Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 110179   Estimate Number: 0009 , Final     Spec Year: 1999
Primary JP: 24339(04)   Residency: CIRCUIT ENGR. DISTRICT # 8 (06009)     Contract No: 611267
Date Created: 04/25/2013   Contractor FEI: 730776271     Account No: 436600

Project Number(s): BRF-123C(055)CI
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD (EW-056): OVER A TRIBUTARY OF LONG CREEK, 5.75 MILES WEST OF THE US-283 JUNCTION. PROJECT LENGTH = 0.207 MILES.
Primary County: ELLIS              
Name of Road: COUNTY ROAD              
Prime Contractor: SEWELL BROS., INC.           Time Charged: 233.00
    1220 E. MAIN           Time Allowed: 235.00
    CORDELL , OK   73632           Percent Time: 99.15 %

  Paid To Date: $546,761.64 Payable This Statement: $-0.55

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.                                
SEWELL BROS., 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:    04/25/2013
Contract ID: 110179   Estimate Number: 0009     Contract No: 611267
Residency: CIRCUIT ENGR. DISTRICT # 8 (06009)   Estimate Type: Final     Account No: 436600

Project Number(s): BRF-123C(055)CI
Primary Job Piece No: 24339(04)
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD (EW-056): OVER A TRIBUTARY OF LONG CREEK, 5.75 MILES WEST OF THE US-283 JUNCTION. PROJECT LENGTH = 0.207 MILES.
Primary County: ELLIS              
Name of Road: COUNTY ROAD              
Prime Contractor: SEWELL BROS., INC.              
    1220 E. MAIN              
    CORDELL , OK   73632              
Surety Company: WESTFIELD INSURANCE COMPANY              

Date Let: 03/17/2011 NTP Effective Date: 07/05/2011 Pay Period: 01/16/2013  TO  04/15/2013
Date Awarded: 04/04/2011 Date Work Began: 06/13/2011 Original Contract Time: 90
Date Contract Executed: 04/18/2011 Date Time Stopped: 02/01/2012 Current Time Charged: 233.00
Date NTP Issued: 04/27/2011 Completion Date: 02/01/2012 Current Time Allowed: 235.00
General Liability Expires: 07/01/2013 Workman's Comp Expires: 07/01/2013 Percent Time Used: 99.15 %
Specification Year: 1999        

Current Contract Amount: $546,761.64 Total to Date Prev to Date This Estimate
Bid Amount: $508,780.11 Participating: $543,514.32 $543,514.87 $-0.55
Percent Complete: 100 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $0.00 Total Earnings: $543,514.32 $543,514.87 $-0.55
Unearned Balance: $-37,981.53 Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $543,514.32 $543,514.87 $-0.55
Other Adjustments: $3,247.32 $3,247.32 $0.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $546,761.64 $546,762.19 $-0.55

Estimate Adjustment Detail

Contract ID: 110179   Estimate Number: 0009     Primary JP: 24339(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 ced08 CLSM Approved 11/04/2011 7.0 $48,102.35
002 ced8 Final Quantity Change Order on BRO-123C(55)CO Approved 03/19/2013 0.0 $-10,120.82


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
System Application of Liquidated Damages 0005 --1.0 $500.00 $-500.00
System Application of Liquidated Damages 0006 --5.0 $500.00 $-2,500.00
System Application of Liquidated Damages 0007 --8.0 $500.00 $-4,000.00
System Application of Liquidated Damages 0008 -14.0 $500.00 $7,000.00
Subtotals For Liquidated Damages $0.00


CONTRACT ADJUSTMENTS HISTORY
Adjustment Description Estimate Nbr Adjustment Amount
Withhold to Funds Avail(Prog. Est. Only) 0006 $-3,100.00
LD Adjustment (Prog. Est. Only) 0007 $7,000.00
W/hold Funds-Payroll/DBE(Prog. Est Only) 0007 $3,100.00
LD Adjustment (Prog. Est. Only) 0008 $-7,000.00
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
24339(04) 0007 (SP)ASPHALT CONCRETE TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0006 371.01 $4.38 $1,625.25
24339(04) 0008 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0006 324.00 $5.00 $1,622.07
Subtotals For Line Item Adjustments $3,247.32


