Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 110270   Estimate Number: 0019 , Final     Spec Year: 2009
Primary JP: 24965(04)   Residency: SALLISAW (01200)     Contract No: 710007
Date Created: 03/28/2014   Contractor FEI: 208746250     Account No: 434100

Project Number(s): CIRB-131C(085)RB
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD (KERR LAKE ROAD): OVER SANS BOIS CREEK, AT THE KERR RESERVOIR, 2.5 MILES NORTH OF SH-9. PROJECT LENGTH = 1.271 MILES.
Primary County: HASKELL              
Name of Road: COUNTY ROAD              
Prime Contractor: GLOVER & ASSOCIATES, INC.           Time Charged: 134.00
    2832 N. COUNTRY CLUB           Time Allowed: 150.00
    MUSKOGEE , OK   74403           Percent Time: 89.33 %

  Paid To Date: $1,385,426.57 Payable This Statement: $4,613.98

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.                                
GLOVER & ASSOCIATES, 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:    03/28/2014
Contract ID: 110270   Estimate Number: 0019     Contract No: 710007
Residency: SALLISAW (01200)   Estimate Type: Final     Account No: 434100

Project Number(s): CIRB-131C(085)RB
Primary Job Piece No: 24965(04)
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD (KERR LAKE ROAD): OVER SANS BOIS CREEK, AT THE KERR RESERVOIR, 2.5 MILES NORTH OF SH-9. PROJECT LENGTH = 1.271 MILES.
Primary County: HASKELL              
Name of Road: COUNTY ROAD              
Prime Contractor: GLOVER & ASSOCIATES, INC.              
    2832 N. COUNTRY CLUB              
    MUSKOGEE , OK   74403              
Surety Company: WESTFIELD INSURANCE COMPANY              

Date Let: 05/19/2011 NTP Effective Date: 09/01/2011 Pay Period: 02/01/2014  TO  03/28/2014
Date Awarded: 06/01/2011 Date Work Began: 09/01/2011 Original Contract Time: 150
Date Contract Executed: 06/14/2011 Date Time Stopped: 01/02/2014 Current Time Charged: 134.00
Date NTP Issued: 06/22/2011 Completion Date: 01/02/2014 Current Time Allowed: 150.00
General Liability Expires: 02/01/2015 Workman's Comp Expires: 02/01/2015 Percent Time Used: 89.33 %
Specification Year: 2009        

Bid Amount: $1,419,499.88 Total to Date Prev to Date This Estimate
Funds Available (Bid + Positive C/O): $1,442,764.71 Participating: $0.00 $0.00 $0.00
Percent Complete: 96.03 % Non Participating: $1,390,330.30 $1,387,821.50 $2,508.80
Unearned Balance: $57,338.14 Total Earnings: $1,390,330.30 $1,387,821.50 $2,508.80
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $1,390,330.30 $1,387,821.50 $2,508.80
Other Adjustments: $-4,903.73 $-7,008.91 $2,105.18
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $1,385,426.57 $1,380,812.59 $4,613.98

Estimate Adjustment Detail

Contract ID: 110270   Estimate Number: 0019     Primary JP: 24965(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Crack Sealing, Traffic Control, Re-Mobilization Approved 10/24/2012 0.0 $12,500.00
002 Crack-Sealing, Mobilization and Traffic Control Approved 09/30/2013 0.0 $10,625.00
003 Traffic Stripe - Platic for Multi-Polymer Approved 02/14/2014 0.0 $139.83
004 Final Quantity Change Order Approved 03/27/2014 0.0 $-52,434.41


