Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 110508   Estimate Number: 0012 , Final     Spec Year: 2009
Primary JP: 26488(04)   Residency: CLINTON (05100)     Contract No: 710695
Date Created: 01/17/2014   Contractor FEI: 730731258     Account No: 400700

Project Number(s): IMY-0040-4(430)102
Contract Description: RESURFACE (ASPHALT) I-40: FROM MILE MARKER 102.2 EXTEND EAST 2.06 MILES. PROJECT LENGTH = 2.058 MILES.
Primary County: CADDO              
Name of Road: I-40              
Prime Contractor: HASKELL LEMON CONSTRUCTION CO.           Time Charged: 120.00
    P. O. BOX 75608           Time Allowed: 120.00
    OKLAHOMA CITY , OK   73147-0608           Percent Time: 100.00 %

  Paid To Date: $4,729,371.18 Payable This Statement: $0.02

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.                                
HASKELL LEMON CONSTRUCTION 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:    01/17/2014
Contract ID: 110508   Estimate Number: 0012     Contract No: 710695
Residency: CLINTON (05100)   Estimate Type: Final     Account No: 400700

Project Number(s): IMY-0040-4(430)102
Primary Job Piece No: 26488(04)
Contract Description: RESURFACE (ASPHALT) I-40: FROM MILE MARKER 102.2 EXTEND EAST 2.06 MILES. PROJECT LENGTH = 2.058 MILES.
Primary County: CADDO              
Name of Road: I-40              
Prime Contractor: HASKELL LEMON CONSTRUCTION CO.              
    P. O. BOX 75608              
    OKLAHOMA CITY , OK   73147-0608              
Surety Company: WESTERN SURETY COMPANY              

Date Let: 11/17/2011 NTP Effective Date: 05/07/2012 Pay Period: 01/01/2014  TO  01/15/2014
Date Awarded: 12/05/2011 Date Work Began: 02/06/2012 Original Contract Time: 120
Date Contract Executed: 12/12/2011 Date Time Stopped: 10/15/2012 Current Time Charged: 120.00
Date NTP Issued: 12/15/2011 Completion Date: 10/15/2012 Current Time Allowed: 120.00
General Liability Expires: 07/01/2014 Workman's Comp Expires: 07/01/2014 Percent Time Used: 100.00 %
Specification Year: 2009        

Bid Amount: $4,682,467.35 Total to Date Prev to Date This Estimate
Funds Available (Bid + Positive C/O): $4,743,514.92 Participating: $4,729,371.18 $4,729,371.18 $0.00
Percent Complete: 99.70 % Non Participating: $0.00 $0.00 $0.00
Unearned Balance: $14,143.74 Total Earnings: $4,729,371.18 $4,729,371.18 $0.00
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $4,729,371.18 $4,729,371.18 $0.00
Other Adjustments: $0.00 $-0.02 $0.02
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $4,729,371.18 $4,729,371.16 $0.02

Estimate Adjustment Detail

Contract ID: 110508   Estimate Number: 0012     Primary JP: 26488(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Multi-polymer stripe specification change Approved 06/13/2012 0.0 $2,740.40
002 Smoothness pay adjustment Approved 09/11/2012 0.0 $58,307.17
003 Final Quantity Change Order Approved 12/19/2013 0.0 $-14,143.76


