Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 110007   Estimate Number: 0012 , Final     Spec Year: 1999
Primary JP: 27330(04)   Residency: DUNCAN (07100)     Contract No: 611029
Date Created: 03/10/2014   Contractor FEI: 731452899     Account No: 404700

Project Number(s): SBR-116C(190)SB
Contract Description: BRIDGE REHABILITATION SH-65: OVER WEST FORK OF BEAVER CREEK, 4.2 MILES NORTH OF THE SH-7 JUNCTION. PROJECT LENGTH = 0.191 MILES.
Primary County: COMANCHE              
Name of Road: SH-65              
Prime Contractor: PBX CORPORATION           Time Charged: 572.00
    P.O. BOX 644           Time Allowed: 582.00
    SAPULPA , OK   74067           Percent Time: 98.28 %

  Paid To Date: $703,709.84 Payable This Statement: $190.00

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:    03/10/2014
Contract ID: 110007   Estimate Number: 0012     Contract No: 611029
Residency: DUNCAN (07100)   Estimate Type: Final     Account No: 404700

Project Number(s): SBR-116C(190)SB
Primary Job Piece No: 27330(04)
Contract Description: BRIDGE REHABILITATION SH-65: OVER WEST FORK OF BEAVER CREEK, 4.2 MILES NORTH OF THE SH-7 JUNCTION. PROJECT LENGTH = 0.191 MILES.
Primary County: COMANCHE              
Name of Road: SH-65              
Prime Contractor: PBX CORPORATION              
    P.O. BOX 644              
    SAPULPA , OK   74067              
Surety Company: WESTFIELD INSURANCE COMPANY              

Date Let: 01/20/2011 NTP Effective Date: 06/06/2011 Pay Period: 12/01/2013  TO  02/28/2014
Date Awarded: 02/07/2011 Date Work Began: 07/08/2011 Original Contract Time: 120
Date Contract Executed: 02/16/2011 Date Time Stopped: 01/02/2013 Current Time Charged: 572.00
Date NTP Issued: 02/22/2011 Completion Date: 01/02/2013 Current Time Allowed: 582.00
General Liability Expires: 10/05/2014 Workman's Comp Expires: 10/05/2014 Percent Time Used: 98.28 %
Specification Year: 1999        

Bid Amount: $749,504.60 Total to Date Prev to Date This Estimate
Funds Available (Bid + Positive C/O): $749,504.60 Participating: $0.00 $0.00 $0.00
Percent Complete: 93.89 % Non Participating: $703,242.80 $703,052.80 $190.00
Unearned Balance: $45,794.76 Total Earnings: $703,242.80 $703,052.80 $190.00
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $703,242.80 $703,052.80 $190.00
Other Adjustments: $467.04 $467.04 $0.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $703,709.84 $703,519.84 $190.00

Estimate Adjustment Detail

Contract ID: 110007   Estimate Number: 0012     Primary JP: 27330(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 03/05/2014 0.0 $-46,261.80


