Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 110455   Estimate Number: 0012 , Final     Spec Year: 2009
Primary JP: 28593(05)   Residency: ENGINEERING SERVICES & TESTING (08001)     Contract No: 710148
Date Created: 11/07/2013   Contractor FEI: 731452899     Account No: 400800

Project Number(s): BRFY-172A(531)3B
Contract Description: JOINT SEAL/REPAIR I-244/US-64/US-75/UNION AVE: AT VARIOUS LOCATIONS IN DIVISION VIII.
Primary County: TULSA              
Name of Road: MULTIPLE LOCATIONS              
Prime Contractor: PBX CORPORATION           Time Charged: 87.00
    P.O. BOX 644           Time Allowed: 122.00
    SAPULPA , OK   74067           Percent Time: 71.31 %

  Paid To Date: $907,918.77 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.                                
PBX CORPORATION                                
 
_________________________________________________
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:    11/07/2013
Contract ID: 110455   Estimate Number: 0012     Contract No: 710148
Residency: ENGINEERING SERVICES & TESTING (08001)   Estimate Type: Final     Account No: 400800

Project Number(s): BRFY-172A(531)3B
Primary Job Piece No: 28593(05)
Contract Description: JOINT SEAL/REPAIR I-244/US-64/US-75/UNION AVE: AT VARIOUS LOCATIONS IN DIVISION VIII.
Primary County: TULSA              
Name of Road: MULTIPLE LOCATIONS              
Prime Contractor: PBX CORPORATION              
    P.O. BOX 644              
    SAPULPA , OK   74067              
Surety Company: WESTFIELD INSURANCE COMPANY              

Date Let: 09/15/2011 NTP Effective Date: 11/28/2011 Pay Period: 11/06/2013  TO  11/07/2013
Date Awarded: 10/03/2011 Date Work Began: 02/16/2012 Original Contract Time: 90
Date Contract Executed: 10/12/2011 Date Time Stopped: 10/01/2012 Current Time Charged: 87.00
Date NTP Issued: 10/20/2011 Completion Date: 10/01/2012 Current Time Allowed: 122.00
General Liability Expires: 10/05/2014 Workman's Comp Expires: 10/05/2014 Percent Time Used: 71.31 %
Specification Year: 2009        

Bid Amount: $700,136.30 Total to Date Prev to Date This Estimate
Funds Available (Bid + Positive C/O): $907,918.77 Participating: $907,918.78 $907,918.78 $0.00
Percent Complete: 100 % Non Participating: $0.00 $0.00 $0.00
Unearned Balance: $0.00 Total Earnings: $907,918.78 $907,918.78 $0.00
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $907,918.78 $907,918.78 $0.00
Other Adjustments: $-0.01 $-0.01 $0.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $907,918.77 $907,918.77 $0.00

Estimate Adjustment Detail

Contract ID: 110455   Estimate Number: 0012     Primary JP: 28593(05)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Emergency Full Depth Bridge Deck Repair B, G, H Approved 09/11/2012 32.0 $104,851.55
002 Additional Rapid Cure Joint Sealant and Elastomeric Mortar Approved 03/05/2013 0.0 $94,182.00
003 Final Quantity Change Order Approved 11/04/2013 0.0 $8,748.92


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
Withhold to Funds Avail(Prog. Est. Only) 0009 $-70,900.00
Withhold to Funds Avail(Prog. Est. Only) 0010 $65,900.00
Withhold to Funds Avail(Prog. Est. Only) 0011 $5,000.00
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
28593(05) 0011 ELASTOMERIC MORTAR * Rounding Error Correction 0011 0.00 $0.00 $-0.01
Subtotals For Line Item Adjustments $-0.01
* = 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: 110455   Estimate Number: 0012     Primary JP: 28593(05)



