Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 120034   Estimate Number: 0008 , Final     Spec Year: 2009
Primary JP: 25859(04)   Residency: CIRCUIT ENGR. DISTRICT # 3 (02013)     Contract No: 710898
Date Created: 12/14/2012   Contractor FEI: 202558015     Account No: 436200

Project Number(s): BRO-103D(107)CI
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD: OVER UNNAMED CREEK 1.6 MILES EAST AND 0.3 MILES NORTH OF THE US-69/SH-131 JCT. PROJECT LENGTH = 0.227 MILES.
Primary County: ATOKA              
Name of Road: COUNTY ROAD              
Prime Contractor: C-GAWF CONSTRUCTION, INC.           Time Charged: 94.00
    101 E SHURDEN INDUSTRIAL BLVD           Time Allowed: 90.00
    HENRYETTA , OK   74437           Percent Time: 104.44 %

  Paid To Date: $323,076.92 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.                                
C-GAWF CONSTRUCTION, 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:    12/14/2012
Contract ID: 120034   Estimate Number: 0008     Contract No: 710898
Residency: CIRCUIT ENGR. DISTRICT # 3 (02013)   Estimate Type: Final     Account No: 436200

Project Number(s): BRO-103D(107)CI
Primary Job Piece No: 25859(04)
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD: OVER UNNAMED CREEK 1.6 MILES EAST AND 0.3 MILES NORTH OF THE US-69/SH-131 JCT. PROJECT LENGTH = 0.227 MILES.
Primary County: ATOKA              
Name of Road: COUNTY ROAD              
Prime Contractor: C-GAWF CONSTRUCTION, INC.              
    101 E SHURDEN INDUSTRIAL BLVD              
    HENRYETTA , OK   74437              
Surety Company: EMPLOYERS MUTUAL CASUALTY COMPANY              

Date Let: 01/19/2012 NTP Effective Date: 05/07/2012 Pay Period: 10/01/2012  TO  11/26/2012
Date Awarded: 02/06/2012 Date Work Began: 04/09/2012 Original Contract Time: 90
Date Contract Executed: 02/24/2012 Date Time Stopped: 07/26/2012 Current Time Charged: 94.00
Date NTP Issued: 03/01/2012 Completion Date: 07/26/2012 Current Time Allowed: 90.00
General Liability Expires: 01/03/2013 Workman's Comp Expires: 01/03/2013 Percent Time Used: 104.44 %
Specification Year: 2009        

Current Contract Amount: $325,076.91 Total to Date Prev to Date This Estimate
Bid Amount: $348,136.40 Participating: $325,076.92 $325,076.92 $0.00
Percent Complete: 99.38 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $1,999.99 Total Earnings: $325,076.92 $325,076.92 $0.00
Unearned Balance: $25,059.48 Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $325,076.92 $325,076.92 $0.00
Other Adjustments: $0.00 $0.00 $0.00
Liq Dam/Disincentive: $-2,000.00 $-2,000.00 $0.00
TOTAL: $323,076.92 $323,076.92 $0.00

Estimate Adjustment Detail

Contract ID: 120034   Estimate Number: 0008     Primary JP: 25859(04)



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 11/19/2012 0.0 $-23,059.49


STOCKPILE PAYMENT HISTORY
Project Line Nbr Stockpile Description Adjustment Type Estimate Nbr Adjusted Amount
25859(04) 0014 Concrete Rail for Bridge 'A' Stockpiled Material Adjustment 0005 $-1,354.89
25859(04) 0014 Concrete Rail for Bridge 'A' Stockpiled Material Initial Payment 0001 $1,354.89
25859(04) 0016 Reinforcing Steel for Bridge 'A' Stockpiled Material Adjustment 0002 $-11,042.43
25859(04) 0016 Reinforcing Steel for Bridge 'A' Stockpiled Material Adjustment 0004 $-5,835.14
25859(04) 0016 Reinforcing Steel for Bridge 'A' Stockpiled Material Adjustment 0003 $-5,258.30
25859(04) 0016 Reinforcing Steel for Bridge 'A' Stockpiled Material Initial Payment 0001 $22,135.87
25859(04) 0023 Reinforcing Steel for Bridge B Stockpiled Material Adjustment 0004 $-6,874.32
25859(04) 0023 Reinforcing Steel for Bridge B Stockpiled Material Initial Payment 0003 $16,832.35
25859(04) 0023 Reinforcing Steel for Bridge B Stockpiled Material Adjustment 0005 $-7,093.73
25859(04) 0023 Reinforcing Steel for Bridge B Stockpiled Material Adjustment 0003 $-2,864.30
Subtotals For Stockpile Payments $0.00


LIQUIDATED DAMAGES HISTORY
Adjustment Description Estimate Nbr Time Units Rate Adjustment Amount
System Application of Liquidated Damages 0006 --4.0 $500.00 $-2,000.00
Subtotals For Liquidated Damages $-2,000.00


