Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 120003   Estimate Number: 0013 , Final     Spec Year: 2009
Primary JP: 26295(08)   Residency: ANTLERS (02100)     Contract No: 710958
Date Created: 05/20/2013   Contractor FEI: 730626847     Account No: 400200

Project Number(s): NHY-013N(148)3P
Contract Description: PAVEMENT REHABILITATION (UTBWC) US-69: BEGIN 1.07 MILES NORTH OF SH-78, EXTEND NORTH (SOUTHBOUND LANES ONLY). PROJECT LENGTH = 8.00 MILES.
Primary County: BRYAN              
Name of Road: US-69              
Prime Contractor: THE CUMMINS CONSTRUCTION CO., INC.           Time Charged: 120.00
    P. O. BOX 748           Time Allowed: 120.00
    ENID , OK   73702           Percent Time: 100.00 %

  Paid To Date: $3,807,872.70 Payable This Statement: $3,296.48

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:    05/20/2013
Contract ID: 120003   Estimate Number: 0013     Contract No: 710958
Residency: ANTLERS (02100)   Estimate Type: Final     Account No: 400200

Project Number(s): NHY-013N(148)3P
Primary Job Piece No: 26295(08)
Contract Description: PAVEMENT REHABILITATION (UTBWC) US-69: BEGIN 1.07 MILES NORTH OF SH-78, EXTEND NORTH (SOUTHBOUND LANES ONLY). PROJECT LENGTH = 8.00 MILES.
Primary County: BRYAN              
Name of Road: US-69              
Prime Contractor: THE CUMMINS CONSTRUCTION CO., INC.              
    P. O. BOX 748              
    ENID , OK   73702              
Surety Company: HARTFORD ACCIDENT & INDEMNITY COMPANY              

Date Let: 02/16/2012 NTP Effective Date: 07/02/2012 Pay Period: 12/16/2012  TO  04/19/2013
Date Awarded: 03/05/2012 Date Work Began: 05/29/2012 Original Contract Time: 120
Date Contract Executed: 03/14/2012 Date Time Stopped: 11/16/2012 Current Time Charged: 120.00
Date NTP Issued: 03/21/2012 Completion Date: 11/16/2012 Current Time Allowed: 120.00
General Liability Expires: 09/01/2013 Workman's Comp Expires: 01/01/2014 Percent Time Used: 100.00 %
Specification Year: 2009        

Current Contract Amount: $3,813,166.64 Total to Date Prev to Date This Estimate
Bid Amount: $4,152,484.83 Participating: $3,813,166.66 $3,809,870.18 $3,296.48
Percent Complete: 99.86 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $5,293.94 Total Earnings: $3,813,166.66 $3,809,870.18 $3,296.48
Unearned Balance: $344,612.13 Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $3,813,166.66 $3,809,870.18 $3,296.48
Other Adjustments: $-5,293.96 $-5,293.96 $0.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $3,807,872.70 $3,804,576.22 $3,296.48

Estimate Adjustment Detail

Contract ID: 120003   Estimate Number: 0013     Primary JP: 26295(08)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Final Quantity Change Order Approved 05/20/2013 0.0 $-339,318.19


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
26295(08) 0007 SUPERPAVE, TYPE S4(PG 76-28 OK) * HMA Deduction as per Sec. 411 0008 -20.00 $71.10 $-1,422.00
26295(08) 0007 SUPERPAVE, TYPE S4(PG 76-28 OK) * HMA Deduction as per Sec. 411 0010 -10.00 $71.10 $-711.00
26295(08) 0007 SUPERPAVE, TYPE S4(PG 76-28 OK) * HMA Deduction as per Sec. 411 0010 -30.00 $71.10 $-2,133.00
26295(08) 0008 SUPERPAVE, TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0004 47.31 $1.62 $76.93
26295(08) 0008 SUPERPAVE, TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0006 542.52 $0.42 $231.11
26295(08) 0008 SUPERPAVE, TYPE S4(PG 64-22 OK) * HMA Deduction as per Sec. 411 0010 -20.00 $66.80 $-1,336.00
Subtotals For Line Item Adjustments $-5,293.96
* = 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: 120003   Estimate Number: 0013     Primary JP: 26295(08)