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:    BRFY-172A(531)3B Project:    28593(05) Category:    0200/BRIDGE 'A'
0001 RAPID CURE JOINT SEALANT 504(G) 6390 LF 145.000 415.560   415.560 $30.00 $0.00 $12,466.80
0002 ELASTOMERIC MORTAR 504(H) 6389 CF 47.700 75.620   75.620 $625.00 $0.00 $47,262.50
0003 SILICONE CONSTRUCTION JOINT 509 6386 LF 145.000 0.000   0.000 $7.00 $0.00 $0.00
0004 CLASS B BRIDGE DECK REPAIR 513(B) 6019 SY 50.000 8.190   8.190 $300.00 $0.00 $2,457.00
0005 PREPARATION OF CRACKS, ABOVE WATER 520(A) 6058 LF 50.000 38.500   38.500 $23.00 $0.00 $885.50
0006 EPOXY RESIN, ABOVE WATER 520(C) 6060 GAL 0.500 0.500   0.500 $70.00 $0.00 $35.00
0007 PNEUMATICALLY PLACED MORTAR 521(A) 6210 SY 20.000 17.800   17.800 $525.00 $0.00 $9,345.00
0008 DECK AREA SEALED (FLOODCOATS) 523(C) 6570 SY 814.000 813.450   813.450 $18.00 $0.00 $14,642.10
0009 (PL)REPLACE BRIDGE ITEM (TYPE A) 545 4815 EA 1.000 1.000   1.000 $2,000.00 $0.00 $2,000.00
Subtotals For Category     0200/BRIDGE 'A'    $0.00 $89,093.90
Fed/State Project Number:    BRFY-172A(531)3B Project:    28593(05) Category:    0201/BRIDGE 'B'
0010 RAPID CURE JOINT SEALANT 504(G) 6390 LF 145.000 558.840   558.840 $30.00 $0.00 $16,765.20
0011 ELASTOMERIC MORTAR 504(H) 6389 CF 47.700 70.070   70.070 $625.00 $0.00 $43,793.76
0012 SILICONE CONSTRUCTION JOINT 509 6386 LF 145.000 0.000   0.000 $7.00 $0.00 $0.00
0013 CLASS B BRIDGE DECK REPAIR 513(B) 6019 SY 50.000 15.370   15.370 $300.00 $0.00 $4,611.00
0014 PREPARATION OF CRACKS, ABOVE WATER 520(A) 6058 LF 50.000 66.000   66.000 $23.00 $0.00 $1,518.00
0015 EPOXY RESIN, ABOVE WATER 520(C) 6060 GAL 0.500 0.500   0.500 $70.00 $0.00 $35.00
0016 PNEUMATICALLY PLACED MORTAR 521(A) 6210 SY 10.000 12.650   12.650 $525.00 $0.00 $6,641.25
0017 DECK AREA SEALED (FLOODCOATS) 523(C) 6570 SY 814.000 813.450   813.450 $18.00 $0.00 $14,642.10
8010 (PL)REPAIR BRIDGE ITEM (TYPE A) 540 4510 LSUM 0.000 1.000   1.000 $40,020.85 $0.00 $40,020.85
Subtotals For Category     0201/BRIDGE 'B'    $0.00 $128,027.16
Fed/State Project Number:    BRFY-172A(531)3B Project:    28593(05) Category:    0202/BRIDGE 'C'
0018 CLSM BACKFILL 501(G) 6309 CY 5.000 16.500   16.500 $500.00 $0.00 $8,250.00
0019 RAPID CURE JOINT SEALANT 504(G) 6390 LF 77.400 270.500   270.500 $30.00 $0.00 $8,115.00
0020 ELASTOMERIC MORTAR 504(H) 6389 CF 16.000 8.620   8.620 $700.00 $0.00 $6,034.00
0021 SILICONE CONSTRUCTION JOINT 509 6386 LF 154.400 0.000   0.000 $7.00 $0.00 $0.00
