Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 110341   Estimate Number: 0010 , Final     Spec Year: 2009
Primary JP: 26273(04)   Residency: OKLAHOMA CITY (04600)     Contract No: 710179
Date Created: 09/27/2013   Contractor FEI: 731213020     Account No: 400400

Project Number(s): IMG-0035-3(298)129TR
Contract Description: SAFETY IMPROVEMENT (CABLE BARRIER) I-35: FROM 0.40 MILES NORTH OF THE US-62 JUNCTION IN OKLAHOMA CITY, EXTEND NORTH. PROJECT LENGTH = 2.670 MILES.
Primary County: OKLAHOMA              
Name of Road: I-35              
Prime Contractor: ACTION SAFETY SUPPLY CO.           Time Charged: 98.00
    P.O. BOX 270238           Time Allowed: 97.00
    OKLAHOMA CITY , OK   73137-0238           Percent Time: 101.03 %

  Paid To Date: $668,839.41 Payable This Statement: $0.00

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.                                
ACTION SAFETY SUPPLY CO.                               
 
_________________________________________________
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:    09/27/2013
Contract ID: 110341   Estimate Number: 0010     Contract No: 710179
Residency: OKLAHOMA CITY (04600)   Estimate Type: Final     Account No: 400400

Project Number(s): IMG-0035-3(298)129TR
Primary Job Piece No: 26273(04)
Contract Description: SAFETY IMPROVEMENT (CABLE BARRIER) I-35: FROM 0.40 MILES NORTH OF THE US-62 JUNCTION IN OKLAHOMA CITY, EXTEND NORTH. PROJECT LENGTH = 2.670 MILES.
Primary County: OKLAHOMA              
Name of Road: I-35              
Prime Contractor: ACTION SAFETY SUPPLY CO.              
    P.O. BOX 270238              
    OKLAHOMA CITY , OK   73137-0238              
Surety Company: GRANITE RE, INC.              

Date Let: 07/21/2011 NTP Effective Date: 01/03/2012 Pay Period: 08/31/2013  TO  09/27/2013
Date Awarded: 08/01/2011 Date Work Began: 01/03/2012 Original Contract Time: 90
Date Contract Executed: 08/16/2011 Date Time Stopped: 10/15/2012 Current Time Charged: 98.00
Date NTP Issued: 08/19/2011 Completion Date: 10/15/2012 Current Time Allowed: 97.00
General Liability Expires: 05/01/2014 Workman's Comp Expires: 07/01/2014 Percent Time Used: 101.03 %
Specification Year: 2009        

Current Contract Amount: $618,958.76 Total to Date Prev to Date This Estimate
Bid Amount: $841,662.63 Participating: $675,510.64 $675,510.64 $0.00
Percent Complete: 108 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $-49,880.65 Total Earnings: $675,510.64 $675,510.64 $0.00
Unearned Balance: $172,823.22 Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $675,510.64 $675,510.64 $0.00
Other Adjustments: $-6,171.23 $-6,171.23 $0.00
Liq Dam/Disincentive: $-500.00 $-500.00 $0.00
TOTAL: $668,839.41 $668,839.41 $0.00

Estimate Adjustment Detail

Contract ID: 110341   Estimate Number: 0010     Primary JP: 26273(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Change of Start Date Approved 12/19/2011 0.0 $0.00
002 Additional Work to Remove Concrete Curb Under Pavement Approved 02/08/2013 7.0 $20,578.04
003 Final Quantity Change Order Approved 09/13/2013 0.0 $-192,500.63
004 Loss of Overhead Solid Slab Sod Approved 08/22/2013 0.0 $-50,781.28


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 0006 --6.0 $500.00 $-3,000.00
System Application of Liquidated Damages 0007 --2.0 $500.00 $-1,000.00
System Application of Liquidated Damages 0008 -7.0 $500.00 $3,500.00
Subtotals For Liquidated Damages $-500.00