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
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
26488(04) 0011 OPEN GRADED FRICTION SURFACE COURSE Asphalt Binder Adjustment 0007 2,480.70 $1.82 $4,525.05
26488(04) 0012 TACK COAT * Material Discrepancy Adjustments 0002 -1,225.00 $2.00 $-2,450.00
26488(04) 0012 TACK COAT * Material Discrepancy Adjustments 0003 -3,500.00 $2.00 $-7,000.00
26488(04) 0012 TACK COAT * Material Discrepancy Adjustments 0004 4,725.00 $2.00 $9,450.00
26488(04) 0014 SUPERPAVE, TYPE S3(PG 76-28 OK) * Rounding Error Correction 0011 -0.01 $1.00 $-0.01
26488(04) 0014 SUPERPAVE, TYPE S3(PG 76-28 OK) * Rounding Error Correction 0012 0.01 $1.00 $0.01
26488(04) 0015 SUPERPAVE, TYPE S3(PG 64-22 OK) * QAQC 0004 -1,596.00 $1.00 $-1,596.00
26488(04) 0015 SUPERPAVE, TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0006 4,163.55 $0.48 $2,002.25
26488(04) 0016 (SP) SUPERPAVE, TYPE S3(PG 76-28 E) * QAQC 0003 -2,496.00 $1.00 $-2,496.00
26488(04) 0016 (SP) SUPERPAVE, TYPE S3(PG 76-28 E) * QAQC 0006 -936.00 $1.00 $-936.00
26488(04) 0016 (SP) SUPERPAVE, TYPE S3(PG 76-28 E) Asphalt Binder Adjustment 0010 22.10 $0.48 $10.63
26488(04) 0016 (SP) SUPERPAVE, TYPE S3(PG 76-28 E) * Asphalt Binder Adjustment 0011 -9,318.78 $1.00 $-9,318.78
26488(04) 0018 SUPERPAVE, TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0006 58.05 $0.54 $31.90
26488(04) 0018 SUPERPAVE, TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0008 737.29 $1.50 $1,113.01
26488(04) 0018 SUPERPAVE, TYPE S4(PG 64-22 OK) * Rounding Error Correction 0011 -0.01 $1.00 $-0.01
26488(04) 0018 SUPERPAVE, TYPE S4(PG 64-22 OK) * Rounding Error Correction 0012 0.01 $1.00 $0.01
26488(04) 0019 (SP) SUPERPAVE, TYPE S5(PG 76-28 E) * QAQC 0009 26,344.00 $1.00 $26,344.00
26488(04) 0019 (SP) SUPERPAVE, TYPE S5(PG 76-28 E) * QAQC 0010 -26,344.00 $1.00 $-26,344.00
26488(04) 0019 (SP) SUPERPAVE, TYPE S5(PG 76-28 E) * QAQC 0011 9,118.00 $1.00 $9,118.00
26488(04) 0020 (SP) RICH INTERMEDIATE LAYER * ROADWAY DENSITY 0003 -4,090.00 $1.00 $-4,090.00
26488(04) 0020 (SP) RICH INTERMEDIATE LAYER Asphalt Binder Adjustment 0005 1,658.46 $0.61 $1,025.43
26488(04) 0020 (SP) RICH INTERMEDIATE LAYER Asphalt Binder Adjustment 0006 987.40 $0.61 $610.51
26488(04) 0025 REMOVAL OF GUARDRAIL * Material Discrepancy Adjustments 0008 -5,013.00 $1.40 $-7,018.20
26488(04) 0025 REMOVAL OF GUARDRAIL * Material Discrepancy Adjustments 0010 5,013.00 $1.40 $7,018.20
26488(04) 0027 BEAM GUARDRAIL W-BEAM SINGLE * Material Discrepancy Adjustments 0007 -8.00 $15.00 $-120.00
