Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 110082   Estimate Number: 0019 , Final     Spec Year: 2009
Primary JP: 24882(04)   Residency: ENID (04300)     Contract No: 710187
Date Created: 03/26/2014   Contractor FEI: 420805868     Account No: 404400

Project Number(s): SBR-137N(072)SB
Contract Description: BRIDGE REHABILITATION US-81: OVER THE CIMARRON RIVER, 6.8 MILES NORTH OF THE SH-33 JUNCTION. PROJECT LENGTH = 0.282 MILES.
Primary County: KINGFISHER              
Name of Road: US-81              
Prime Contractor: A. M. COHRON & SON, INC.           Time Charged: 270.00
    62180 GREAT RIVER ROAD           Time Allowed: 218.00
    ATLANTIC , IA   50022           Percent Time: 123.85 %

  Paid To Date: $2,049,462.74 Payable This Statement: $3,074.46

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.                                
A. M. COHRON & SON, 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:    03/26/2014
Contract ID: 110082   Estimate Number: 0019     Contract No: 710187
Residency: ENID (04300)   Estimate Type: Final     Account No: 404400

Project Number(s): SBR-137N(072)SB
Primary Job Piece No: 24882(04)
Contract Description: BRIDGE REHABILITATION US-81: OVER THE CIMARRON RIVER, 6.8 MILES NORTH OF THE SH-33 JUNCTION. PROJECT LENGTH = 0.282 MILES.
Primary County: KINGFISHER              
Name of Road: US-81              
Prime Contractor: A. M. COHRON & SON, INC.              
    62180 GREAT RIVER ROAD              
    ATLANTIC , IA   50022              
Surety Company: UNITED FIRE & CASUALTY CO.              

Date Let: 07/21/2011 NTP Effective Date: 12/05/2011 Pay Period: 01/01/2013  TO  03/26/2014
Date Awarded: 08/01/2011 Date Work Began: 10/26/2011 Original Contract Time: 180
Date Contract Executed: 08/12/2011 Date Time Stopped: 11/01/2012 Current Time Charged: 270.00
Date NTP Issued: 09/12/2011 Completion Date: 11/01/2012 Current Time Allowed: 218.00
General Liability Expires: 07/01/2014 Workman's Comp Expires: 07/01/2014 Percent Time Used: 123.85 %
Specification Year: 2009        

Bid Amount: $2,043,649.08 Total to Date Prev to Date This Estimate
Funds Available (Bid + Positive C/O): $2,088,633.16 Participating: $0.00 $0.00 $0.00
Percent Complete: 98.12 % Non Participating: $2,088,633.15 $2,085,558.69 $3,074.46
Unearned Balance: $39,170.42 Total Earnings: $2,088,633.15 $2,085,558.69 $3,074.46
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $2,088,633.15 $2,085,558.69 $3,074.46
Other Adjustments: $-170.41 $-170.41 $0.00
Liq Dam/Disincentive: $-39,000.00 $-39,000.00 $0.00
TOTAL: $2,049,462.74 $2,046,388.28 $3,074.46

Estimate Adjustment Detail

Contract ID: 110082   Estimate Number: 0019     Primary JP: 24882(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Additional Repairs to structure and incr RCP & guardrail rem Approved 07/13/2012 38.0 $17,226.08
002 Additional Painting - new work and rework Approved 11/14/2012 0.0 $11,723.42
003 Final Quantity Change Order Approved 03/14/2014 0.0 $16,034.58


STOCKPILE PAYMENT HISTORY
Project Line Nbr Stockpile Description Adjustment Type Estimate Nbr Adjusted Amount
24882(04) 0028 epoxy coated reinforcing steel Stockpiled Material Initial Payment 0006 $23,686.91
24882(04) 0028 epoxy coated reinforcing steel Stockpiled Material Adjustment 0011 $-23,686.91
24882(04) 0028 epoxy coated reinforcing steel Stockpiled Material Adjustment 0011 $-18,799.56
24882(04) 0028 epoxy coated reinforcing steel Stockpiled Material Initial Payment 0006 $18,799.56
24882(04) 0028 epoxy coated reinforcing steel Stockpiled Material Adjustment 0011 $-13,883.89
24882(04) 0028 epoxy coated reinforcing steel Stockpiled Material Initial Payment 0006 $13,883.89
Subtotals For Stockpile Payments $0.00


