Contract ID: | 110505 | Estimate Number: | 0014 , Final | Spec Year: | 2009 | |||
Primary JP: | 28194(04) | Residency: | ANTLERS (02100) | Contract No: | 710698 | |||
Date Created: | 03/25/2013 | Contractor FEI: | 730764097A | Account No: | 434200 |
Project Number(s): | SBR-103N(137)SB | ||||||||
Contract Description: | BRIDGE REHABILITATION US-69: OVER NORTH BOGGY RIVER, 5.87 MILES NORTH OF THE SH-7 JUNCTION. PROJECT LENGTH = 0.207 MILES. | ||||||||
Primary County: | ATOKA | ||||||||
Name of Road: | US-69 | ||||||||
Prime Contractor: | MANHATTAN ROAD & BRIDGE COMPANY | Time Charged: | 170.00 | ||||||
5601 S. 122ND E. AVE. | Time Allowed: | 156.00 | |||||||
TULSA , OK 74146 | Percent Time: | 108.97 % |
Paid To Date: | $1,999,799.55 | Payable This Statement: | $4,500.00 |
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. |
MANHATTAN ROAD & BRIDGE COMPANY |
_________________________________________________ |
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 |
Contract ID: | 110505 | Estimate Number: | 0014 | Contract No: | 710698 | |||
Residency: | ANTLERS (02100) | Estimate Type: | Final | Account No: | 434200 | |||
Project Number(s): | SBR-103N(137)SB | ||||||||||||
Primary Job Piece No: | 28194(04) | ||||||||||||
Contract Description: | BRIDGE REHABILITATION US-69: OVER NORTH BOGGY RIVER, 5.87 MILES NORTH OF THE SH-7 JUNCTION. PROJECT LENGTH = 0.207 MILES. | ||||||||||||
Primary County: | ATOKA | ||||||||||||
Name of Road: | US-69 | ||||||||||||
Prime Contractor: | MANHATTAN ROAD & BRIDGE COMPANY | ||||||||||||
5601 S. 122ND E. AVE. | |||||||||||||
TULSA , OK 74146 | |||||||||||||
Surety Company: | FIDELITY & DEPOSIT INSURANCE COMPANY OF MARYLAND | ||||||||||||
Date Let: | 11/17/2011 | NTP Effective Date: | 04/02/2012 | Pay Period: | 01/16/2013 TO 01/31/2013 |
Date Awarded: | 12/05/2011 | Date Work Began: | 03/05/2012 | Original Contract Time: | 150 |
Date Contract Executed: | 12/20/2011 | Date Time Stopped: | 11/01/2012 | Current Time Charged: | 170.00 |
Date NTP Issued: | 12/29/2011 | Completion Date: | 11/01/2012 | Current Time Allowed: | 156.00 |
General Liability Expires: | 10/01/2013 | Workman's Comp Expires: | 10/01/2013 | Percent Time Used: | 108.97 % |
Specification Year: | 2009 | ||||
Current Contract Amount: | $2,010,299.55 | Total to Date | Prev to Date | This Estimate | |||
Bid Amount: | $1,894,957.50 | Participating: | $0.00 | $0.00 | $0.00 | ||
Percent Complete: | 99.48 % | Non Participating: | $2,010,299.55 | $2,010,299.55 | $0.00 | ||
Funds Available: | $10,500.00 | Total Earnings: | $2,010,299.55 | $2,010,299.55 | $0.00 | ||
Unearned Balance: | $-104,842.05 | Stockpiled Materials: | $0.00 | $0.00 | $0.00 | ||
Gross Earnings: | $2,010,299.55 | $2,010,299.55 | $0.00 | ||||