26488(04) 0027 BEAM GUARDRAIL W-BEAM SINGLE * Material Discrepancy Adjustments 0011 8.00 $15.00 $120.00
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: 110508   Estimate Number: 0012     Primary JP: 26488(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:    IMY-0040-4(430)102 Project:    26488(04) Category:    0100/ROADWAY
0001 UNCLASSIFIED BORROW 202(D) 0184 CY 5,000.000 3,860.600   3,860.600 $7.50 $0.00 $28,954.50
0002 TYPE A-SALVAGED TOPSOIL 205(A) 4229 LSUM 1.000 1.000   1.000 $40,000.00 $0.00 $40,000.00
0003 TEMPORARY SILT FENCE 221(C) 2801 LF 1,450.000 4,090.000   4,090.000 $1.30 $0.00 $5,317.00
0004 TEMPORARY SEDIMENT FILTER 221(D) 2803 EA 7.000 7.000   7.000 $275.00 $0.00 $1,925.00
0005 TEMPORARY SILT DIKE 221(F) 0100 LF 546.000 21.000   21.000 $6.50 $0.00 $136.50
0006 SOLID SLAB SODDING 230(A) 2806 SY 75,481.000 39,997.600   39,997.600 $1.10 $0.00 $43,997.36
0007 VEGETATIVE MULCHING 233(A) 2817 AC 19.430 0.000   0.000 $200.00 $0.00 $0.00
0008 MOWING 241 2832 AC 38.860 0.000   0.000 $20.00 $0.00 $0.00
0009 FLY ASH 307(A) 4200 TON 216.000 0.000   0.000 $55.00 $0.00 $0.00
0010 CEMENTITIOUS STABILIZED SUBGRADE 307(E) 4240 SY 3,986.000 0.000   0.000 $4.75 $0.00 $0.00
0011 OPEN GRADED FRICTION SURFACE COURSE 406 4257 TON 2,218.000 2,480.700   2,480.700 $105.00 $0.00 $260,473.50
0012 TACK COAT 407(B) 0250 GAL 32,859.000 17,792.500   17,792.500 $2.00 $0.00 $35,585.00
0013 PRIME COAT 408 5774 GAL 1,641.000 0.000   0.000 $2.00 $0.00 $0.00
0014 SUPERPAVE, TYPE S3(PG 76-28 OK) 411(B) 5935 TON 719.000 645.120 0.000 645.120 $68.50 $0.00 $44,190.73
0015 SUPERPAVE, TYPE S3(PG 64-22 OK) 411(B) 5945 TON 9,846.000 10,327.690   10,327.690 $57.00 $0.00 $588,678.33
0016 (SP) SUPERPAVE, TYPE S3(PG 76-28 E) 411(B) 5950 TON 17,765.000 18,872.220   18,872.220 $78.00 $0.00 $1,472,033.16
0017 SUPERPAVE, TYPE S4(PG 76-28 OK) 411(C) 5950 TON 1,997.000 599.600   599.600 $74.50 $0.00 $44,670.20
0018 SUPERPAVE, TYPE S4(PG 64-22 OK) 411(C) 5960 TON 3,354.000 4,335.150 0.000 4,335.150 $63.50 $0.00 $275,282.04
0019 (SP) SUPERPAVE, TYPE S5(PG 76-28 E) 411(D) 5980 TON 5,730.000 5,662.270   5,662.270 $90.00 $0.00 $509,604.30
0020 (SP) RICH INTERMEDIATE LAYER 411(J) 6410 TON 4,869.000 5,080.830   5,080.830 $95.00 $0.00 $482,678.85
0021 COLD MILLING PAVEMENT 412 5267 SY 91,764.000 95,772.370   95,772.370 $2.00 $0.00 $191,544.73
0022 CLASS C CONCRETE 509(D) 0325 CY 20.000 0.000   0.000 $300.00 $0.00 $0.00
0023 18" CORR. GALV. STEEL PIPE 613(B) 0689 LF 650.000 640.000   640.000 $25.25 $0.00 $16,160.00
0024 REMOVAL OF ASPHALT PAVEMENT 619(B) 4728 SY 2,134.000 5,467.780   5,467.780 $6.00 $0.00 $32,806.68
