Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 110473   Estimate Number: 0007 , Final     Spec Year: 2009
Primary JP: 26248(04)   Residency: CIRCUIT ENGR. DISTRICT # 8 (06009)     Contract No: 710325
Date Created: 04/25/2013   Contractor FEI: 730626847     Account No: 436600

Project Number(s): STP-123C(069)CI
Contract Description: RESURFACE (ASPHALT) COUNTY ROAD (NS-190): FROM 5.0 MILES SOUTH OF SH-15, EXTEND NORTH. PROJECT LENGTH = 4.50 MILES.
Primary County: ELLIS              
Name of Road: COUNTY ROAD              
Prime Contractor: THE CUMMINS CONSTRUCTION CO., INC.           Time Charged: N/A
    P. O. BOX 748           Time Allowed: N/A
    ENID , OK   73702           Percent Time: N/A

  Paid To Date: $1,387,106.30 Payable This Statement: $4,397.82

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.                                
THE CUMMINS CONSTRUCTION CO., 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:    04/25/2013
Contract ID: 110473   Estimate Number: 0007     Contract No: 710325
Residency: CIRCUIT ENGR. DISTRICT # 8 (06009)   Estimate Type: Final     Account No: 436600

Project Number(s): STP-123C(069)CI
Primary Job Piece No: 26248(04)
Contract Description: RESURFACE (ASPHALT) COUNTY ROAD (NS-190): FROM 5.0 MILES SOUTH OF SH-15, EXTEND NORTH. PROJECT LENGTH = 4.50 MILES.
Primary County: ELLIS              
Name of Road: COUNTY ROAD              
Prime Contractor: THE CUMMINS CONSTRUCTION CO., INC.              
    P. O. BOX 748              
    ENID , OK   73702              
Surety Company: HARTFORD ACCIDENT & INDEMNITY COMPANY              

Date Let: 08/18/2011 NTP Effective Date: 10/30/2011 Pay Period: 03/10/2012  TO  04/15/2013
Date Awarded: 09/12/2011 Date Work Began: 10/03/2011 Original Contract Time: N/A
Date Contract Executed: 09/20/2011 Date Time Stopped: 04/15/2012 Current Time Charged: N/A
Date NTP Issued: 09/22/2011 Completion Date: 04/15/2012 Current Time Allowed: N/A
General Liability Expires: 09/01/2013 Workman's Comp Expires: 01/01/2014 Percent Time Used: N/A
Specification Year: 2009 FIXED COMPLETION DATE: 04/15/2012    

Current Contract Amount: $1,387,106.28 Total to Date Prev to Date This Estimate
Bid Amount: $1,318,680.02 Participating: $1,387,106.30 $1,382,708.48 $4,397.82
Percent Complete: 100 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $-0.02 Total Earnings: $1,387,106.30 $1,382,708.48 $4,397.82
Unearned Balance: $-68,426.28 Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $1,387,106.30 $1,382,708.48 $4,397.82
Other Adjustments: $0.00 $0.00 $0.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $1,387,106.30 $1,382,708.48 $4,397.82

Estimate Adjustment Detail

Contract ID: 110473   Estimate Number: 0007     Primary JP: 26248(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 a ced8 Ellis STP overruns Approved 12/19/2011 0.0 $34,436.11
002 a ced08 earthwork overrun Approved 03/05/2012 167.0 $46,102.32
003 aced8 STP FQCO Approved 03/19/2013 0.0 $-12,112.17


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 0003 --15 $750.00 $-11,250.00
System Application of Liquidated Damages 0004 --15 $750.00 $-11,250.00
System Application of Liquidated Damages 0005 --19 $750.00 $-14,250.00
System Application of Liquidated Damages 0006 -49.0 $750.00 $36,750.00
Subtotals For Liquidated Damages $0.00


CONTRACT ADJUSTMENTS HISTORY
Adjustment Description Estimate Nbr Adjustment Amount
LD Adjustment (Prog. Est. Only) 0003 $11,250.00
LD Adjustment (Prog. Est. Only) 0004 $11,250.00
Withhold to Funds Avail(Prog. Est. Only) 0004 $-3,000.00
LD Adjustment (Prog. Est. Only) 0005 $12,250.00
Withhold to Funds Avail(Prog. Est. Only) 0005 $3,000.00
LD Adjustment (Prog. Est. Only) 0006 $-34,750.00
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
No line item adjustments have been created on this contract.
Subtotals For Line Item Adjustments $0.00