0022 CLASS B BRIDGE DECK REPAIR 513(B) 6019 SY 10.000 36.150   36.150 $300.00 $0.00 $10,845.00
0023 PREPARATION OF CRACKS, ABOVE WATER 520(A) 6058 LF 50.000 0.000   0.000 $23.00 $0.00 $0.00
0024 EPOXY RESIN, ABOVE WATER 520(C) 6060 GAL 0.500 0.000   0.000 $70.00 $0.00 $0.00
0025 PNEUMATICALLY PLACED MORTAR 521(A) 6210 SY 10.000 31.470   31.470 $525.00 $0.00 $16,521.75
0026 DECK AREA SEALED (FLOODCOATS) 523(C) 6570 SY 898.000 891.730   891.730 $18.00 $0.00 $16,051.14
0027 MASTIC ASPHALT JOINT MATERIAL 535 6410 CF 26.000 26.000   26.000 $400.00 $0.00 $10,400.00
0028 (PL)REPAIR BRIDGE ITEM (TYPE A) 540 4515 EA 1.000 1.000   1.000 $3,500.00 $0.00 $3,500.00
0029 (PL)REPLACE BRIDGE ITEM (TYPE A) 545 4815 EA 3.000 0.000   0.000 $1,500.00 $0.00 $0.00
Subtotals For Category     0202/BRIDGE 'C'    $0.00 $79,716.89
Fed/State Project Number:    BRFY-172A(531)3B Project:    28593(05) Category:    0203/BRIDGE 'D'
0030 CLSM BACKFILL 501(G) 6309 CY 5.000 0.000   0.000 $500.00 $0.00 $0.00
0031 (PL)FALSEWORK JACKING 502 6116 LSUM 1.000 1.000   1.000 $3,000.00 $0.00 $3,000.00
0032 RAPID CURE JOINT SEALANT 504(G) 6390 LF 83.000 322.400   322.400 $30.00 $0.00 $9,672.00
0033 ELASTOMERIC MORTAR 504(H) 6389 CF 27.100 32.480   32.480 $625.00 $0.00 $20,300.00
0034 SILICONE CONSTRUCTION JOINT 509 6386 LF 239.000 0.000   0.000 $7.00 $0.00 $0.00
0035 CLASS B BRIDGE DECK REPAIR 513(B) 6019 SY 10.000 7.580   7.580 $300.00 $0.00 $2,274.00
0036 PREPARATION OF CRACKS, ABOVE WATER 520(A) 6058 LF 50.000 37.420   37.420 $23.00 $0.00 $860.66
0037 EPOXY RESIN, ABOVE WATER 520(C) 6060 GAL 0.500 0.500   0.500 $70.00 $0.00 $35.00
0038 PNEUMATICALLY PLACED MORTAR 521(A) 6210 SY 10.000 8.510   8.510 $525.00 $0.00 $4,467.75
0039 DECK AREA SEALED (FLOODCOATS) 523(C) 6570 SY 772.000 771.510   771.510 $18.00 $0.00 $13,887.18
0040 (PL)REPAIR BRIDGE ITEM (TYPE A) 540 4515 EA 1.000 1.000   1.000 $1,500.00 $0.00 $1,500.00
0041 (PL)REPLACE BRIDGE ITEM (TYPE A) 545 4815 EA 1.000 1.000   1.000 $2,000.00 $0.00 $2,000.00
0042 (PL)REPLACE BRIDGE ITEM (TYPE B) 545 4825 EA 1.000 1.000   1.000 $3,000.00 $0.00 $3,000.00
Subtotals For Category     0203/BRIDGE 'D'    $0.00 $60,996.59
Fed/State Project Number:    BRFY-172A(531)3B Project:    28593(05) Category:    0204/BRIDGE 'E'
0043 CLSM BACKFILL 501(G) 6309 CY 5.000 0.000   0.000 $500.00 $0.00 $0.00
0044 RAPID CURE JOINT SEALANT 504(G) 6390 LF 83.000 322.400   322.400 $30.00 $0.00 $9,672.00