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
24965(04) 0011 SUPERPAVE, TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0007 1,190.91 $1.16 $1,386.76
24965(04) 0011 SUPERPAVE, TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0008 2,554.21 $1.16 $2,974.25
24965(04) 0011 SUPERPAVE, TYPE S3(PG 64-22 OK) * HMA Deduction as per Sec. 411 0008 0.00 $0.00 $-6,079.00
24965(04) 0011 SUPERPAVE, TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0012 6.00 $1.26 $7.62
24965(04) 0011 SUPERPAVE, TYPE S3(PG 64-22 OK) * HMA Deduction as per Sec. 411 0012 0.00 $0.00 $-9,118.50
24965(04) 0011 SUPERPAVE, TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0013 18.00 $1.26 $22.85
24965(04) 0011 SUPERPAVE, TYPE S3(PG 64-22 OK) * HMA Deduction as per Sec. 411 0019 0.00 $0.00 $2,105.18
24965(04) 0012 SUPERPAVE, TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0012 426.41 $1.45 $618.64
24965(04) 0012 SUPERPAVE, TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0013 2,196.80 $1.45 $3,187.12
24965(04) 0012 SUPERPAVE, TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0018 -7.14 $1.21 $-8.65
Subtotals For Line Item Adjustments $-4,903.73
* = 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: 110270   Estimate Number: 0019     Primary JP: 24965(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:    CIRB-131C(085)RB Project:    24965(04) Category:    0100/ROADWAY
0001 UNCLASSIFIED EXCAVATION 202(A) 0183 CY 8,500.000 8,500.000   8,500.000 $6.00 $0.00 $51,000.00
0002 TEMPORARY SILT FENCE 221(C) 2801 LF 12,093.000 11,949.000   11,949.000 $1.11 $0.00 $13,263.39
0003 SOLID SLAB SODDING 230(A) 2806 SY 6,500.000 7,513.610   7,513.610 $1.24 $0.00 $9,316.88
0004 SEEDING METHOD A 232(A) 2813 AC 2.000 0.000   0.000 $295.00 $0.00 $0.00
0005 VEGETATIVE MULCHING 233(A) 2817 AC 4.000 4.000   4.000 $75.00 $0.00 $300.00
0006 AGGREGATE BASE TYPE A 303(A) 2100 CY 4,500.000 4,273.120 70.000 4,273.120 $35.84 $2,508.80 $153,148.62
0007 LIME STABILIZED SUBGRADE 307(H) 4270 SY 19,127.000 19,125.560   19,125.560 $6.72 $0.00 $128,523.76
0008 SEPARATOR FABRIC 325 5271 SY 25,956.000 25,956.110   25,956.110 $1.23 $0.00 $31,926.01
0009 TRAFFIC BOUND SURFACE COURSE TYPE E 402(E) 0225 TON 200.000 0.000   0.000 $34.10 $0.00 $0.00
0010 PRIME COAT 408 5774 GAL 9,236.000 9,100.000   9,100.000 $0.50 $0.00 $4,550.00
0011 SUPERPAVE, TYPE S3(PG 64-22 OK) 411(B) 5945 TON 4,032.000 3,769.120 0.000 3,769.120 $60.79 $0.00 $229,124.81
0012 SUPERPAVE, TYPE S4(PG 64-22 OK) 411(C) 5960 TON 2,800.000 2,616.070   2,616.070 $66.95 $0.00 $175,145.89
0013 CLASS C CONCRETE 509(D) 0325 CY 10.000 0.000   0.000 $440.00 $0.00 $0.00
0014 TYPE I PLAIN RIPRAP 601(A) 0297 TON 100.000 14.030   14.030 $52.27 $0.00 $733.35
0015 WATER LINE LOWERED 612(J) 4480 LF 6,187.500 6,169.000   6,169.000 $12.00 $0.00 $74,028.00
0016 REMOVAL OF ASPHALT PAVEMENT 619(B) 4728 SY 14,440.000 14,321.240   14,321.240 $2.00 $0.00 $28,642.48
0017 REMOVAL OF GUARDRAIL 619(B) 4780 LF 11,944.000 11,900.000   11,900.000 $1.00 $0.00 $11,900.00
0018 BEAM GUARDRAIL W-BEAM SINGLE 623(A) 0932 LF 11,372.500 11,389.000   11,389.000 $17.10 $0.00 $194,751.90
0019 GUARDRAIL ANCHOR UNIT (TYPE B) 623(F) 4447 EA 4.000 4.000   4.000 $687.50 $0.00 $2,750.00
0020 SHEET ALUMINUM SIGNS 850(A) 8110 SF 10.360 10.360   10.360 $15.40 $0.00 $159.54
0021 2" SQUARE TUBE POST 851(C) 8324 LF 22.000 22.000   22.000 $11.00 $0.00 $242.00