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: 110473   Estimate Number: 0007     Primary JP: 26248(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:    STP-123C(069)CI Project:    26248(04) Category:    0100/ROADWAY
0001 UNCLASSIFIED BORROW 202(D) 0184 CY 1,320.000 4,296.600 0.600 4,296.600 $33.84 $20.30 $145,396.94
0002 TEMPORARY SILT FENCE 221(C) 2801 LF 500.000 576.000 -28.000 576.000 $1.66 $-46.48 $956.16
0003 TEMPORARY SILT DIKE 221(F) 0100 LF 500.000 0.000   0.000 $6.29 $0.00 $0.00
0004 SOLID SLAB SODDING 230(A) 2806 SY 18,480.000 22,639.060   22,639.060 $1.31 $0.00 $29,657.17
0005 TRAFFIC BOUND SURFACE COURSE TYPE E 402(E) 0225 TON 371.750 579.050 -2.850 579.050 $51.39 $-146.46 $29,757.38
0006 TACK COAT 407(B) 0250 GAL 8,760.000 4,312.500 37.500 4,312.500 $2.96 $111.00 $12,765.00
0007 SUPERPAVE, TYPE S4(PG 64-22 OK) 411(C) 5960 TON 10,720.000 10,650.000 51.150 10,650.000 $87.50 $4,475.63 $931,875.01
0008 SUPERPAVE, TYPE S3(PATCH)(PG64-22OK) 411(H) 6210 TON 400.000 580.140 -0.020 580.140 $189.29 $-3.79 $109,814.70
0009 18" R.C.PIPE CLASS III 613(A) 0491 LF 111.000 120.000   120.000 $95.57 $0.00 $11,468.40
0010 24" R.C.PIPE CLASS III 613(A) 0492 LF 86.000 88.000   88.000 $110.66 $0.00 $9,738.08
0011 51" X 31" R.C.PIPE ARCH CLASS A-III 613(A) 4499 LF 90.000 80.000   80.000 $251.50 $0.00 $20,120.00
0012 18" CORR. GALV. STEEL PIPE 613(B) 0689 LF 191.000 159.000   159.000 $55.33 $0.00 $8,797.47
0013 51" X 31" PREFAB. CULVERT END SECTION, ARCH 613(L) 4540 EA 4.000 4.000   4.000 $3,883.16 $0.00 $15,532.64
0014 18" PREFAB. CULVERT END SECTION, ROUND 613(L) 5726 EA 18.000 16.000   16.000 $1,257.50 $0.00 $20,120.00
0015 24" PREFAB. CULVERT END SECTION, ROUND 613(L) 5730 EA 4.000 4.000   4.000 $1,861.10 $0.00 $7,444.40
0016 BEAM GUARDRAIL W-BEAM SINGLE 623(A) 0932 LF 150.000 150.000   150.000 $11.07 $0.00 $1,660.50
0017 GUARDRAIL ANCHOR UNIT (TYPE B) 623(F) 4447 EA 12.000 12.000   12.000 $675.00 $0.00 $8,100.00
0018 SHEET ALUMINUM SIGNS 850(A) 8110 SF 155.680 155.680   155.680 $24.15 $0.00 $3,759.67
0019 TRAFFIC STRIPE(PAINT)(4" WIDE) 854(A) 8800 LF 61,479.000 63,370.000   63,370.000 $0.08 $0.00 $5,069.60
0020 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $4,507.00 $0.00 $4,507.00
8000 UNCLASSIFIED BORROW 202(D) 0184 CY 0.000 2,646.600 0.600 2,646.600 $-20.64 $-12.38 $-54,625.82
Subtotals For Category     0100/ROADWAY    $4,397.82 $1,321,914.30
Fed/State Project Number:    STP-123C(069)CI Project:    26248(04) Category:    0600/STAKING
0021 CONSTRUCTION STAKING LEVEL II 642(B) 0096 LSUM 1.000 1.000   1.000 $2,842.00 $0.00 $2,842.00
Subtotals For Category     0600/STAKING    $0.00 $2,842.00
Fed/State Project Number:    STP-123C(069)CI Project:    26248(04) Category:    0640/CONSTRUCTION
0022 SWPPP DOCUMENTATION AND MANAGEMENT 220 2800 LSUM 1.000 1.000   1.000 $3,439.00 $0.00 $3,439.00
0023 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $52,694.00 $0.00 $52,694.00
0024 (SP)CONTRACTORS QUALITY CONTROL 643 0087 LSUM 1.000 1.000   1.000 $6,217.00 $0.00 $6,217.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $62,350.00
Subtotals For Project STP-123C(069)CI /26248(04) $4,397.82 $1,387,106.30