0045 ELASTOMERIC MORTAR 504(H) 6389 CF 27.100 34.100   34.100 $625.00 $0.00 $21,312.50
0046 SILICONE CONSTRUCTION JOINT 509 6386 LF 239.000 0.000   0.000 $7.00 $0.00 $0.00
0047 CLASS B BRIDGE DECK REPAIR 513(B) 6019 SY 10.000 4.320   4.320 $300.00 $0.00 $1,296.00
0048 PREPARATION OF CRACKS, ABOVE WATER 520(A) 6058 LF 50.000 14.830   14.830 $23.00 $0.00 $341.09
0049 EPOXY RESIN, ABOVE WATER 520(C) 6060 GAL 0.500 0.500   0.500 $70.00 $0.00 $35.00
0050 PNEUMATICALLY PLACED MORTAR 521(A) 6210 SY 10.000 2.500   2.500 $525.00 $0.00 $1,312.50
0051 DECK AREA SEALED (FLOODCOATS) 523(C) 6570 SY 772.000 771.510   771.510 $18.00 $0.00 $13,887.18
Subtotals For Category     0204/BRIDGE 'E'    $0.00 $47,856.27
Fed/State Project Number:    BRFY-172A(531)3B Project:    28593(05) Category:    0205/BRIDGE 'F'
0052 RAPID CURE JOINT SEALANT 504(G) 6390 LF 98.000 172.750   172.750 $30.00 $0.00 $5,182.50
0053 ELASTOMERIC MORTAR 504(H) 6389 CF 23.400 29.030   29.030 $625.00 $0.00 $18,143.75
0054 SILICONE CONSTRUCTION JOINT 509 6386 LF 49.000 0.000   0.000 $7.00 $0.00 $0.00
0055 PREPARATION OF CRACKS, ABOVE WATER 520(A) 6058 LF 50.000 70.000   70.000 $23.00 $0.00 $1,610.00
0056 EPOXY RESIN, ABOVE WATER 520(C) 6060 GAL 0.500 0.500   0.500 $70.00 $0.00 $35.00
0057 PNEUMATICALLY PLACED MORTAR 521(A) 6210 SY 50.000 50.310   50.310 $525.00 $0.00 $26,412.75
0058 SEALER CRACK PREPARATION 523(A) 6550 LF 105.000 111.400   111.400 $2.00 $0.00 $222.80
0059 SEALER RESIN 523(B) 6560 GAL 1.100 1.100   1.100 $50.00 $0.00 $55.00
0060 DECK AREA SEALED (FLOODCOATS) 523(C) 6570 SY 588.000 587.130   587.130 $18.00 $0.00 $10,568.34
0061 (PL)REPAIR BRIDGE ITEM (TYPE A) 540 4515 EA 2.000 2.000   2.000 $25,000.00 $0.00 $50,000.00
Subtotals For Category     0205/BRIDGE 'F'    $0.00 $112,230.14
Fed/State Project Number:    BRFY-172A(531)3B Project:    28593(05) Category:    0206/BRIDGE 'G'
0062 CLSM BACKFILL 501(G) 6309 CY 5.000 0.000   0.000 $500.00 $0.00 $0.00
0063 RAPID CURE JOINT SEALANT 504(G) 6390 LF 108.500 331.440   331.440 $30.00 $0.00 $9,943.20
0064 ELASTOMERIC MORTAR 504(H) 6389 CF 40.700 48.270   48.270 $625.00 $0.00 $30,168.75
0065 SILICONE CONSTRUCTION JOINT 509 6386 LF 108.500 0.000   0.000 $7.00 $0.00 $0.00
0066 CLASS B BRIDGE DECK REPAIR 513(B) 6019 SY 10.000 28.310   28.310 $300.00 $0.00 $8,493.00
0067 PREPARATION OF CRACKS, ABOVE WATER 520(A) 6058 LF 50.000 11.830   11.830 $23.00 $0.00 $272.09
0068 EPOXY RESIN, ABOVE WATER 520(C) 6060 GAL 0.500 0.500   0.500 $70.00 $0.00 $35.00