Other Adjustments: | $0.00 | $0.00 | $0.00 | ||||
Liq Dam/Disincentive: | $-10,500.00 | $-15,000.00 | $4,500.00 | ||||
TOTAL: | $1,999,799.55 | $1,995,299.55 | $4,500.00 |
Contract ID: | 110505 | Estimate Number: | 0014 | Primary JP: | 28194(04) | |||
CHANGE ORDER HISTORY | |||||
Change Order Nbr. | Change Order Description | Status | Approval Date | Contract Time Adjustment | Total Change Order Amount |
001 | ADD ITEM FOR GLARE SCREEN | Approved | 05/11/2012 | 0.0 | $2,073.60 |
002 | ADD ITEM PAINTING EXISTING STRUCTURES | Approved | 05/29/2012 | 0.0 | $4,626.00 |
003 | Final Quantity Change Order | Approved | 01/08/2013 | 0.0 | $108,642.45 |
004 | Time adjustment due to additional and changes in work. | Approved | 01/31/2013 | 6.0 | $0.00 |
STOCKPILE PAYMENT HISTORY | |||||
Project | Line Nbr | Stockpile Description | Adjustment Type | Estimate Nbr | Adjusted Amount |
28194(04) | 0023 | REBAR-GR60 EPOXY CTD | Stockpiled Material Adjustment | 0010 | $-7.39 |
28194(04) | 0023 | REBAR-GR60 EPOXY CTD | Stockpiled Material Initial Payment | 0004 | $6,732.29 |
28194(04) | 0023 | REBAR-GR60 EPOXY CTD | Stockpiled Material Adjustment | 0009 | $-6,724.90 |
28194(04) | 0026 | REBAR-GR60 EPOXY CTD | Stockpiled Material Adjustment | 0010 | $-10,353.20 |
28194(04) | 0026 | REBAR-GR60 EPOXY CTD | Stockpiled Material Initial Payment | 0004 | $10,353.20 |
28194(04) | 0027 | SSTL FABS (AML) | Stockpiled Material Initial Payment | 0001 | $105,575.40 |
28194(04) | 0027 | SSTL FABS (AML) | Stockpiled Material Adjustment | 0006 | $-105,575.40 |
28194(04) | 0029 | SSTL FABS (AML) | Stockpiled Material Adjustment | 0006 | $-8,534.00 |
28194(04) | 0029 | SSTL FABS (AML) | Stockpiled Material Initial Payment | 0001 | $8,534.00 |
28194(04) | 0034 | REBAR-GR60 EPOXY CTD | Stockpiled Material Adjustment | 0009 | $-48,281.75 |
28194(04) | 0034 | REBAR-GR60 EPOXY CTD | Stockpiled Material Adjustment | 0004 | $-7,920.00 |
28194(04) | 0034 | REBAR-GR60 EPOXY CTD | Stockpiled Material Initial Payment | 0004 | $56,201.75 | Subtotals For Stockpile Payments | $0.00 |
LIQUIDATED DAMAGES HISTORY | ||||
Adjustment Description | Estimate Nbr | Time Units | Rate | Adjustment Amount |
System Application of Liquidated Damages | 0012 | --8.0 | $750.00 | $-6,000.00 |
System Application of Liquidated Damages | 0013 | --12 | $750.00 | $-9,000.00 |
System Application of Liquidated Damages | 0014 | -6.0 | $750.00 | $4,500.00 | Subtotals For Liquidated Damages | $-10,500.00 |
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 |
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 | $ |
Contract ID: | 110505 | Estimate Number: | 0014 | Primary JP: | 28194(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: SBR-103N(137)SB | Project: 28194(04) | Category: 0100/ROADWAY | ||||||||
