Oklahoma Department of Transportation
Final Estimate Affidavit
Contract ID: 110322   Estimate Number: 0011 , Final     Spec Year: 2009
Primary JP: 24196(04)   Residency: CIRCUIT ENGR. DISTRICT # 8 (06009)     Contract No: 710556
Date Created: 10/25/2013   Contractor FEI: 730776271     Account No: 436600
Project Number(s): BRF-176C(121)CI
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD (NS-237): OVER UNNAMED CREEK, 7.0 MILES WEST AND 6.5 MILES SOUTH OF THE US-64/US-281 JUNCTION. PROJECT LENGTH = 0.180 MILES.
Primary County: WOODS              
Name of Road: COUNTY ROAD              
Prime Contractor: SEWELL BROS., INC.           Time Charged: 115.00
    1220 E. MAIN           Time Allowed: 111.00
    CORDELL , OK   73632           Percent Time: 103.60 %
  Paid To Date: $435,533.07 Payable This Statement: $695.27
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:    10/25/2013
Contract ID: 110322   Estimate Number: 0011     Contract No: 710556
Residency: CIRCUIT ENGR. DISTRICT # 8 (06009)   Estimate Type: Final     Account No: 436600
Project Number(s): BRF-176C(121)CI
Primary Job Piece No: 24196(04)
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD (NS-237): OVER UNNAMED CREEK, 7.0 MILES WEST AND 6.5 MILES SOUTH OF THE US-64/US-281 JUNCTION. PROJECT LENGTH = 0.180 MILES.
Primary County: WOODS              
Name of Road: COUNTY ROAD              
Prime Contractor: SEWELL BROS., INC.              
    1220 E. MAIN              
    CORDELL , OK   73632              
Surety Company: WESTFIELD INSURANCE COMPANY              
Date Let: 10/20/2011 NTP Effective Date: 02/06/2012 Pay Period: 09/01/2012  TO  10/15/2013
Date Awarded: 11/07/2011 Date Work Began: 12/29/2011 Original Contract Time: 105
Date Contract Executed: 11/22/2011 Date Time Stopped: 02/08/2013 Current Time Charged: 115.00
Date NTP Issued: 11/29/2011 Completion Date: 02/08/2013 Current Time Allowed: 111.00
General Liability Expires: 07/01/2014 Workman's Comp Expires: 07/01/2014 Percent Time Used: 103.60 %
Specification Year: 2009        
Current Contract Amount: $437,152.28 Total to Date Prev to Date This Estimate
Bid Amount: $410,082.80 Participating: $437,152.28 $436,456.96 $695.32
Percent Complete: 99.63 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $1,619.21 Total Earnings: $437,152.28 $436,456.96 $695.32
Unearned Balance: $-25,450.27 Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $437,152.28 $436,456.96 $695.32
Other Adjustments: $380.79 $380.84 $-0.05
Liq Dam/Disincentive: $-2,000.00 $-2,000.00 $0.00
TOTAL: $435,533.07 $434,837.80 $695.27

Estimate Adjustment Detail
Contract ID: 110322   Estimate Number: 0011     Primary JP: 24196(04)


CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 aCED8 CLSM at Avard bridge. Approved 04/10/2012 6.0 $22,381.33
002 a ced8 Extend Guardrail Approved 08/29/2012 0.0 $5,550.00
003 ced8 Final Quantity change order BRF-176C(121)CI Approved 05/29/2013 0.0 $-861.85


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 0008 --4.0 $500.00 $-2,000.00
Subtotals For Liquidated Damages $-2,000.00


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
24196(04) 0007 SUPERPAVE, TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0008 591.00 $0.64 $380.84
24196(04) 0007 SUPERPAVE, TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0011 0.29 $-0.16 $-0.05
Subtotals For Line Item Adjustments $380.79