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: 110179   Estimate Number: 0009     Primary JP: 24339(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:    BRF-123C(055)CI Project:    24339(04) Category:    0100/ROADWAY
0001 EARTHWORK 202(G) 0185 LSUM 1.000 1.000   1.000 $25,000.00 $0.00 $25,000.00
0002 TEMPORARY SILT FENCE 223 2801 LF 1,200.000 720.000   720.000 $1.40 $0.00 $1,008.00
0003 SOLID SLAB SODDING 230(A) 2806 SY 7,650.000 7,063.560   7,063.560 $1.20 $0.00 $8,476.27
0004 VEGETATIVE MULCHING 233(A) 2817 AC 1.580 0.000   0.000 $325.00 $0.00 $0.00
0005 AGGREGATE BASE 303 5912 TON 908.000 1,033.790   1,033.790 $41.00 $0.00 $42,385.39
0006 TACK COAT 407 0250 GAL 274.000 150.000   150.000 $4.50 $0.00 $675.00
0007 (SP)ASPHALT CONCRETE TYPE S3(PG 64-22 OK) 411(S3) 5945 TON 292.000 371.010   371.010 $135.00 $0.00 $50,086.35
0008 (SP)ASPHALT CONCRETE TYPE S4(PG 64-22 OK) 411(S4) 5960 TON 289.000 324.000   324.000 $135.00 $0.00 $43,740.00
0009 CLASS C CONCRETE 509(D) 0325 CY 127.000 116.000   116.000 $275.00 $0.00 $31,900.00
0010 TYPE C4 CULVERT END TREATMENT 613(CC) 7188 EA 2.000 6.000   6.000 $1,025.00 $0.00 $6,150.00
0011 42" X 29" CORR. GALV. STEEL PIPE ARCH 613(D) 4530 LF 56.000 188.000   188.000 $54.00 $0.00 $10,152.00
8000 CLSM BACKFILL 501(G) 6309 CY 0.000 118.000   118.000 $120.73 $0.00 $14,246.14
8001 ASPHALT BINDER PRICE ADJUSTMENT 109 M1150 LSUM 0.000 1.000   0.000 $3,247.32 $0.00 $0.00
Subtotals For Category     0100/ROADWAY    $0.00 $233,819.15
Fed/State Project Number:    BRF-123C(055)CI Project:    24339(04) Category:    0200/BRIDGE 'A'
0012 SUBSTRUCTURE EXCAVATION COMMON 501(B) 1307 CY 104.000 104.000   104.000 $10.00 $0.00 $1,040.00
0013 UNCLASSIFIED BACKFILL 501(D) 6353 CY 118.000 0.000   0.000 $10.00 $0.00 $0.00
0014 PRESTRESSED CONCRETE BEAMS (TYPE III) 503(A) 1312 LF 296.670 296.670   296.670 $183.00 $0.00 $54,290.61
0015 CONCRETE RAIL (TR1) 504(E) 1380 LF 231.000 231.000   231.000 $55.00 $0.00 $12,705.00
0016 STRUCTURAL STEEL 506(A) 1322 LB 1,620.000 1,620.000   1,620.000 $5.00 $0.00 $8,100.00
0017 CLASS AA CONCRETE 509(A) 1326 CY 58.300 58.300   58.300 $600.00 $0.00 $34,980.00
0018 CLASS A CONCRETE 509(B) 1328 CY 78.840 78.840   78.840 $550.00 $0.00 $43,362.00
0019 REINFORCING STEEL 511(A) 1332 LB 23,044.000 23,044.000   23,044.000 $1.00 $0.00 $23,044.00
0020 PILES, FURNISHED (HP 10X42) 514(A) 6010 LF 320.000 320.000   320.000 $25.00 $0.00 $8,000.00
0021 PILES, FURNISHED (HP 12X53) 514(A) 6011 LF 1,120.000 1,120.000   1,120.000 $33.00 $0.00 $36,960.00
0022 PILES, DRIVEN (HP 10X42) 514(B) 6292 LF 320.000 276.950 -0.050 276.950 $11.00 $-0.55 $3,046.45
0023 PILES, DRIVEN (HP 12X53) 514(B) 6294 LF 1,120.000 846.900   846.900 $11.00 $0.00 $9,315.90
0024 TYPE I-A PLAIN RIPRAP 601(A-1)1353 TON 700.000 669.540   669.540 $50.00 $0.00 $33,477.00
0025 TYPE I-A FILTER BLANKET 601(A-2)1355 TON 170.000 178.470   178.470 $43.00 $0.00 $7,674.21
0026 REMOVAL OF EXISTING BRIDGE STRUCTURE 619(D) 1397 LSUM 1.000 1.000   1.000 $5,000.00 $0.00 $5,000.00
0027 GUARD RAIL ANCHOR UNIT (TYPE II) 623(F) 6033 EA 4.000 4.000   4.000 $2,300.00 $0.00 $9,200.00
0028 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $2,100.00 $0.00 $2,100.00
Subtotals For Category     0200/BRIDGE 'A'    $-0.55 $292,295.17
Fed/State Project Number:    BRF-123C(055)CI Project:    24339(04) Category:    0600/STAKING
0029 STAKING 642 0098 LSUM 1.000 1.000   1.000 $4,400.00 $0.00 $4,400.00
Subtotals For Category     0600/STAKING    $0.00 $4,400.00
Fed/State Project Number:    BRF-123C(055)CI Project:    24339(04) Category:    0640/CONSTRUCTION
0030 (SP)SWPPP DOCUMENTATION AND MANAGEMENT 220 2800 LSUM 1.000 1.000   1.000 $1,000.00 $0.00 $1,000.00
0031 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $12,000.00 $0.00 $12,000.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $13,000.00
Subtotals For Project BRF-123C(055)CI /24339(04) $-0.55 $543,514.32


1 CURRENT QUANTITIES DO NOT MATCH THE QUANTITY PAID TO DATE