0001 | CLEARING AND GRUBBING | 201(A) 0102 | LSUM | 1.000 | 1.000 | 1.000 | $80,000.00 | $0.00 | $80,000.00 | |
0002 | UNCLASSIFIED EXCAVATION | 202(A) 0183 | CY | 1,416.000 | 1,416.000 | 1,416.000 | $15.00 | $0.00 | $21,240.00 | |
0003 | UNCLASSIFIED BORROW | 202(D) 0184 | CY | 2,887.000 | 2,887.000 | 2,887.000 | $6.00 | $0.00 | $17,322.00 | |
0004 | TYPE A-SALVAGED TOPSOIL | 205(A) 4229 | LSUM | 1.000 | 1.000 | 1.000 | $7,000.00 | $0.00 | $7,000.00 | |
0005 | TEMPORARY SILT FENCE | 221(C) 2801 | LF | 1,451.000 | 1,001.000 | 1,001.000 | $2.25 | $0.00 | $2,252.25 | |
0006 | TEMPORARY SEDIMENT FILTER | 221(D) 2803 | EA | 2.000 | 2.000 | 2.000 | $170.00 | $0.00 | $340.00 | |
0007 | SOLID SLAB SODDING | 230(A) 2806 | SY | 2,796.000 | 6,908.540 | 6,908.540 | $3.00 | $0.00 | $20,725.62 | |
0008 | AGGREGATE BASE TYPE A | 303(A) 2100 | CY | 292.000 | 178.720 | 178.720 | $45.00 | $0.00 | $8,042.40 | |
0009 | SUPERPAVE, TYPE S3(PG 64-22 OK) | 411(B) 5945 | TON | 317.000 | 924.870 | 924.870 | $170.50 | $0.00 | $157,690.34 | |
0010 | SUPERPAVE, TYPE S4(PG 64-22 OK) | 411(C) 5960 | TON | 261.000 | 402.860 | 402.860 | $176.00 | $0.00 | $70,903.36 | |
0011 | COLD MILLING PAVEMENT | 412 5267 | SY | 1,112.000 | 0.000 | 0.000 | $23.50 | $0.00 | $0.00 | |
0012 | RUMBLE STRIP-METHOD HMA-CON | 413(A) 4861 | LF | 334.000 | 0.000 | 0.000 | $3.00 | $0.00 | $0.00 | |
0013 | RUMBLE STRIP-METHOD PCC-CON | 413(C) 4868 | LF | 334.000 | 0.000 | 0.000 | $4.00 | $0.00 | $0.00 | |
0014 | BONDED CONCRETE OVERLAY | 414(D) 0220 | SY | 1,112.000 | 820.000 | 820.000 | $20.00 | $0.00 | $16,400.00 | |
0015 | P.C. CONCRETE FOR PAVEMENT | 414(G) 5275 | CY | 195.000 | 136.700 | 136.700 | $140.00 | $0.00 | $19,138.00 | |
0016 | 18" CORR. GALV. STEEL PIPE | 613(B) 0689 | LF | 186.000 | 186.000 | 186.000 | $60.00 | $0.00 | $11,160.00 | |
0017 | REMOVAL OF ASPHALT PAVEMENT | 619(B) 4728 | SY | 656.000 | 329.660 | 329.660 | $13.50 | $0.00 | $4,450.41 | |
0018 | REMOVAL OF GUARDRAIL | 619(B) 4780 | LF | 750.000 | 925.000 | 925.000 | $3.50 | $0.00 | $3,237.50 | |
0019 | BEAM GUARDRAIL W-BEAM SINGLE | 623(A) 0932 | LF | 750.000 | 700.000 | 700.000 | $16.50 | $0.00 | $11,550.00 | |
0020 | GUARDRAIL END TREATMENT (GET) | 623(G) 8571 | EA | 2.000 | 2.000 | 2.000 | $2,300.00 | $0.00 | $4,600.00 | |
0021 | GUARDRAIL BRIDGE CONNECTION-TYPE A | 623(I) 8675 | EA | 2.000 | 2.000 | 2.000 | $1,600.00 | $0.00 | $3,200.00 | |
Subtotals For Category 0100/ROADWAY | $0.00 | $459,251.88 | ||||||||
Fed/State Project Number: SBR-103N(137)SB | Project: 28194(04) | Category: 0200/BRIDGE 'A' | ||||||||
0022 | CLSM BACKFILL | 501(G) 6309 | CY | 120.000 | 153.520 | 153.520 | $130.00 | $0.00 | $19,957.60 | |