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
27330(04) 0006 (SP)ASPHALT CONCRETE TYPE S5(PG 64-22 OK) Asphalt Binder Adjustment 0006 471.62 $6.21 $2,928.89
27330(04) 0006 (SP)ASPHALT CONCRETE TYPE S5(PG 64-22 OK) * HMA Deduction as per Sec. 411 0011 -16.97 $145.00 $-2,461.85
27330(04) 0020 STRUCTURAL STEEL * Overrun 0005 -340.00 $5.00 $-1,700.00
27330(04) 0020 STRUCTURAL STEEL * Overrun Re-adjustment 0011 340.00 $5.00 $1,700.00
27330(04) 0026 COLLECTION & HANDLING OF WASTE * Missing Material Certification 0006 -1.00 $800.00 $-800.00
27330(04) 0026 COLLECTION & HANDLING OF WASTE * Missing Material Certification 0011 1.00 $800.00 $800.00
Subtotals For Line Item Adjustments $467.04
* = 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: 110007   Estimate Number: 0012     Primary JP: 27330(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:    SBR-116C(190)SB Project:    27330(04) Category:    0100/ROADWAY
0001 SELECT BORROW 202(D) 0186 CY 55.000 0.000   0.000 $200.00 $0.00 $0.00
0002 TEMPORARY BALE BARRIER 222 2801 LF 200.000 0.000   0.000 $2.30 $0.00 $0.00
0003 TEMPORARY SILT FENCE 223 2801 LF 510.000 0.000   0.000 $2.10 $0.00 $0.00
0004 SOLID SLAB SODDING 230(A) 2806 SY 340.000 0.000   0.000 $2.20 $0.00 $0.00
0005 TACK COAT 407 0250 GAL 250.000 350.000   350.000 $5.00 $0.00 $1,750.00
0006 (SP)ASPHALT CONCRETE TYPE S5(PG 64-22 OK) 411(S5) 5975 TON 670.000 471.620   471.620 $145.00 $0.00 $68,384.90
0007 COLD MILLING PAVEMENT 417 5267 SY 2,500.000 2,273.660   2,273.660 $6.00 $0.00 $13,641.96
0008 REMOVAL OF GUARD RAIL 619(B) 4780 LF 240.000 218.000   218.000 $2.00 $0.00 $436.00
0009 BEAM GUARD RAIL-W-BEAM-SINGLE 623(A) 0932 LF 237.500 249.500   249.500 $17.00 $0.00 $4,241.50
0010 THRIE BEAM BRIDGE CONNECTION-TYPE A 623(E) 7114 EA 4.000 4.000   4.000 $1,300.00 $0.00 $5,200.00
0011 GUARD RAIL ANCHOR UNIT (TYPE B) 623(F) 4447 EA 1.000 1.000   1.000 $500.00 $0.00 $500.00
0012 (SP)G.E.T. GUARD RAIL END SECTION 623(H) 8571 EA 3.000 3.000   3.000 $2,100.00 $0.00 $6,300.00
Subtotals For Category     0100/ROADWAY    $0.00 $100,454.36
Fed/State Project Number:    SBR-116C(190)SB Project:    27330(04) Category:    0200/BRIDGE 'A'
0013 CLSM BACKFILL 501(G) 6309 CY 7.000 34.170   34.170 $200.00 $0.00 $6,834.00
0014 (PL)FALSEWORK JACKING 502 6116 LSUM 1.000 1.000   1.000 $3,000.00 $0.00 $3,000.00
0015 APPROACH SLAB 504(A) 1304 SY 188.000 188.000   188.000 $200.00 $0.00 $37,600.00
0016 SEALED EXPANSION JOINT 504(C) 6250 LF 71.000 71.000   71.000 $275.00 $0.00 $19,525.00
0017 CONCRETE RAIL (TR4) 504(E) 6245 LF 516.300 516.300   516.300 $90.00 $0.00 $46,467.00
0018 RAPID CURE JOINT SEALANT 504(H) 6390 LF 34.500 34.500   34.500 $25.00 $0.00 $862.50
0019 CLASS C BRIDGE DECK REPAIR 505(C) 6020 SY 30.000 0.000   0.000 $350.00 $0.00 $0.00
0020 STRUCTURAL STEEL 506(A) 1322 LB 2,160.000 2,160.000   2,160.000 $5.00 $0.00 $10,800.00
0021 CLASS AA CONCRETE 509(A) 1326 CY 160.000 160.000   160.000 $700.00 $0.00 $112,000.00