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:    NHY-013N(148)3P Project:    26295(08) Category:    0100/ROADWAY
0001 UNCLASSIFIED EXCAVATION 202(A) 0183 CY 400.000 400.000   400.000 $16.50 $0.00 $6,600.00
0002 AGGREGATE BASE TYPE B 303(B) 2110 CY 260.000 255.990   255.990 $60.00 $0.00 $15,359.40
0003 SEPARATOR FABRIC 325 5271 SY 1,965.000 1,529.950   1,529.950 $1.50 $0.00 $2,294.93
0004 TRAFFIC BOUND SURFACE COURSE TYPE E 402(E) 0225 TON 5,660.000 4,131.030   4,131.030 $21.00 $0.00 $86,751.63
0005 ULTRA-THIN BONDED WEARING COURSE, TYPE C 404(G) 4845 TON 18,098.000 15,948.820   15,948.820 $93.30 $0.00 $1,488,024.91
0006 POLYMER MODIFIED CATIONIC RAPID SET - 1 407(C) 0300 GAL 37,207.000 53,219.000 0.000 53,219.000 $3.05 $0.00 $162,317.95
0007 SUPERPAVE, TYPE S4(PG 76-28 OK) 411(C) 5950 TON 14,962.000 13,685.920   13,685.920 $71.10 $0.00 $973,068.91
0008 SUPERPAVE, TYPE S4(PG 64-22 OK) 411(C) 5960 TON 5,156.000 5,320.630   5,320.630 $66.80 $0.00 $355,418.09
0009 COLD MILLING PAVEMENT 412 5267 SY 16,720.000 14,373.650   14,373.650 $2.10 $0.00 $30,184.67
0010 RUMBLE STRIP-METHOD HMA-CON 413(A) 4861 LF 85,878.000 80,214.000   80,214.000 $0.11 $0.00 $8,823.54
0011 P.C.CONCRETE PAVEMENT(PLACEMENT) 414(A) 0210 SY 412.000 292.440   292.440 $67.00 $0.00 $19,593.48
0012 FULL DEPTH P.C. CONCRETE PATCHING(PLACEMENT ONLY) 414(E) 0225 SY 2,900.000 2,212.050   2,212.050 $95.00 $0.00 $210,144.75
0013 P.C. CONCRETE FOR PAVEMENT 414(G) 5275 CY 697.000 699.790   699.790 $120.00 $0.00 $83,974.80
0014 TYPE 3 TERMINAL JOINT 414(I) 5266 EA 2.000 2.000   2.000 $7,000.00 $0.00 $14,000.00
0015 TERMINAL JOINT SLEEPER SLAB 414(J) 5263 SY 125.000 124.480   124.480 $150.00 $0.00 $18,672.00
0016 CONCRETE JOINT SEALING 415 6300 LF 800.000 1,210.000   1,210.000 $4.00 $0.00 $4,840.00
0017 APPROACH SLAB 504(A) 1304 SY 280.000 342.220   342.220 $160.00 $0.00 $54,755.20
0018 EDGE DRAIN CONDUIT-PERFORATED 613(J) 5915 LF 1,000.000 35.000   35.000 $6.50 $0.00 $227.50
0019 EDGE DRAIN OUTLET LATERAL-NONPERFORATED 613(K) 5916 LF 500.000 0.000   0.000 $4.75 $0.00 $0.00
0020 OUTLET LATERAL HEADWALL 613(Q) 5946 EA 4.000 1.000   1.000 $980.00 $0.00 $980.00
0021 REMOVAL OF STRUCTURES & OBSTRUCTIONS 619(A) 0920 LSUM 1.000 1.000   1.000 $1,620.00 $0.00 $1,620.00
0022 REMOVAL OF CONCRETE PAVEMENT 619(B) 4727 SY 1,115.000 1,208.430   1,208.430 $30.00 $0.00 $36,252.90
0023 REMOVAL OF DRAINAGE INLETS 619(B) 4741 EA 3.000 3.000   3.000 $500.00 $0.00 $1,500.00
Subtotals For Category     0100/ROADWAY    $0.00 $3,575,404.66
Fed/State Project Number:    NHY-013N(148)3P Project:    26295(08) Category:    0300/TRAFFIC
0024 TRAFFIC STRIPE(PLASTIC)(4" WIDE) 855(A) 8812 LF 88,200.000 87,500.000 -11,263.000 87,500.000 $0.44 $-4,955.72 $38,500.00
0025 TRAFFIC STRIPE(PLASTIC)(6" WIDE) 855(A) 8813 LF 14,800.000 11,700.000 9,470.000 11,700.000 $0.66 $6,250.20 $7,722.00
0026 TRAFFIC STRIPE(PLASTIC)(8" WIDE) 855(A) 8814 LF 3,000.000 6,750.000 2,275.000 6,750.000 $0.88 $2,002.00 $5,940.00
0027 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $20,600.00 $0.00 $20,600.00
Subtotals For Category     0300/TRAFFIC    $3,296.48 $72,762.00
Fed/State Project Number:    NHY-013N(148)3P Project:    26295(08) Category:    0640/CONSTRUCTION
0028 MOBILIZATION 641 1552 LSUM 1.000 1.000   1.000 $165,000.00 $0.00 $165,000.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $165,000.00
Subtotals For Project NHY-013N(148)3P /26295(08) $3,296.48 $3,813,166.66