0023 | APPROACH SLAB | 504(A) 1304 | SY | 182.200 | 182.200 | 182.200 | $160.00 | $0.00 | $29,152.00 | |
0024 | SAW-CUT GROOVING | 504(B) 1305 | SY | 1,909.300 | 1,909.300 | 1,909.300 | $4.50 | $0.00 | $8,591.85 | |
0025 | SEALED EXPANSION JOINT | 504(C) 6250 | LF | 78.000 | 78.000 | 78.000 | $245.00 | $0.00 | $19,110.00 | |
0026 | 42" F-SHAPED PARAPET | 504(E) 6190 | LF | 905.000 | 905.000 | 905.000 | $65.00 | $0.00 | $58,825.00 | |
0027 | STRUCTURAL STEEL | 506(A) 1322 | LB | 167,580.000 | 167,580.000 | 167,580.000 | $2.50 | $0.00 | $418,950.00 | |
0028 | WEATHERING STEEL FIXED BEARING ASSEMBLY | 507(A) 6172 | EA | 2.000 | 2.000 | 2.000 | $16,000.00 | $0.00 | $32,000.00 | |
0029 | WEATHERING STEEL EXPANSION BEARING ASSEMBLY | 507(B) 6176 | EA | 2.000 | 2.000 | 2.000 | $6,000.00 | $0.00 | $12,000.00 | |
0030 | CLASS AA CONCRETE | 509(A) 1326 | CY | 441.000 | 441.000 | 441.000 | $425.00 | $0.00 | $187,425.00 | |
0031 | CLASS A CONCRETE | 509(B) 1328 | CY | 107.400 | 107.400 | 107.400 | $800.00 | $0.00 | $85,920.00 | |
0032 | CLASS C CONCRETE | 509(D) 1331 | CY | 5.800 | 8.500 | 8.500 | $600.00 | $0.00 | $5,100.00 | |
0033 | REINFORCING STEEL | 511(A) 1332 | LB | 1,080.000 | 1,080.000 | 1,080.000 | $1.50 | $0.00 | $1,620.00 | |
0034 | EPOXY COATED REINFORCING STEEL | 511(B) 6010 | LB | 133,260.000 | 134,115.000 | 134,115.000 | $1.00 | $0.00 | $134,115.00 | |
0035 | PAINTING EXISTING STRUCTURES | 512(A) 1323 | LSUM | 1.000 | 1.000 | 1.000 | $20,000.00 | $0.00 | $20,000.00 | |
0036 | COLLECTION AND HANDLING OF WASTE | 512(B) 6303 | LSUM | 1.000 | 0.000 | 0.000 | $1,500.00 | $0.00 | $0.00 | |
0037 | PILES, FURNISHED (HP 10X42) | 514(A) 6010 | LF | 112.000 | 112.000 | 112.000 | $50.00 | $0.00 | $5,600.00 | |
0038 | PILES, FURNISHED (HP 12X53) | 514(A) 6011 | LF | 36.000 | 42.000 | 42.000 | $75.00 | $0.00 | $3,150.00 | |
0039 | PILES, DRIVEN (HP 10X42) | 514(B) 6292 | LF | 112.000 | 111.000 | 111.000 | $22.50 | $0.00 | $2,497.50 | |
0040 | PILES, DRIVEN (HP 12X53) | 514(B) 6294 | LF | 36.000 | 42.000 | 42.000 | $22.50 | $0.00 | $945.00 | |
0041 | WATER REPELLENT (VISUALLY INSPECTED) | 515(A) 6013 | SY | 876.000 | 876.000 | 876.000 | $4.00 | $0.00 | $3,504.00 | |
0042 | DRILLED SHAFTS 30" DIAMETER | 516(A) 6091 | LF | 19.000 | 19.000 | 19.000 | $500.00 | $0.00 | $9,500.00 | |
0043 | DRILLED SHAFTS 60" DIAMETER | 516(A) 6096 | LF | 86.000 | 66.000 | 66.000 | $750.00 | $0.00 | $49,500.00 | |
0044 | SEALER CRACK PREPARATION | 523(A) 6550 | LF | 164.000 | 164.000 | 164.000 | $5.00 | $0.00 | $820.00 | |
0045 | SEALER RESIN | 523(B) 6560 | GAL | 4.500 | 4.500 | 4.500 | $150.00 | $0.00 | $675.00 | |
0046 | REMOVAL OF BRIDGE ITEMS | 619(B) 2500 | LSUM | 1.000 | 1.000 | 1.000 | $185,000.00 | $0.00 | $185,000.00 | |