CONTRACT ADJUSTMENTS HISTORY
Adjustment Description Estimate Nbr Adjustment Amount
LD Adjustment (Prog. Est. Only) 0006 $3,000.00
LD Adjustment (Prog. Est. Only) 0007 $500.00
LD Adjustment (Prog. Est. Only) 0009 $-3,500.00
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
26273(04) 0007 SUPERPAVE, TYPE S3(PG 76-28 OK) Asphalt Binder Adjustment 0006 328.12 $0.55 $182.94
26273(04) 0007 SUPERPAVE, TYPE S3(PG 76-28 OK) * QAQC 0006 0.00 $0.00 $-790.34
26273(04) 0008 SUPERPAVE, TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0006 641.76 $0.55 $357.81
26273(04) 0009 SUPERPAVE, TYPE S4(PG 76-28 OK) Asphalt Binder Adjustment 0006 259.12 $0.63 $165.11
26273(04) 0009 SUPERPAVE, TYPE S4(PG 76-28 OK) * QAQC 0006 0.00 $0.00 $-6,086.75
26273(04) 0040 EXTRUDED ALUMINUM PANEL SIGNS(OVERHEAD SIGNS) * Material Discrepancy Adjustments 0007 -555.25 $21.00 $-11,660.25
26273(04) 0040 EXTRUDED ALUMINUM PANEL SIGNS(OVERHEAD SIGNS) * Material Discrepancy Adjustments 0008 555.25 $21.00 $11,660.25
26273(04) 0056 INLET ADJUST TO GRADE * Material Discrepancy Adjustments 0007 -4.00 $2,500.00 $-10,000.00
26273(04) 0056 INLET ADJUST TO GRADE * Material Discrepancy Adjustments 0008 4.00 $2,500.00 $10,000.00
Subtotals For Line Item Adjustments $-6,171.23
* = 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: 110341   Estimate Number: 0010     Primary JP: 26273(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:    IMG-0035-3(298)129TR Project:    26273(04) Category:    0100/ROADWAY
0001 AGGREGATE BASE TYPE A 303(A) 2100 CY 926.000 794.230   794.230 $32.00 $0.00 $25,415.36
0002 SUBGRADE, METHOD B 310(B) 0149 SY 3,283.000 2,263.700   2,263.700 $2.00 $0.00 $4,527.40
0003 SEPARATOR FABRIC 325 5271 SY 3,830.000 2,858.690   2,858.690 $1.30 $0.00 $3,716.29
0004 GEOGRID REINFORCEMENT 326(B) 0100 SY 3,283.000 2,382.700   2,382.700 $3.10 $0.00 $7,386.37
0005 TACK COAT 407(B) 0250 GAL 1,018.000 400.000   400.000 $3.10 $0.00 $1,240.00
0006 PRIME COAT 408 5774 GAL 1,079.000 900.000   900.000 $3.10 $0.00 $2,790.00
0007 SUPERPAVE, TYPE S3(PG 76-28 OK) 411(B) 5935 TON 342.000 328.120   328.120 $86.00 $0.00 $28,218.32
0008 SUPERPAVE, TYPE S3(PG 64-22 OK) 411(B) 5945 TON 700.000 641.760   641.760 $80.00 $0.00 $51,340.80
0009 SUPERPAVE, TYPE S4(PG 76-28 OK) 411(C) 5950 TON 225.000 259.120   259.120 $97.00 $0.00 $25,134.64
0010 INLET (SMD-TYPE 2) 611(G) 6002 EA 1.000 1.000   1.000 $4,500.00 $0.00 $4,500.00
0011 18" R.C.PIPE CLASS III 613(A) 0491 LF 5.000 6.750   6.750 $175.00 $0.00 $1,181.25
0012 EDGE DRAIN CONDUIT-PERFORATED 613(J) 5915 LF 1,231.000 1,071.000   1,071.000 $11.00 $0.00 $11,781.00
0013 EDGE DRAIN OUTLET LATERAL-NONPERFORATED 613(K) 5916 LF 615.000 0.000   0.000 $11.00 $0.00 $0.00
0014 STANDARD BEDDING MATERIAL, CLASS C 613(T) 1187 CY 1.910 1.850   1.850 $100.00 $0.00 $185.00
0015 PIPE UNDERDRAIN COVER MAT'L. 613(U) 1100 CY 46.000 31.880   31.880 $65.00 $0.00 $2,072.20
0016 TRENCH EXCAVATION 613(V) 1180 CY 1.910 2.580   2.580 $100.00 $0.00 $258.00