LIQUIDATED DAMAGES HISTORY
Adjustment Description Estimate Nbr Time Units Rate Adjustment Amount
System Application of Liquidated Damages 0012 --13 $750.00 $-9,750.00
System Application of Liquidated Damages 0013 --17 $750.00 $-12,750.00
System Application of Liquidated Damages 0014 -7.0 $750.00 $5,250.00
System Application of Liquidated Damages 0015 --29 $750.00 $-21,750.00
Subtotals For Liquidated Damages $-39,000.00


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
24882(04) 0007 SUPERPAVE, TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0003 412.76 $-0.24 $-100.12
24882(04) 0009 SUPERPAVE, TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0003 253.56 $-0.27 $-70.29
Subtotals For Line Item Adjustments $-170.41


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: 110082   Estimate Number: 0019     Primary JP: 24882(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-137N(072)SB Project:    24882(04) Category:    0100/ROADWAY
0001 UNCLASSIFIED EXCAVATION 202(A) 0183 CY 2,000.000 2,000.000   2,000.000 $6.75 $0.00 $13,500.00
0002 UNCLASSIFIED BORROW 202(D) 0184 CY 1,000.000 1,000.000   1,000.000 $12.50 $0.00 $12,500.00
0003 TEMPORARY SILT FENCE 221(C) 2801 LF 10,000.000 135.000   135.000 $1.22 $0.00 $164.70
0004 SEEDING METHOD A 232(A) 2813 AC 2.000 2.000   2.000 $750.00 $0.00 $1,500.00
0005 AGGREGATE BASE TYPE A 303(A) 2100 CY 429.000 315.360   315.360 $48.90 $0.00 $15,421.10
0006 TACK COAT 407(B) 0250 GAL 12.500 130.000 130.000 130.000 $10.00 $1,300.00 $1,300.00
0007 SUPERPAVE, TYPE S3(PG 64-22 OK) 411(B) 5945 TON 1,014.000 412.760   412.760 $85.00 $0.00 $35,084.60
0008 SUPERPAVE, TYPE S4(PG 70-28 OK) 411(C) 5955 TON 28.000 292.610   292.610 $99.00 $0.00 $28,968.39
0009 SUPERPAVE, TYPE S4(PG 64-22 OK) 411(C) 5960 TON 608.000 253.560   253.560 $99.00 $0.00 $25,102.44
0010 COLD MILLING PAVEMENT 412 5267 SY 167.000 1,250.000   1,250.000 $52.00 $0.00 $65,000.00
0011 CLASS C CONCRETE 509(D) 0325 CY 16.200 2.750 0.750 2.750 $325.00 $243.75 $893.75
0012 12" R.C.PIPE CLASS III 613(A) 0400 LF 150.000 402.000   402.000 $32.00 $0.00 $12,864.00
0013 12" PREFAB. CULVERT END SECTION, ROUND 613(L) 5722 EA 4.000 1.000   1.000 $525.00 $0.00 $525.00
0014 REMOVAL OF GUARDRAIL 619(B) 4780 LF 265.000 352.000   352.000 $2.00 $0.00 $704.00
0015 BEAM GUARDRAIL W-BEAM SINGLE 623(A) 0932 LF 512.500 512.500   512.500 $13.74 $0.00 $7,041.75
0016 BEAM GUARDRAIL TRANSITION SECTION 623(E) 7113 EA 4.000 0.000   0.000 $250.00 $0.00 $0.00