8001 | PAINTING EXISTING STRUCTURES | 512(A) 1323 | LSUM | 0.000 | 1.000 | 1.000 | $4,626.00 | $0.00 | $4,626.00 | |
Subtotals For Category 0200/BRIDGE 'A' | $0.00 | $1,298,583.95 | ||||||||
Fed/State Project Number: SBR-103N(137)SB | Project: 28194(04) | Category: 0330/TRAFFIC CONTROL | ||||||||
0047 | TRAFFIC STRIPE(MULTI-POLYMER)(4" WIDE) | 856(A) 8530 | LF | 6,500.000 | 7,530.000 | 7,530.000 | $1.00 | $0.00 | $7,530.00 | |
0048 | TRAFFIC STRIPE(MULTI-POLY.)(6" WIDE) | 856(A) 8535 | LF | 1,732.000 | 228.000 | 228.000 | $1.50 | $0.00 | $342.00 | |
0049 | CONSTRUCTION TRAFFIC STRIPE(PAINT)(4" WIDE) | 857(A) 8839 | LF | 9,744.000 | 11,436.000 | 11,436.000 | $0.20 | $0.00 | $2,287.20 | |
0050 | (PL)CONSTRUCTION ZONE PAVEMENT MARKERS(FLEX TAB)TYPE 2-1 | 857(E) 8887 | EA | 2,150.000 | 1,058.000 | 1,058.000 | $0.50 | $0.00 | $529.00 | |
0051 | PAVEMENT MARKING REMOVAL(TRAFFIC STRIPE) | 857(F) 8006 | LF | 2,500.000 | 9,846.000 | 9,846.000 | $0.30 | $0.00 | $2,953.80 | |
0052 | DELIVER PORTABLE LONGITUDINAL BARRIER | 877(B) 8484 | LF | 3,250.000 | 3,120.000 | 3,120.000 | $25.00 | $0.00 | $78,000.00 | |
0053 | ARROW DISPLAY(TYPE C) | 880(A) 8812 | SD | 180.000 | 438.000 | 438.000 | $12.00 | $0.00 | $5,256.00 | |
0054 | CONSTRUCTION SIGNS 0 TO 6.25 SF | 880(B) 8818 | SD | 4,500.000 | 7,655.000 | 7,655.000 | $0.05 | $0.00 | $382.75 | |
0055 | CONSTRUCTION SIGNS 6.26 SF TO 15.99 SF | 880(B) 8821 | SD | 2,880.000 | 9,249.000 | 9,249.000 | $1.05 | $0.00 | $9,711.45 | |
0056 | CONSTRUCTION SIGNS 16.0 SF TO 32.99 SF | 880(B) 8824 | SD | 1,980.000 | 3,881.000 | 3,881.000 | $1.05 | $0.00 | $4,075.05 | |
0057 | CONSTRUCTION BARRICADES(TYPE III) | 880(C) 8842 | SD | 2,160.000 | 2,984.000 | 2,984.000 | $0.15 | $0.00 | $447.60 | |
0058 | WING BARRICADES | 880(C) 8848 | SD | 360.000 | 657.000 | 657.000 | $2.25 | $0.00 | $1,478.25 | |
0059 | WARNING LIGHTS(TYPE A) | 880(E) 8860 | SD | 8,280.000 | 9,226.000 | 9,226.000 | $0.02 | $0.00 | $184.52 | |
0060 | DRUMS | 880(F) 8878 | SD | 8,640.000 | 34,950.000 | 34,950.000 | $0.75 | $0.00 | $26,212.50 | |
8000 | MODULAR GLARE SCREEN (TEMPORARY) | 878(B) 8487 | SD | 0.000 | 180.000 | 180.000 | $11.52 | $0.00 | $2,073.60 | |
Subtotals For Category 0330/TRAFFIC CONTROL | $0.00 | $141,463.72 | ||||||||
Fed/State Project Number: SBR-103N(137)SB | Project: 28194(04) | Category: 0640/CONSTRUCTION | ||||||||
0061 | MOBILIZATION | 641 1552 | LSUM | 1.000 | 1.000 | 1.000 | $100,000.00 | $0.00 | $100,000.00 | |
0062 | CONSTRUCTION STAKING LEVEL II | 642(B) 0096 | LSUM | 1.000 | 1.000 | 1.000 | $11,000.00 | $0.00 | $11,000.00 | |
Subtotals For Category 0640/CONSTRUCTION | $0.00 | $111,000.00 | ||||||||
Subtotals For Project SBR-103N(137)SB /28194(04) | $0.00 | $2,010,299.55 |