0069 PNEUMATICALLY PLACED MORTAR 521(A) 6210 SY 10.000 9.570   9.570 $525.00 $0.00 $5,024.25
0070 DECK AREA SEALED (FLOODCOATS) 523(C) 6570 SY 942.000 941.550   941.550 $18.00 $0.00 $16,947.90
8011 (PL)REPAIR BRIDGE ITEM (TYPE A) 540 4510 LSUM 0.000 1.000   1.000 $32,415.35 $0.00 $32,415.35
Subtotals For Category     0206/BRIDGE 'G'    $0.00 $103,299.54
Fed/State Project Number:    BRFY-172A(531)3B Project:    28593(05) Category:    0207/BRIDGE 'H'
0071 CLSM BACKFILL 501(G) 6309 CY 5.000 0.000   0.000 $500.00 $0.00 $0.00
0072 RAPID CURE JOINT SEALANT 504(G) 6390 LF 108.500 331.440   331.440 $30.00 $0.00 $9,943.20
0073 ELASTOMERIC MORTAR 504(H) 6389 CF 36.200 46.650   46.650 $625.00 $0.00 $29,156.25
0074 SILICONE CONSTRUCTION JOINT 509 6386 LF 108.500 0.000   0.000 $7.00 $0.00 $0.00
0075 CLASS B BRIDGE DECK REPAIR 513(B) 6019 SY 10.000 12.370   12.370 $300.00 $0.00 $3,711.00
0076 CLASS C BRIDGE DECK REPAIR 513(C) 6020 SY 3.000 2.220   2.220 $450.00 $0.00 $999.00
0077 PREPARATION OF CRACKS, ABOVE WATER 520(A) 6058 LF 50.000 16.830   16.830 $23.00 $0.00 $387.09
0078 EPOXY RESIN, ABOVE WATER 520(C) 6060 GAL 0.500 0.500   0.500 $70.00 $0.00 $35.00
0079 PNEUMATICALLY PLACED MORTAR 521(A) 6210 SY 10.000 1.260   1.260 $525.00 $0.00 $661.50
0080 DECK AREA SEALED (FLOODCOATS) 523(C) 6570 SY 942.000 941.550   941.550 $18.00 $0.00 $16,947.90
0081 (PL)REPAIR BRIDGE ITEM (TYPE A) 540 4515 EA 1.000 1.000   1.000 $3,000.00 $0.00 $3,000.00
0082 (PL)REPAIR BRIDGE ITEM (TYPE B) 540 4525 EA 1.000 1.000   1.000 $700.00 $0.00 $700.00
8012 (PL)REPAIR BRIDGE ITEM (TYPE A) 540 4510 LSUM 0.000 1.000   1.000 $32,415.35 $0.00 $32,415.35
Subtotals For Category     0207/BRIDGE 'H'    $0.00 $97,956.29
Fed/State Project Number:    BRFY-172A(531)3B Project:    28593(05) Category:    0300/TRAFFIC CONTROL
0083 (PL)TRUCK MOUNTED ATTENUATOR 876(A) 8482 SD 120.000 379.000   379.000 $85.00 $0.00 $32,215.00
0084 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $80,000.00 $0.00 $80,000.00
0085 PORT.CHANGEABLE MESSAGE SIGN 882(A) 8306 SD 240.000 310.000   310.000 $85.00 $0.00 $26,350.00
Subtotals For Category     0300/TRAFFIC CONTROL    $0.00 $138,565.00
Fed/State Project Number:    BRFY-172A(531)3B Project:    28593(05) Category:    0640/CONSTRUCTION
0086 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $50,177.00 $0.00 $50,177.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $50,177.00
Subtotals For Project BRFY-172A(531)3B /28593(05) $0.00 $907,918.78