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: 110322   Estimate Number: 0011     Primary JP: 24196(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-176C(121)CI Project:    24196(04) Category:    0100/ROADWAY
0001 EARTHWORK 202(H) 0185 LSUM 1.000 1.000   1.000 $10,000.00 $0.00 $10,000.00
0002 TEMPORARY SILT FENCE 221(C) 2801 LF 1,700.000 650.000   650.000 $2.20 $0.00 $1,430.00
0003 SOLID SLAB SODDING 230(A) 2806 SY 5,681.000 6,481.050   6,481.050 $1.60 $0.00 $10,369.68
0004 VEGETATIVE MULCHING 233(A) 2817 AC 1.170 0.000   0.000 $500.00 $0.00 $0.00
0005 AGGREGATE BASE TYPE A 303(A) 2100 CY 420.000 482.010 0.800 482.010 $84.55 $67.64 $40,753.95
0006 TACK COAT 407(B) 0250 GAL 127.000 12.000 -12.000 12.000 $5.00 $-60.00 $60.00
0007 SUPERPAVE, TYPE S4(PG 64-22 OK) 411(C) 5960 TON 568.000 591.290 0.290 591.290 $120.00 $34.80 $70,954.80
0008 CLASS C CONCRETE 509(D) 0325 CY 10.000 0.000   0.000 $300.00 $0.00 $0.00
8003 BEAM GUARDRAIL W-BEAM SINGLE 623(A) 1418 LF 0.000 300.000   300.000 $16.50 $0.00 $4,950.00
8004 GUARDRAIL ANCHOR UNIT (TYPE B) 623(F) 6030 EA 0.000 1.000   1.000 $600.00 $0.00 $600.00
Subtotals For Category     0100/ROADWAY    $42.44 $139,118.43
Fed/State Project Number:    BRF-176C(121)CI Project:    24196(04) Category:    0200/BRIDGE 'A'
0009 SUBSTRUCTURE EXCAVATION COMMON 501(B) 1307 CY 104.000 104.000   104.000 $7.00 $0.00 $728.00
0010 UNCLASSIFIED BACKFILL 501(D) 6353 CY 118.000 0.000   0.000 $7.00 $0.00 $0.00
0011 PRESTRESSED CONCRETE BEAMS (TYPE III) 503(A) 1312 LF 296.670 296.670   296.670 $176.00 $0.00 $52,213.92
0012 SAW-CUT GROOVING 504(B) 1305 SY 230.330 230.350 0.020 230.350 $6.00 $0.12 $1,382.10
0013 CONCRETE RAIL (TR3) 504(D) 6239 LF 231.000 231.000   231.000 $55.00 $0.00 $12,705.00
0014 STRUCTURAL STEEL 506(A) 1322 LB 375.000 375.000   375.000 $3.00 $0.00 $1,125.00
0015 WEATHERING STEEL FIXED BEARING ASSEMBLY 507(A) 6172 EA 4.000 4.000   4.000 $700.00 $0.00 $2,800.00
0016 WEATHERING STEEL EXPANSION BEARING ASSEMBLY 507(B) 6176 EA 4.000 4.000   4.000 $700.00 $0.00 $2,800.00
0017 CLASS AA CONCRETE 509(A) 1326 CY 58.300 58.300   58.300 $500.00 $0.00 $29,150.00
0018 CLASS A CONCRETE 509(B) 1328 CY 77.400 77.400   77.400 $485.00 $0.00 $37,539.00
0019 REINFORCING STEEL 511(A) 1332 LB 23,757.000 23,757.000   23,757.000 $0.90 $0.00 $21,381.30
0020 PILES, FURNISHED (HP 10X42) 514(A) 6010 LF 80.000 80.000   80.000 $25.00 $0.00 $2,000.00
0021 PILES, FURNISHED (HP 12X53) 514(A) 6011 LF 200.000 200.000   200.000 $35.00 $0.00 $7,000.00
0022 (PL)PILOT HOLES 514(K) 6260 LF 225.000 225.000   225.000 $120.00 $0.00 $27,000.00
0023 TYPE I-A PLAIN RIPRAP 601(B) 1353 TON 768.000 655.950 0.440 655.950 $44.00 $19.36 $28,861.80
0024 TYPE I-A FILTER BLANKET 601(C) 1355 TON 208.000 238.510 0.210 238.510 $40.00 $8.40 $9,540.40
0025 REMOVAL OF EXISTING BRIDGE STRUCTURE 619(D) 1397 LSUM 1.000 1.000   1.000 $6,000.00 $0.00 $6,000.00
0026 GUARDRAIL ANCHOR UNIT (TYPE II) 623(F) 6033 EA 4.000 4.000   4.000 $2,000.00 $0.00 $8,000.00
0027 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $1,900.00 $0.00 $1,900.00
8000 CLSM BACKFILL 501(G) 6309 CY 0.000 139.520   139.520 $142.75 $0.00 $19,916.48
8001 6" NON-PERF.PIPE UNDERDRAIN RND. 613(I) 1096 LF 0.000 50.000   50.000 $31.95 $0.00 $1,597.50
8002 6" PERFORATED PIPE UNDERDRAIN ROUND 613(H) 6204 LF 0.000 53.000   53.000 $31.95 $0.00 $1,693.35
Subtotals For Category     0200/BRIDGE 'A'    $27.88 $275,333.85
Fed/State Project Number:    BRF-176C(121)CI Project:    24196(04) Category:    0600/STAKING
0028 CONSTRUCTION STAKING LEVEL II 642(B) 0096 LSUM 1.000 1.000 0.050 1.000 $6,500.00 $325.00 $6,500.00
Subtotals For Category     0600/STAKING    $325.00 $6,500.00
Fed/State Project Number:    BRF-176C(121)CI Project:    24196(04) Category:    0640/CONSTRUCTION
0029 SWPPP DOCUMENTATION AND MANAGEMENT 220 2800 LSUM 1.000 1.000 0.250 1.000 $1,200.00 $300.00 $1,200.00
0030 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $15,000.00 $0.00 $15,000.00
Subtotals For Category     0640/CONSTRUCTION    $300.00 $16,200.00
Subtotals For Project BRF-176C(121)CI /24196(04) $695.32 $437,152.28