0017 REMOVAL OF ASPHALT PAVEMENT 619(B) 4728 SY 476.000 595.000   595.000 $8.00 $0.00 $4,760.00
0018 SAWING PAVEMENT 619(C) 0924 LF 1,080.000 2,142.000   2,142.000 $3.00 $0.00 $6,426.00
8000 REMOVAL OF CURB AND GUTTER 619(B) 4726 LF 0.000 1,071.000   1,071.000 $0.60 $0.00 $642.60
8002 SAWING PAVEMENT 619(C) 0924 LF 0.000 1,071.000   1,071.000 $2.40 $0.00 $2,570.40
8010 SOLID SLAB SODDING 230(A) 2806 SY 0.000 57,706.000   57,706.000 $0.10 $0.00 $5,770.60
Subtotals For Category     0100/ROADWAY    $0.00 $189,916.23
Fed/State Project Number:    IMG-0035-3(298)129TR Project:    26273(04) Category:    0300/TRAFFIC
0019 CONSTRUCTION TRAFFIC STRIPE(PAINT)(4" WIDE) 857(A) 8839 LF 4,200.000 10,404.000   10,404.000 $0.10 $0.00 $1,040.40
0020 (PL)CONSTRUCTION ZONE PAVEMENT MARKERS(FLEX TAB)TYPE 2-1 857(E) 8887 EA 615.000 0.000   0.000 $0.40 $0.00 $0.00
0021 PAVEMENT MARKING REMOVAL(TRAFFIC STRIPE) 857(F) 8006 LF 4,000.000 14,253.140   14,253.140 $0.25 $0.00 $3,563.29
0022 (SP)CONST.ZONE IMPACT ATTEN. 871(B) 8705 SD 60.000 149.000   149.000 $30.00 $0.00 $4,470.00
0023 (PL)TRUCK MOUNTED ATTENUATOR 876(A) 8482 SD 90.000 11.000   11.000 $4.00 $0.00 $44.00
0024 DELIVER PORTABLE LONGITUDINAL BARRIER 877(B) 8484 LF 1,475.000 1,400.000   1,400.000 $12.65 $0.00 $17,710.00
0025 ARROW DISPLAY(TYPE C) 880(A) 8812 SD 90.000 3.000   3.000 $0.40 $0.00 $1.20
0026 CONSTRUCTION SIGNS 0 TO 6.25 SF 880(B) 8818 SD 2,790.000 2,717.000   2,717.000 $0.50 $0.00 $1,358.50
0027 CONSTRUCTION SIGNS 6.26 SF TO 15.99 SF 880(B) 8821 SD 2,160.000 1,375.000   1,375.000 $0.50 $0.00 $687.50
0028 CONSTRUCTION SIGNS 16.0 SF TO 32.99 SF 880(B) 8824 SD 1,980.000 4,920.000   4,920.000 $1.00 $0.00 $4,920.00
0029 CONSTRUCTION BARRICADES(TYPE III) 880(C) 8842 SD 720.000 0.000   0.000 $0.05 $0.00 $0.00
0030 WING BARRICADES 880(C) 8848 SD 540.000 1,008.000   1,008.000 $0.05 $0.00 $50.40
0031 VERTICAL PANELS 880(D) 8854 SD 1,800.000 0.000   0.000 $0.02 $0.00 $0.00
0032 WARNING LIGHTS(TYPE A) 880(E) 8860 SD 3,690.000 3,933.000   3,933.000 $0.02 $0.00 $78.66
0033 DRUMS 880(F) 8878 SD 2,700.000 5,510.000   5,510.000 $0.02 $0.00 $110.20
0034 CHANNELIZER CONES 880(G) 8890 SD 42,750.000 50,690.000   50,690.000 $0.02 $0.00 $1,013.80
0035 TRAFFIC SURVEILLANCE, POLICE 880(L) 8911 HOUR 720.000 162.000   162.000 $51.00 $0.00 $8,262.00
0036 (SP)SMART WORK ZONE SYSTEM-PORTABLE CHANGEABLE MESSAGE SIGN 882 8370 SD 1,080.000 488.000   488.000 $17.00 $0.00 $8,296.00
0037 (SP)SMART WORK ZONE SYSTEM-PAN-TILT-ZOOM CAMERA (PTZC) 882 8374 SD 180.000 0.000   0.000 $12.00 $0.00 $0.00
0038 (SP)SMART WORK ZONE SYSTEM-WEBSITE SYSTEM 882 8376 SD 90.000 168.000   168.000 $3.00 $0.00 $504.00
0039 (PL)TRAFFIC ITEMS 890 7700 LSUM 1.000 1.000   1.000 $59,125.00 $0.00 $59,125.00
8001 RELOCATION OF PORT. LONGITUDINAL BARRIER 877(C) 8486 LF 0.000 1,400.000   1,400.000 $5.55 $0.00 $7,770.00
Subtotals For Category     0300/TRAFFIC    $0.00 $119,004.95