0022 CLASS C CONCRETE 509(D) 1331 CY 8.000 5.040   5.040 $1,000.00 $0.00 $5,040.00
0023 (PL)MECHANICAL SPLICES 511 6306 EA 476.000 476.000   476.000 $16.00 $0.00 $7,616.00
0024 EPOXY COATED REINFORCING STEEL 511(B) 6010 LB 35,298.000 35,298.000   35,298.000 $1.25 $0.00 $44,122.50
0025 PAINTING EXISTING STRUCTURES 512(A) 1323 LSUM 1.000 1.000   1.000 $21,000.00 $0.00 $21,000.00
0026 COLLECTION & HANDLING OF WASTE 512(B) 6303 LSUM 1.000 1.000   1.000 $800.00 $0.00 $800.00
0027 PREPARATION OF CRACKS ABOVE WATER 520(A) 6058 LF 30.000 0.000   0.000 $15.00 $0.00 $0.00
0028 EPOXY RESIN ABOVE WATER 520(C) 6060 GAL 5.000 0.000   0.000 $80.00 $0.00 $0.00
0029 PNEUMATICALLY PLACED MORTAR 521(A) 6210 SY 20.000 27.430   27.430 $500.00 $0.00 $13,715.00
0030 (SP) SEALER CRACK PREPARATION 523(A) 6550 LF 305.300 305.470   305.470 $2.00 $0.00 $610.94
0031 (SP) SEALER RESIN 523(B) 6560 GAL 4.900 4.900   4.900 $45.00 $0.00 $220.50
0032 (PL)FIXED BEARING ASSEMBLY 535 6164 EA 25.000 25.000   25.000 $1,400.00 $0.00 $35,000.00
0033 (PL)EXPANSION BEARING ASSEMBLY 535 6165 EA 25.000 25.000   25.000 $1,400.00 $0.00 $35,000.00
0034 (PL)REPAIR BRIDGE ITEM (TYPE A) 540 4515 EA 6.000 28.000   28.000 $1,200.00 $0.00 $33,600.00
0035 (PL)REPAIR BRIDGE ITEM (TYPE B) 540 4525 EA 6.000 13.000   13.000 $1,500.00 $0.00 $19,500.00
0036 (PL)REMOVAL OF BRIDGE ITEMS 619(B) 2500 LSUM 1.000 1.000   1.000 $50,000.00 $0.00 $50,000.00
Subtotals For Category     0200/BRIDGE 'A'    $0.00 $503,313.44
Fed/State Project Number:    SBR-116C(190)SB Project:    27330(04) Category:    0300/TRAFFIC
0037 (PL)CURVED APPROACH GUARD RAIL 623 8572 EA 1.000 1.000   1.000 $600.00 $0.00 $600.00
0038 RELOCATION OF RENTED PORTABLE TYPE PRECAST CONCRETE MEDIAN 627(O) 4410 LF 1,230.000 0.000   0.000 $2.00 $0.00 $0.00
0039 RENTED PORTABLE TYPE PRECAST CONCRETE MEDIAN BARRIER 627(P) 4425 LF 1,230.000 0.000   0.000 $30.00 $0.00 $0.00
0040 (PL)PORTABLE TRAFFIC SIGNAL SYSTEM 823 8478 SD 100.000 134.000 2.000 134.000 $95.00 $190.00 $12,730.00
0041 TRAFFIC STRIPE(PLASTIC)(4" WIDE) 855(A) 8812 LF 4,040.000 5,254.000   5,254.000 $1.50 $0.00 $7,881.00
0042 (PL)CONST.ZONE IMPACT ATTEN. 871 8705 SD 200.000 0.000   0.000 $10.00 $0.00 $0.00
0043 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $20,214.00 $0.00 $20,214.00
0044 PORT.CHANGEABLE MESSAGE SIGN 882(B) 8306 SD 200.000 242.000   242.000 $25.00 $0.00 $6,050.00
Subtotals For Category     0300/TRAFFIC    $190.00 $47,475.00
Fed/State Project Number:    SBR-116C(190)SB Project:    27330(04) Category:    0600/STAKING
0045 STAKING 642 0098 LSUM 1.000 1.000   1.000 $2,000.00 $0.00 $2,000.00
Subtotals For Category     0600/STAKING    $0.00 $2,000.00
Fed/State Project Number:    SBR-116C(190)SB Project:    27330(04) Category:    0640/CONSTRUCTION
0046 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $50,000.00 $0.00 $50,000.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $50,000.00
Subtotals For Project SBR-116C(190)SB /27330(04) $190.00 $703,242.80