 5960 TON 92.000 77.790   77.790 $110.00 $0.00 $8,556.90
0013 9" P.C. DOWEL JOINTED CONCRETE PAVEMENT 414(A1) 5754 SY 1,307.000 1,987.870   1,987.870 $45.00 $0.00 $89,454.15
0014 CONCRETE CURB (8" BARRIER-INTEGRAL) 609(A) 0380 LF 403.000 1,010.000   1,010.000 $7.00 $0.00 $7,070.00
0015 4" CONCRETE SIDEWALK 610(A) 0602 SY 121.000 232.890   232.890 $40.00 $0.00 $9,315.60
0016 VALVE BOXES ADJUST TO GRADE 612(G) 0647 EA 1.000 1.000   1.000 $350.00 $0.00 $350.00
0017 15" R.C.PIPE CLASS III 613(B) 0403 LF 9.000 6.000   6.000 $100.00 $0.00 $600.00
0018 15" PREFAB. CULVERT END SECTION, ROUND 613(M) 5724 EA 2.000 2.000   2.000 $500.00 $0.00 $1,000.00
0019 REMOVAL OF CONCRETE PAVEMENT 619(B) 4727 SY 653.000 1,567.200   1,567.200 $8.00 $0.00 $12,537.60
0020 REMOVAL OF ASPHALT PAVEMENT 619(B) 4728 SY 284.000 298.330   298.330 $7.00 $0.00 $2,088.31
0021 REMOVAL OF CURB 619(B) 4791 LF 484.000 1,179.000   1,179.000 $2.00 $0.00 $2,358.00
0022 REMOVAL OF SIDEWALK 619(B) 4792 SY 97.000 139.720   139.720 $5.00 $0.00 $698.60
Subtotals For Category     0100/ROADWAY    $0.00 $201,323.72
Fed/State Project Number:    STP-STIM(511)IG Project:    27388(04) Category:    0300/TRAFFIC
0023 RELOCATION OF RENTED PORTABLE TYPE PRECAST CONCRETE MEDIAN 627(O) 4410 LF 488.000 495.000   495.000 $12.00 $0.00 $5,940.00
0024 RENTED PORTABLE TYPE PRECAST CONCRETE MEDIAN BARRIER 627(P) 4425 LF 526.000 540.000   540.000 $22.00 $0.00 $11,880.00
0025 TRAFFIC STRIPE(PLASTIC)(4" WIDE) 855(A) 8812 LF 2,889.000 3,752.500   3,752.500 $1.65 $0.00 $6,191.62
0026 TRAFFIC STRIPE(PLASTIC)(ARROWS) 855(B) 8818 EA 16.000 16.000   16.000 $125.00 $0.00 $2,000.00
0027 (PL)CONSTRUCTION ZONE PAVEMENT MARKERS(FLEX TAB)TYPE 2-2 856(G) 8890 EA 212.000 252.000   252.000 $1.00 $0.00 $252.00
0028 PAVEMENT MARKING REMOVAL(TRAFFIC STRIPE) 859(A) 8006 LF 1,712.000 1,214.000   1,214.000 $0.35 $0.00 $424.90
0029 CONSTRUCTION SIGNS 0 TO 6.25 SF 880(B) 8818 SD 1,200.000 180.000   180.000 $0.10 $0.00 $18.00
0030 CONSTRUCTION SIGNS 6.26 SF TO 15.99 SF 880(B) 8821 SD 1,200.000 1,210.000   1,210.000 $0.50 $0.00 $605.00
0031 CONSTRUCTION SIGNS 16.0 SF TO 32.99 SF 880(B) 8824 SD 2,400.000 2,019.000   2,019.000 $0.25 $0.00 $504.75
0032 BARRICADES(TYPE III) 880(C) 8842 SD 1,200.000 249.000   249.000 $0.50 $0.00 $124.50
0033 WARNING LIGHTS(TYPE A) 880(E) 8860 SD 4,800.000 863.000   863.000 $0.05 $0.00 $43.15