0022 GUARDRAIL DELINEATORS(TYPE 2, CODE 1) 853 9069 EA 227.000 231.000   231.000 $17.60 $0.00 $4,065.60
0023 TRAFFIC STRIPE(PLASTIC)(4" WIDE) 855(A) 8812 LF 25,000.000 0.000 -25,237.000 0.000 $0.59 $-14,889.83 $0.00
0024 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $4,125.00 $0.00 $4,125.00
0025 PORT.CHANGEABLE MESSAGE SIGN 882(A) 8306 SD 50.000 28.000   28.000 $33.00 $0.00 $924.00
8001 CONSTRUCTION MISCELLANEOUS 104 0300 LF 0.000 8,931.000   8,931.000 $0.88 $0.00 $7,859.28
8002 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 0.000 1.000   1.000 $2,500.00 $0.00 $2,500.00
8004 CONSTRUCTION MISCELLANEOUS 104 0300 LF 0.000 4,412.000   4,412.000 $1.25 $0.00 $5,515.00
8005 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 0.000 1.000   1.000 $2,500.00 $0.00 $2,500.00
Subtotals For Category     0100/ROADWAY    $-12,381.03 $1,136,995.51
Fed/State Project Number:    CIRB-131C(085)RB Project:    24965(04) Category:    0200/BRIDGE 'A'
0026 CLSM BACKFILL 501(G) 6309 CY 10.000 10.000   10.000 $385.00 $0.00 $3,850.00
0027 (PL)FALSEWORK JACKING 502 6116 LSUM 1.000 1.000   1.000 $5,060.00 $0.00 $5,060.00
0028 APPROACH SLAB 504(A) 1304 SY 111.600 111.600   111.600 $247.50 $0.00 $27,621.00
0029 SEALED EXPANSION JOINT 504(C) 6250 LF 50.000 50.000   50.000 $330.00 $0.00 $16,500.00
0030 RAPID CURE JOINT SEALANT 504(G) 6390 LF 57.000 57.000   57.000 $27.50 $0.00 $1,567.50
0031 CLASS C CONCRETE 509(D) 1331 CY 5.400 5.400   5.400 $1,100.00 $0.00 $5,940.00
0032 CLEANING AND PAINTING BRIDGE METAL RAIL 512 6280 LF 1,061.000 1,061.000   1,061.000 $44.00 $0.00 $46,684.00
0033 CLASS C BRIDGE DECK REPAIR 513(C) 6020 SY 18.000 18.000   18.000 $605.00 $0.00 $10,890.00
0034 PREPARATION OF CRACKS, ABOVE WATER 520(A) 6058 LF 40.000 103.500   103.500 $22.00 $0.00 $2,277.00
0035 EPOXY RESIN, ABOVE WATER 520(C) 6060 GAL 3.500 1.300   1.300 $88.00 $0.00 $114.40
0036 DECK AREA SEALED (FLOODCOATS) 523(C) 6570 SY 1,420.000 1,420.000   1,420.000 $19.80 $0.00 $28,116.00
0037 (PL)REPAIR BRIDGE ITEMS 540 4505 EA 8.000 8.000   8.000 $550.00 $0.00 $4,400.00
0038 (PL)REPLACE BRIDGE ITEMS 545 4805 EA 4.000 4.000   4.000 $220.00 $0.00 $880.00
0039 TYPE I PLAIN RIPRAP 601(A) 1351 TON 44.000 44.000   44.000 $121.00 $0.00 $5,324.00
0040 REMOVAL OF BRIDGE ITEMS 619(B) 2505 EA 2.000 2.000   2.000 $5,500.00 $0.00 $11,000.00
Subtotals For Category     0200/BRIDGE 'A'    $0.00 $170,223.90
Fed/State Project Number:    CIRB-131C(085)RB Project:    24965(04) Category:    0600/STAKING
0041 CONSTRUCTION STAKING LEVEL II 642(B) 0096 LSUM 1.000 1.000   1.000 $17,417.40 $0.00 $17,417.40
8006 TRAFFIC STRIPE(MULTI-POLY.)(4" WIDE) 856(A) 8530 LF 0.000 25,237.000 25,237.000 25,237.000 $0.59 $14,889.83 $14,889.83
Subtotals For Category     0600/STAKING    $14,889.83 $32,307.23
Fed/State Project Number:    CIRB-131C(085)RB Project:    24965(04) Category:    0640/CONSTRUCTION
0042 SWPPP DOCUMENTATION AND MANAGEMENT 220 2800 LSUM 1.000 1.000   1.000 $825.00 $0.00 $825.00
0043 MOBILIZATION 641 1552 LSUM 1.000 1.000   1.000 $46,278.66 $0.00 $46,278.66
8000 MOBILIZATION 641 1552 LSUM 0.000 1.000   1.000 $1,200.00 $0.00 $1,200.00
8003 MOBILIZATION 641 1399 LSUM 0.000 1.000   1.000 $2,500.00 $0.00 $2,500.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $50,803.66
Subtotals For Project CIRB-131C(085)RB /24965(04) $2,508.80 $1,390,330.30