Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 110411   Estimate Number: 0014 , Final     Spec Year: 2009
Primary JP: 25910(04)   Residency: CIRCUIT ENGR. DISTRICT # 8 (06009)     Contract No: 710564
Date Created: 06/06/2014   Contractor FEI: 730776271     Account No: 436600

Project Number(s): BRO-102D(136)CI
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD (EW-030): OVER EAGLE CHIEF CREEK 1.0 MILE NORTH OF SH-45 AND 5.7 MILES WEST OF SH-8, WEST OF CARMEN. PROJECT LENGTH = 0.274 MILE.
Primary County: ALFALFA              
Name of Road: COUNTY ROAD              
Prime Contractor: SEWELL BROS., INC.           Time Charged: 155.00
    1220 E. MAIN           Time Allowed: 156.00
    CORDELL , OK   73632           Percent Time: 99.36 %

  Paid To Date: $875,669.31 Payable This Statement: $16,075.69

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:    06/06/2014
Contract ID: 110411   Estimate Number: 0014     Contract No: 710564
Residency: CIRCUIT ENGR. DISTRICT # 8 (06009)   Estimate Type: Final     Account No: 436600

Project Number(s): BRO-102D(136)CI
Primary Job Piece No: 25910(04)
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD (EW-030): OVER EAGLE CHIEF CREEK 1.0 MILE NORTH OF SH-45 AND 5.7 MILES WEST OF SH-8, WEST OF CARMEN. PROJECT LENGTH = 0.274 MILE.
Primary County: ALFALFA              
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: 12/01/2012  TO  05/31/2014
Date Awarded: 11/07/2011 Date Work Began: 01/23/2012 Original Contract Time: 150
Date Contract Executed: 11/22/2011 Date Time Stopped: 10/28/2013 Current Time Charged: 155.00
Date NTP Issued: 11/29/2011 Completion Date: 10/28/2013 Current Time Allowed: 156.00
General Liability Expires: 07/01/2014 Workman's Comp Expires: 07/01/2014 Percent Time Used: 99.36 %
Specification Year: 2009        

Bid Amount: $875,761.90 Total to Date Prev to Date This Estimate
Funds Available (Bid + Positive C/O): $885,283.90 Participating: $875,669.31 $860,493.62 $15,175.69
Percent Complete: 98.91 % Non Participating: $0.00 $0.00 $0.00
Unearned Balance: $9,614.59 Total Earnings: $875,669.31 $860,493.62 $15,175.69
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $875,669.31 $860,493.62 $15,175.69
Other Adjustments: $0.00 $-900.00 $900.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $875,669.31 $859,593.62 $16,075.69

Estimate Adjustment Detail

Contract ID: 110411   Estimate Number: 0014     Primary JP: 25910(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 ACED8 Additional Drive Approved 07/31/2012 6.0 $9,522.00
002 ced8 Alfalfa Eagle Chief 136 Final Quantity Change Ordr Approved 06/03/2014 0.0 $-9,614.59