0034 WARNING LIGHTS(TYPE C) 880(E) 8872 SD 5,000.000 5,754.000   5,754.000 $0.05 $0.00 $287.70
0035 DRUMS 880(F) 8878 SD 5,000.000 5,100.000   5,100.000 $0.15 $0.00 $765.00
Subtotals For Category     0300/TRAFFIC    $0.00 $29,036.62
Fed/State Project Number:    STP-STIM(511)IG Project:    27388(04) Category:    0310/TRAFFIC SIGNALS
0036 2" PVC SCH.40 PLASTIC CONDUIT TRENCHED 802(B) 8342 LF 105.000 153.000   153.000 $6.50 $0.00 $994.50
0037 3" PVC SCH.40 PLASTIC CONDUIT TRENCHED 802(B) 8346 LF 200.000 761.000   761.000 $12.00 $0.00 $9,132.00
0038 (PL)HDPE CONDUIT BORED 802(B) 8550 LF 460.000 356.000   356.000 $12.00 $0.00 $4,272.00
0039 (PL)HDPE CONDUIT TRENCHED 802(B) 8555 LF 230.000 0.000   0.000 $6.50 $0.00 $0.00
0040 PULL BOX(SIZE II) 803 8066 EA 11.000 9.000   9.000 $1,000.00 $0.00 $9,000.00
0041 PULL BOX(SIZE III) 803 8067 EA 1.000 1.000   1.000 $1,000.00 $0.00 $1,000.00
0042 STRUCTURAL CONCRETE 804(A) 2915 CY 22.900 28.660   28.660 $650.00 $0.00 $18,629.00
0043 REINFORCING STEEL 804(B) 2916 LB 3,378.000 4,516.900   4,516.900 $1.25 $0.00 $5,646.12
0044 32'MH POLE 45'TS & 10'LMA(G.STL.) 806(A) 8313 EA 1.000 1.000   1.000 $8,000.00 $0.00 $8,000.00
0045 32'MH POLE 50'TS & 10'LMA(G.STL.) 806(A) 8314 EA 2.000 2.000   2.000 $8,500.00 $0.00 $17,000.00
0046 32'MH POLE 25',TS & 10'LMA(G.STL.) 806(A) 8351 EA 1.000 1.000   1.000 $6,500.00 $0.00 $6,500.00
0047 32'MH POLE,55'TS & 10'LMA(G.STL.) 806(A) 8353 EA 2.000 2.000   2.000 $9,800.00 $0.00 $19,600.00
0048 10' MTG.HT.TS PED.POLE(G.STL.) 806(B) 8894 EA 3.000 3.000   3.000 $1,200.00 $0.00 $3,600.00
0049 SERVICE POLE 810(A) 3118 EA 1.000 1.000   1.000 $1,600.00 $0.00 $1,600.00
0050 1/C NO.6 ELECTRICAL CONDUCTOR 811 8040 LF 835.000 2,434.000   2,434.000 $0.65 $0.00 $1,582.10
0051 1/C NO.12 ELECTRICAL CONDUCTOR 811 8046 LF 2,095.000 2,227.000   2,227.000 $0.35 $0.00 $779.45
0052 (PL)TRAFFIC SIGNAL SPAN WIRE EQUIPMENT 823 8482 LSUM 1.000 1.000   1.000 $9,800.00 $0.00 $9,800.00
0053 VEH.ACT.SOL.ST.TRAF.SIG.CON.ASM 825 8550 EA 1.000 1.000   1.000 $21,000.00 $0.00 $21,000.00
0054 (PL)DETECTION SYSTEM (VIDEO) 828 8132 LSUM 1.000 1.000   1.000 $3,600.00 $0.00 $3,600.00
0055 PEDESTRIAN PUSH BUTTON 830 8000 EA 9.000 9.000   9.000 $1,000.00 $0.00 $9,000.00
0056 1WAY 3SEC. ADJ. SIG. HD. S-6 831 8231 EA 15.000 15.000   15.000 $1,000.00 $0.00 $15,000.00