0017 GUARDRAIL ANCHOR UNIT (TYPE B) 623(F) 4447 EA 2.000 2.000   2.000 $350.00 $0.00 $700.00
0018 GUARDRAIL END TREATMENT (GET) 623(G) 8571 EA 2.000 2.000   2.000 $1,900.00 $0.00 $3,800.00
8000 GUARDRAIL BRIDGE CONNECTION-TYPE A 623(I) 8675 EA 0.000 4.000   4.000 $1,870.00 $0.00 $7,480.00
Subtotals For Category     0100/ROADWAY    $1,543.75 $232,549.73
Fed/State Project Number:    SBR-137N(072)SB Project:    24882(04) Category:    0200/BRIDGE 'A'
0019 CLSM BACKFILL 501(G) 6309 CY 6.000 4.800   4.800 $425.00 $0.00 $2,040.00
0020 APPROACH SLAB 504(A) 1304 SY 214.400 214.400   214.400 $158.58 $0.00 $33,999.55
0021 SAW-CUT GROOVING 504(B) 1305 SY 3,582.500 3,120.040   3,120.040 $5.02 $0.00 $15,662.60
0022 SEALED EXPANSION JOINT 504(C) 6250 LF 128.700 128.700   128.700 $337.90 $0.00 $43,487.74
0023 CONCRETE RAIL (TR4) 504(D) 6245 LF 2,149.500 2,149.500   2,149.500 $45.75 $0.00 $98,339.62
0024 RAPID CURE JOINT SEALANT 504(G) 6390 LF 32.200 32.200   32.200 $21.68 $0.00 $698.10
0025 STRUCTURAL STEEL 506(A) 1322 LB 41,790.000 45,872.650 151.650 45,872.650 $5.85 $887.15 $268,355.00
0026 CLASS AA CONCRETE 509(A) 1326 CY 929.200 929.200 0.200 929.200 $537.72 $107.54 $499,649.41
0027 REINFORCING STEEL 511(A) 1332 LB 12,865.000 12,865.000   12,865.000 $1.02 $0.00 $13,122.30
0028 EPOXY COATED REINFORCING STEEL 511(B) 6010 LB 360,346.000 360,346.000 146.000 360,346.000 $1.06 $154.76 $381,966.76
0029 PAINTING EXISTING STRUCTURES 512(A) 1323 LSUM 1.000 1.000   1.000 $52,500.00 $0.00 $52,500.00
0030 COLLECTION AND HANDLING OF WASTE 512(B) 6303 LSUM 1.000 1.000   1.000 $16,000.00 $0.00 $16,000.00
0031 WATER REPELLENT (VISUALLY INSPECTED) 515(A) 6013 SY 1,639.200 1,651.140 11.940 1,651.140 $3.40 $40.60 $5,613.88
0032 PREPARATION OF CRACKS, ABOVE WATER 520(A) 6058 LF 50.000 61.000   61.000 $35.30 $0.00 $2,153.30
0033 EPOXY RESIN, ABOVE WATER 520(C) 6060 GAL 2.000 1.000   1.000 $70.00 $0.00 $70.00
0034 PNEUMATICALLY PLACED MORTAR 521(A) 6210 SY 6.000 24.300 0.250 24.300 $741.66 $185.42 $18,022.34
0035 SEALER CRACK PREPARATION 523(A) 6550 LF 418.200 0.000   0.000 $3.00 $0.00 $0.00
0036 SEALER RESIN 523(B) 6560 GAL 4.200 0.000   0.000 $100.00 $0.00 $0.00
0037 (SP)CARBON FIBER-REINFORCED POLYMER 524(A) 6610 SF 82.700 90.520 0.420 90.520 $93.42 $39.24 $8,456.38
0038 (PL)REPAIR BRIDGE ITEM (TYPE A) 540 4515 EA 980.000 211.000   211.000 $62.53 $0.00 $13,193.83
0039 (PL)REPAIR BRIDGE ITEM (TYPE B) 540 4525 EA 62.000 134.000   134.000 $312.19 $0.00 $41,833.46
0040 (PL)REPAIR BRIDGE ITEM (TYPE C) 540 4535 EA 4.000 4.000   4.000 $296.22 $0.00 $1,184.88