STOCKPILE PAYMENT HISTORY
Project Line Nbr Stockpile Description Adjustment Type Estimate Nbr Adjusted Amount
25910(04) 0014 PC BR ITM FABS (AML) Stockpiled Material Adjustment 0006 $-151,752.18
25910(04) 0014 PC BR ITM FABS (AML) Stockpiled Material Initial Payment 0001 $151,752.18
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
25910(04) 8000 UNCLASSIFIED EXCAVATION * Material Discrepancy Adjustments 0012 -150.00 $6.00 $-900.00
25910(04) 8000 UNCLASSIFIED EXCAVATION * Material Discrepancy Adjustments 0014 0.00 $0.00 $900.00
Subtotals For Line Item Adjustments $0.00
* = 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: 110411   Estimate Number: 0014     Primary JP: 25910(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:    BRO-102D(136)CI Project:    25910(04) Category:    0100/ROADWAY
0001 EARTHWORK 202(H) 0185 LSUM 1.000 1.000   1.000 $30,000.00 $0.00 $30,000.00
0002 TEMPORARY SILT FENCE 221(C) 2801 LF 200.000 700.000   700.000 $2.00 $0.00 $1,400.00
0003 TEMPORARY SILT DIKE 221(F) 0100 LF 1,100.000 0.000   0.000 $5.50 $0.00 $0.00
0004 SOLID SLAB SODDING 230(A) 2806 SY 14,446.000 10,193.170 251.680 10,193.170 $1.60 $402.69 $16,309.07
0005 VEGETATIVE MULCHING 233(A) 2817 AC 2.980 0.000   0.000 $500.00 $0.00 $0.00
0006 TRAFFIC BOUND SURFACE COURSE TYPE E 402(E) 0225 TON 629.000 829.710 51.320 829.710 $35.55 $1,824.43 $29,496.19
0007 CLASS C CONCRETE 509(D) 0325 CY 10.000 0.000   0.000 $300.00 $0.00 $0.00
0008 36" CORR. GALV. STEEL PIPE 613(B) 0692 LF 166.000 246.000   246.000 $38.00 $0.00 $9,348.00
0009 42" CORR. GALV. STEEL PIPE 613(B) 0693 LF 148.000 148.000   148.000 $46.00 $0.00 $6,808.00
0010 TYPE D4 CULVERT END TREATMENT 613(M) 7189 EA 4.000 6.000   6.000 $950.00 $0.00 $5,700.00
0011 TYPE DD4 CULVERT END TREATMENT 613(M) 7194 EA 2.000 2.000   2.000 $1,100.00 $0.00 $2,200.00
8000 UNCLASSIFIED EXCAVATION 202(A) 0183 CY 0.000 150.000 -150.000 150.000 $6.00 $-900.00 $900.00
8001 24" CORR. GALV. STEEL PIPE 613(B) 0690 LF 0.000 0.000   0.000 $38.00 $0.00 $0.00
8002 TYPE B4 SLOPED CONCRETE END SECTION 613(N) 7501 EA 0.000 0.000   0.000 $1,000.00 $0.00 $0.00
Subtotals For Category     0100/ROADWAY    $1,327.12 $102,161.26
Fed/State Project Number:    BRO-102D(136)CI Project:    25910(04) Category:    0200/BRIDGE
0012 SUBSTRUCTURE EXCAVATION COMMON 501(B) 1307 CY 96.000 96.000   96.000 $7.00 $0.00 $672.00
0013 UNCLASSIFIED BACKFILL 501(D) 6353 CY 114.000 114.000   114.000 $7.00 $0.00 $798.00
0014 PRESTRESSED CONCRETE BEAMS (TYPE IV) 503(A) 1313 LF 1,128.500 1,128.500   1,128.500 $175.00 $0.00 $197,487.50
0015 SEALED EXPANSION JOINT 504(C) 6250 LF 33.970 33.970   33.970 $235.00 $0.00 $7,982.95
0016 CONCRETE RAIL (TR3) 504(D) 6239 LF 643.160 643.160   643.160 $55.00 $0.00 $35,373.80
0017 STRUCTURAL STEEL 506(A) 1322 LB 530.000 530.000   530.000 $3.50 $0.00 $1,855.00
0018 WEATHERING STEEL FIXED BEARING ASSEMBLY 507(A) 6172 EA 12.000 12.000   12.000 $800.00 $0.00 $9,600.00
0019 WEATHERING STEEL EXPANSION BEARING ASSEMBLY 507(B) 6176 EA 12.000 12.000   12.000 $800.00 $0.00 $9,600.00
0020 CLASS AA CONCRETE 509(A) 1326 CY 215.800 215.800   215.800 $450.00 $0.00 $97,110.00
0021 CLASS A CONCRETE 509(B) 1328 CY 95.800 95.800   95.800 $450.00 $0.00 $43,110.00
0022 REINFORCING STEEL 511(A) 1332 LB 61,459.000 61,459.000   61,459.000 $0.90 $0.00 $55,313.10
0023 PILES, FURNISHED (HP 10X42) 514(A) 6010 LF 979.000 979.000 0.000 979.000 $24.00 $0.00 $23,496.00
0024 PILES, DRIVEN (HP 10X42) 514(B) 6292 LF 979.000 636.830 313.530 636.830 $11.00 $3,448.83 $7,005.13
0025 DRILLED SHAFTS 42" DIAMETER 516(A) 6093 LF 218.000 221.660 2.660 221.660 $400.00 $1,064.00 $88,664.00
0026 TYPE I-A PLAIN RIPRAP 601(B) 1353 TON 2,386.000 2,482.790 93.790 2,482.790 $44.00 $4,126.76 $109,242.76
0027 TYPE I-A FILTER BLANKET 601(C) 1355 TON 720.000 753.790 68.820 753.790 $39.00 $2,683.98 $29,397.81
0028 REMOVAL OF EXISTING BRIDGE STRUCTURE 619(D) 1397 LSUM 1.000 1.000   1.000 $7,500.00 $0.00 $7,500.00
0029 GUARDRAIL ANCHOR UNIT (TYPE II) 623(F) 6033 EA 4.000 4.000   4.000 $2,200.00 $0.00 $8,800.00
0030 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000 0.250 1.000 $2,000.00 $500.00 $2,000.00
Subtotals For Category     0200/BRIDGE    $11,823.57 $735,008.05
Fed/State Project Number:    BRO-102D(136)CI Project:    25910(04) Category:    0600/STAKING
0031 CONSTRUCTION STAKING LEVEL II 642(B) 0096 LSUM 1.000 1.000 0.250 1.000 $7,500.00 $1,875.00 $7,500.00
Subtotals For Category     0600/STAKING    $1,875.00 $7,500.00
Fed/State Project Number:    BRO-102D(136)CI Project:    25910(04) Category:    0640/CONSTRUCTION
0032 SWPPP DOCUMENTATION AND MANAGEMENT 220 2800 LSUM 1.000 1.000 0.150 1.000 $1,000.00 $150.00 $1,000.00
0033 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $30,000.00 $0.00 $30,000.00
Subtotals For Category     0640/CONSTRUCTION    $150.00 $31,000.00
Subtotals For Project BRO-102D(136)CI /25910(04) $15,175.69 $875,669.31