0025 REMOVAL OF GUARDRAIL 619(B) 4780 LF 4,970.000 5,050.000   5,050.000 $1.40 $0.00 $7,070.00
0026 SAWING PAVEMENT 619(C) 0924 LF 1,352.000 0.000   0.000 $1.00 $0.00 $0.00
0027 BEAM GUARDRAIL W-BEAM SINGLE 623(A) 0932 LF 4,650.000 4,662.500   4,662.500 $15.00 $0.00 $69,937.50
0028 GUARDRAIL ANCHOR UNIT (TYPE B) 623(F) 4447 EA 10.000 10.000   10.000 $800.00 $0.00 $8,000.00
0029 GUARDRAIL END TREATMENT (GET) 623(G) 8571 EA 10.000 12.000   12.000 $2,200.00 $0.00 $26,400.00
0030 GUARDRAIL DELINEATORS(TYPE 1, CODE 1) 853 9066 EA 112.000 144.000   144.000 $5.00 $0.00 $720.00
9001 PAVEMENT/BRIDGE SMOOTHNESS ADJUSTMENT 430 5010 LSUM 0.000 1.000   1.000 $58,307.17 $0.00 $58,307.17
9002 ASPHALT BINDER PRICE ADJUSTMENT 109 1150 LSUM 0.000 1.000   1.000 $18,179.47 $0.00 $18,179.47
9003 ADJUSTMENT FOR NON-CONFORMING MATERIALS 105 2100 LSUM 0.000 1.000   1.000 $-4,716.00 $0.00 $-4,716.00
Subtotals For Category     0100/ROADWAY    $0.00 $4,257,936.02
Fed/State Project Number:    IMY-0040-4(430)102 Project:    26488(04) Category:    0300/TRAFFIC CONTROL
0031 RUMBLE STRIP-METHOD HMA-CON 413(A) 4861 LF 49,000.000 47,020.000   47,020.000 $0.18 $0.00 $8,463.60
0032 CONSTRUCTION TRAFFIC STRIPE(PAINT)(4" WIDE) 857(A) 8839 LF 103,000.000 99,099.000   99,099.000 $0.08 $0.00 $7,927.92
0033 (PL)CONSTRUCTION ZONE PAVEMENT MARKERS(FLEX TAB)TYPE 2-1 857(E) 8887 EA 20,600.000 430.000   430.000 $0.35 $0.00 $150.50
0034 PAVEMENT MARKING REMOVAL(TRAFFIC STRIPE) 857(F) 8006 LF 20,000.000 33,301.000   33,301.000 $0.04 $0.00 $1,332.04
0035 (PL)TRUCK MOUNTED ATTENUATOR 876(A) 8482 SD 240.000 0.000   0.000 $4.20 $0.00 $0.00
0036 DELIVER PORTABLE LONGITUDINAL BARRIER 877(B) 8484 LF 12,500.000 12,464.000   12,464.000 $10.00 $0.00 $124,640.00
0037 RELOCATION OF PORTABLE LONGITUDINAL BARRIER 877(C) 8486 LF 12,500.000 12,464.000   12,464.000 $5.00 $0.00 $62,320.00
0038 MODULAR GLARE SCREEN (TEMPORARY) 878(B) 8487 SD 11,520.000 8,280.000   8,280.000 $0.13 $0.00 $1,076.40
0039 ARROW DISPLAY(TYPE C) 880(A) 8812 SD 240.000 220.000   220.000 $3.15 $0.00 $693.00
0040 CONSTRUCTION SIGNS 0 TO 6.25 SF 880(B) 8818 SD 5,040.000 6,688.000   6,688.000 $1.00 $0.00 $6,688.00
0041 CONSTRUCTION SIGNS 6.26 SF TO 15.99 SF 880(B) 8821 SD 5,760.000 4,777.000   4,777.000 $1.00 $0.00 $4,777.00
0042 CONSTRUCTION SIGNS 16.0 SF TO 32.99 SF 880(B) 8824 SD 2,560.000 4,016.000   4,016.000 $1.05 $0.00 $4,216.80
0043 CONSTRUCTION BARRICADES(TYPE III) 880(C) 8842 SD 1,680.000 2,143.000   2,143.000 $1.05 $0.00 $2,250.15
0044 WING BARRICADES 880(C) 8848 SD 480.000 644.000   644.000 $0.11 $0.00 $70.84