0041 REMOVAL OF BRIDGE ITEMS 619(B) 2500 LSUM 1.000 1.000   1.000 $88,500.00 $0.00 $88,500.00
8001 CONSTRUCTION MISCELLANEOUS 104 0600 EA 0.000 720.000   720.000 $27.85 $0.00 $20,052.00
8002 CONSTRUCTION MISCELLANEOUS 104 0700 LSUM 0.000 1.000   1.000 $5,000.00 $0.00 $5,000.00
8003 PAINTING EXISTING STRUCTURES 512(A) 1323 LSUM 0.000 1.000   1.000 $11,723.42 $0.00 $11,723.42
Subtotals For Category     0200/BRIDGE 'A'    $1,414.71 $1,641,624.57
Fed/State Project Number:    SBR-137N(072)SB Project:    24882(04) Category:    0300/TRAFFIC
0042 TRAFFIC STRIPE(PLASTIC)(4" WIDE) 855(A) 8812 LF 9,070.000 10,065.000   10,065.000 $0.67 $0.00 $6,743.55
0043 CONSTRUCTION TRAFFIC STRIPE(PAINT)(4" WIDE) 857(A) 8839 LF 11,200.000 9,888.000   9,888.000 $0.15 $0.00 $1,483.20
0044 PAVEMENT MARKING REMOVAL(TRAFFIC STRIPE) 857(F) 8006 LF 17,550.000 11,967.000   11,967.000 $0.10 $0.00 $1,196.70
0045 DELIVER PORTABLE LONGITUDINAL BARRIER 877(B) 8484 LF 3,000.000 2,680.000   2,680.000 $22.00 $0.00 $58,960.00
0046 ARROW DISPLAY(TYPE C) 880(A) 8812 SD 360.000 516.000   516.000 $2.00 $0.00 $1,032.00
0047 CONSTRUCTION SIGNS 0 TO 6.25 SF 880(B) 8818 SD 7,020.000 12,034.000   12,034.000 $0.19 $0.00 $2,286.46
0048 CONSTRUCTION SIGNS 6.26 SF TO 15.99 SF 880(B) 8821 SD 4,410.000 7,856.000   7,856.000 $0.19 $0.00 $1,492.64
0049 CONSTRUCTION SIGNS 16.0 SF TO 32.99 SF 880(B) 8824 SD 3,480.000 7,854.000 58.000 7,854.000 $2.00 $116.00 $15,708.00
0050 CONSTRUCTION BARRICADES(TYPE III) 880(C) 8842 SD 2,250.000 3,905.000   3,905.000 $2.00 $0.00 $7,810.00
0051 WARNING LIGHTS(TYPE A) 880(E) 8860 SD 6,980.000 14,277.000   14,277.000 $0.55 $0.00 $7,852.35
0052 WARNING LIGHTS(TYPE C) 880(E) 8872 SD 22,200.000 24,713.000   24,713.000 $0.03 $0.00 $741.39
0053 DRUMS 880(F) 8878 SD 22,200.000 26,395.000   26,395.000 $0.04 $0.00 $1,055.80
Subtotals For Category     0300/TRAFFIC    $116.00 $106,362.09
Fed/State Project Number:    SBR-137N(072)SB Project:    24882(04) Category:    0600/STAKING
0054 CONSTRUCTION STAKING LEVEL I 642(A) 0095 LSUM 1.000 1.000   1.000 $5,500.00 $0.00 $5,500.00
Subtotals For Category     0600/STAKING    $0.00 $5,500.00
Fed/State Project Number:    SBR-137N(072)SB Project:    24882(04) Category:    0640/CONSTRUCTION
0055 MOBILIZATION 641 1552 LSUM 1.000 1.000   1.000 $102,596.76 $0.00 $102,596.76
Subtotals For Category     0640/CONSTRUCTION    $0.00 $102,596.76
Subtotals For Project SBR-137N(072)SB /24882(04) $3,074.46 $2,088,633.15