0057 1WAY 3SEC. ADJ. SIG. HD. S-9 831 8252 EA 6.000 6.000   6.000 $950.00 $0.00 $5,700.00
0058 1WAY 5SEC. ADJ. SIG. HD. S-19 831 8286 EA 2.000 2.000   2.000 $1,300.00 $0.00 $2,600.00
0059 1WAY 2SEC. ADJ. PED. SIG. HD. S-20 831 8295 EA 9.000 9.000   9.000 $800.00 $0.00 $7,200.00
0060 BACKPLATE 833 3030 EA 23.000 23.000   23.000 $60.00 $0.00 $1,380.00
0061 (PL)UNDERGROUND COMMUNICATION CABLE 834 8358 LF 425.000 950.000   950.000 $2.10 $0.00 $1,995.00
0062 5/C TRAF.SIG.ELECT.CABLE 834(A) 8207 LF 815.000 908.000   908.000 $0.60 $0.00 $544.80
0063 7/C TRAF.SIG.ELECT.CABLE 834(A) 8208 LF 575.000 574.000   574.000 $0.75 $0.00 $430.50
0064 9/C TRAF.SIG.EL.CABLE 834(A) 8209 LF 1,330.000 456.000   456.000 $1.10 $0.00 $501.60
0065 12/C TRAF.SIG.ELECT.CABLE 834(A) 8210 LF 750.000 0.000   0.000 $1.25 $0.00 $0.00
0066 21/C TRAF.SIG.EL.CABLE 834(A) 8213 LF 1,350.000 1,640.000   1,640.000 $2.00 $0.00 $3,280.00
0067 2/C SHIELDED LOOP DETECTOR LEAD-IN CABLE 834(B) 8220 LF 1,665.000 7,842.000   7,842.000 $0.65 $0.00 $5,097.30
0068 (PL)E.P.S. OPTICAL DETECTOR 840(B) 8593 EA 2.000 2.000   2.000 $2,100.00 $0.00 $4,200.00
0069 (PL)E.P.S. OPTICAL DETECTOR CABLE 840(C) 8594 LF 405.000 1,023.000   1,023.000 $1.00 $0.00 $1,023.00
0070 (PL)E.P.S. 2 CHANNEL PHASE SELECTOR 840(D) 8595 EA 2.000 2.000   2.000 $3,600.00 $0.00 $7,200.00
0071 MAST ARM MOUNTED SIGNS(ALUMINUM) 850(C) 8118 SF 25.500 23.000   23.000 $26.00 $0.00 $598.00
0072 (PL)REMOVAL OF TRAFFIC SIGNAL EQUIPMENT 890(A) 8726 LSUM 1.000 1.000   1.000 $3,300.00 $0.00 $3,300.00
Subtotals For Category     0310/TRAFFIC SIGNALS    $0.00 $210,785.37
Fed/State Project Number:    STP-STIM(511)IG Project:    27388(04) Category:    0600/STAKING
0073 STAKING 642 0098 LSUM 1.000 1.000   1.000 $6,000.00 $0.00 $6,000.00
Subtotals For Category     0600/STAKING    $0.00 $6,000.00
Fed/State Project Number:    STP-STIM(511)IG Project:    27388(04) Category:    0640/CONSTRUCTION
0074 MOBILIZATION 641 1552 LSUM 1.000 1.000   1.000 $7,000.00 $0.00 $7,000.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $7,000.00
Fed/State Project Number:    STP-STIM(511)IG Project:    27388(04) Category:    0850/NON ARRA FUNDING
8000 MOBILIZATION 641 1552 LSUM 0.000 1.000   1.000 $3,880.00 $0.00 $3,880.00
Subtotals For Category     0850/NON ARRA FUNDING    $0.00 $3,880.00
Subtotals For Project STP-STIM(511)IG /27388(04) $0.00 $458,025.71