Fed/State Project Number:    IMG-0035-3(298)129TR Project:    26273(04) Category:    0301/SIGNING & STRIPING
0040 EXTRUDED ALUMINUM PANEL SIGNS(OVERHEAD SIGNS) 850(B) 8114 SF 554.500 555.250   555.250 $21.00 $0.00 $11,660.25
0041 REPAIR OVHD.SN.STR.TYPE C-1 ALUM. 852(L) 8772 EA 1.000 0.000   0.000 $9,000.00 $0.00 $0.00
0042 TRAFFIC STRIPE(PLASTIC)(4" WIDE) 855(A) 8812 LF 2,500.000 5,268.000   5,268.000 $0.90 $0.00 $4,741.20
0043 TRAFFIC STRIPE(PLASTIC)(6" WIDE) 855(A) 8813 LF 850.000 921.000   921.000 $1.50 $0.00 $1,381.50
0044 TRAFFIC STRIPE(PLASTIC)(SYMBOLS) 855(B) 8824 EA 6.000 0.000   0.000 $1,650.00 $0.00 $0.00
Subtotals For Category     0301/SIGNING & STRIPING    $0.00 $17,782.95
Fed/State Project Number:    IMG-0035-3(298)129TR Project:    26273(04) Category:    0304/CABLE BARRIER
0045 UNCLASSIFIED EXCAVATION 202(A) 0183 CY 1,393.000 1,393.000   1,393.000 $12.00 $0.00 $16,716.00
0046 UNCLASSIFIED BORROW 202(D) 0184 CY 500.000 0.000   0.000 $20.00 $0.00 $0.00
0047 TEMPORARY SILT FENCE 221(C) 2801 LF 1,150.000 0.000   0.000 $0.59 $0.00 $0.00
0048 TEMPORARY SEDIMENT FILTER 221(D) 2803 EA 11.000 13.000   13.000 $100.00 $0.00 $1,300.00
0049 TEMPORARY SILT DIKE 221(F) 0100 LF 910.000 0.000   0.000 $7.00 $0.00 $0.00
0050 SOLID SLAB SODDING 230(A) 2806 SY 57,706.000 -57,706.000   0.000 $0.98 $0.00 $0.00
0051 MOWING 241 2832 AC 28.000 41.230   41.230 $59.00 $0.00 $2,432.57
0052 TRAFFIC BOUND SURFACE COURSE TYPE E 402(E) 0225 TON 1,687.000 1,440.270   1,440.270 $28.50 $0.00 $41,047.70
0053 CLASS AA CONCRETE 509(A) 0319 CY 146.000 142.050   142.050 $110.00 $0.00 $15,625.50
0054 CLASS C CONCRETE 509(D) 0325 CY 61.000 0.840   0.840 $550.00 $0.00 $462.00
0055 REINFORCING STEEL 511(A) 0332 LB 639.000 0.000   0.000 $1.75 $0.00 $0.00
0056 INLET ADJUST TO GRADE 612(C) 0645 EA 5.000 4.000   4.000 $2,500.00 $0.00 $10,000.00
0057 SAWING PAVEMENT 619(C) 0924 LF 100.000 0.000   0.000 $3.00 $0.00 $0.00
0058 HIGH-TENSION CABLE BARRIER(TL-4) 628(B) 5125 LF 13,095.000 13,094.000   13,094.000 $8.71 $0.00 $114,048.74
0059 END ANCHORS 628(C) 5110 EA 8.000 8.000   8.000 $5,000.00 $0.00 $40,000.00
0060 CABLE BARRIER TENSION METER 628(E) 5175 EA 1.000 0.000   0.000 $3,000.00 $0.00 $0.00
0061 SAND FILLED IMPACT ATTENUATION MODULE 870(A) 8011 EA 90.000 114.000   114.000 $300.00 $0.00 $34,200.00
Subtotals For Category     0304/CABLE BARRIER    $0.00 $275,832.51
Fed/State Project Number:    IMG-0035-3(298)129TR Project:    26273(04) Category:    0600/STAKING
0062 CONSTRUCTION STAKING LEVEL II 642(B) 0096 LSUM 1.000 1.000   1.000 $6,000.00 $0.00 $6,000.00
Subtotals For Category     0600/STAKING    $0.00 $6,000.00
Fed/State Project Number:    IMG-0035-3(298)129TR Project:    26273(04) Category:    0640/CONSTRUCTION
0063 MOBILIZATION 641 1552 LSUM 1.000 1.000   1.000 $66,974.00 $0.00 $66,974.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $66,974.00
Subtotals For Project IMG-0035-3(298)129TR /26273(04) $0.00 $675,510.64


1 CURRENT QUANTITIES DO NOT MATCH THE QUANTITY PAID TO DATE