0045 VERTICAL PANELS 880(D) 8854 SD 26,160.000 9,082.000   9,082.000 $0.11 $0.00 $999.02
0046 WARNING LIGHTS(TYPE A) 880(E) 8860 SD 5,280.000 6,830.000   6,830.000 $0.52 $0.00 $3,551.60
0047 DRUMS 880(F) 8878 SD 7,200.000 17,974.000   17,974.000 $0.42 $0.00 $7,549.08
0048 CHANNELIZER CONES 880(G) 8890 SD 8,700.000 14,669.000   14,669.000 $0.11 $0.00 $1,613.59
0049 TRAFFIC SURVEILLANCE, POLICE 880(L) 8911 HOUR 350.000 0.000   0.000 $65.00 $0.00 $0.00
0050 PORT.CHANGEABLE MESSAGE SIGN 882(A) 8306 SD 480.000 220.000   220.000 $4.20 $0.00 $924.00
Subtotals For Category     0300/TRAFFIC CONTROL    $0.00 $239,243.54
Fed/State Project Number:    IMY-0040-4(430)102 Project:    26488(04) Category:    0301/TRAFFIC STRIPING
0051 DELINEATORS(TYPE 1, CODE 1) 853 9024 EA 40.000 40.000   40.000 $15.50 $0.00 $620.00
0052 TRAFFIC STRIPE(MULTI-POLYMER)(4" WIDE) 856(A) 8530 LF 43,472.000 0.000   0.000 $0.60 $0.00 $0.00
0053 TRAFFIC STRIPE(MULTI-POLY.)(6" WIDE) 856(A) 8535 LF 7,200.000 54,808.000   54,808.000 $0.61 $0.00 $33,432.88
9000 CONSTRUCTION MISCELLANEOUS 104 0300 LF 0.000 54,808.000   54,808.000 $0.05 $0.00 $2,740.40
Subtotals For Category     0301/TRAFFIC STRIPING    $0.00 $36,793.28
Fed/State Project Number:    IMY-0040-4(430)102 Project:    26488(04) Category:    0304/CABLE BARRIER
0054 TRAFFIC BOUND SURFACE COURSE TYPE E 402(E) 0225 TON 773.000 933.740   933.740 $35.25 $0.00 $32,914.34
0055 CLASS AA CONCRETE 509(A) 0319 CY 49.000 53.680   53.680 $300.00 $0.00 $16,104.00
0056 CLASS C CONCRETE 509(D) 0325 CY 135.000 0.000   0.000 $225.00 $0.00 $0.00
0057 REMOVAL OF CABLE BARRIER 619(B) 5190 LF 1,190.000 1,271.000   1,271.000 $6.00 $0.00 $7,626.00
0058 INSTALLATION OF CABLE BARRIER SYSTEM 628 5180 LF 1,190.000 1,271.000   1,271.000 $3.00 $0.00 $3,813.00
0059 HIGH-TENSION CABLE BARRIER(TL-4) 628(B) 5125 LF 560.000 644.000   644.000 $10.50 $0.00 $6,762.00
0060 END ANCHORS 628(C) 5110 EA 8.000 8.000   8.000 $3,000.00 $0.00 $24,000.00
Subtotals For Category     0304/CABLE BARRIER    $0.00 $91,219.34
Fed/State Project Number:    IMY-0040-4(430)102 Project:    26488(04) Category:    0640/CONSTRUCTION
0061 SWPPP DOCUMENTATION AND MANAGEMENT 220 2800 LSUM 1.000 1.000   1.000 $2,500.00 $0.00 $2,500.00
0062 MOBILIZATION 641 1552 LSUM 1.000 1.000   1.000 $56,000.00 $0.00 $56,000.00
0063 (SP)CONTRACTORS QUALITY CONTROL 643 0087 LSUM 1.000 1.000   1.000 $45,679.00 $0.00 $45,679.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $104,179.00
Subtotals For Project IMY-0040-4(430)102 /26488(04) $0.00 $4,729,371.18