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 $

Line Item Detail

Contract ID: 120034   Estimate Number: 0008     Primary JP: 25859(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:    BRO-103D(107)CI Project:    25859(04) Category:    0100/ROADWAY
0001 CLEARING AND GRUBBING 201(A) 0102 LSUM 1.000 1.000   1.000 $15,000.00 $0.00 $15,000.00
0002 EARTHWORK 202(H) 0185 LSUM 1.000 1.000   1.000 $25,000.00 $0.00 $25,000.00
0003 TEMPORARY SILT FENCE 221(C) 2801 LF 800.000 0.000   0.000 $3.00 $0.00 $0.00
0004 TEMPORARY SILT DIKE 221(F) 0100 LF 150.000 0.000   0.000 $9.95 $0.00 $0.00
0005 SOLID SLAB SODDING 230(A) 2806 SY 2,950.000 0.000   0.000 $3.00 $0.00 $0.00
0006 VEGETATIVE MULCHING 233(A) 2817 AC 1.200 0.000   0.000 $1,500.00 $0.00 $0.00
0007 TRAFFIC BOUND SURFACE COURSE TYPE E 402(E) 0225 TON 900.000 939.850   939.850 $22.50 $0.00 $21,146.63
0008 CLASS C CONCRETE 509(D) 0325 CY 30.000 0.000   0.000 $225.00 $0.00 $0.00
0009 TYPE I-A PLAIN RIPRAP 601(B) 0536 TON 300.000 251.540   251.540 $32.50 $0.00 $8,175.05
0010 FILTER FABRIC (RIPRAP) 601(I) 6312 SY 400.000 386.670   386.670 $1.55 $0.00 $599.34
0011 18" CORR. GALV. STEEL PIPE 613(B) 0689 LF 48.000 30.000   30.000 $26.00 $0.00 $780.00
0012 18" PREFAB. CULVERT END SECTION, ROUND 613(L) 5726 EA 4.000 2.000   2.000 $300.00 $0.00 $600.00
Subtotals For Category     0100/ROADWAY    $0.00 $71,301.02
Fed/State Project Number:    BRO-103D(107)CI Project:    25859(04) Category:    0200/BRIDGE 'A'
0013 STRUCTURAL EXCAVATION UNCLASSIFIED 501(A) 1306 CY 57.470 57.470   57.470 $100.00 $0.00 $5,747.00
0014 CONCRETE RAIL (TR3) 504(D) 6239 LF 159.000 159.000   159.000 $50.00 $0.00 $7,950.00
0015 CLASS A CONCRETE 509(B) 1328 CY 198.690 198.690   198.690 $330.00 $0.00 $65,567.70
0016 REINFORCING STEEL 511(A) 1332 LB 42,097.000 42,097.000   42,097.000 $0.70 $0.00 $29,467.90
0017 REMOVAL OF EXISTING BRIDGE STRUCTURE 619(D) 1397 LSUM 1.000 1.000   1.000 $10,000.00 $0.00 $10,000.00
0018 GUARDRAIL ANCHOR UNIT (TYPE III) 623(F) 6034 EA 4.000 4.000   4.000 $2,035.00 $0.00 $8,140.00
0019 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $2,310.00 $0.00 $2,310.00
Subtotals For Category     0200/BRIDGE 'A'    $0.00 $129,182.60
Fed/State Project Number:    BRO-103D(107)CI Project:    25859(04) Category:    0201/BRIDGE 'B'
0020 STRUCTURAL EXCAVATION UNCLASSIFIED 501(A) 1306 CY 41.250 41.250   41.250 $100.00 $0.00 $4,125.00
0021 CONCRETE RAIL (TR3) 504(D) 6239 LF 139.060 139.060   139.060 $50.00 $0.00 $6,953.00
0022 CLASS A CONCRETE 509(B) 1328 CY 166.840 166.840   166.840 $330.00 $0.00 $55,057.20
0023 REINFORCING STEEL 511(A) 1332 LB 29,383.000 29,383.000   29,383.000 $0.70 $0.00 $20,568.10
0024 REMOVAL OF EXISTING BRIDGE STRUCTURE 619(D) 1397 LSUM 1.000 1.000   1.000 $10,000.00 $0.00 $10,000.00
0025 GUARDRAIL ANCHOR UNIT (TYPE III) 623(F) 6034 EA 4.000 4.000   4.000 $2,035.00 $0.00 $8,140.00
Subtotals For Category     0201/BRIDGE 'B'    $0.00 $104,843.30
Fed/State Project Number:    BRO-103D(107)CI Project:    25859(04) Category:    0600/STAKING
0026 CONSTRUCTION STAKING LEVEL II 642(B) 0096 LSUM 1.000 1.000   1.000 $4,750.00 $0.00 $4,750.00
Subtotals For Category     0600/STAKING    $0.00 $4,750.00
Fed/State Project Number:    BRO-103D(107)CI Project:    25859(04) Category:    0640/CONSTRUCTION
0027 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $15,000.00 $0.00 $15,000.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $15,000.00
Subtotals For Project BRO-103D(107)CI /25859(04) $0.00 $325,076.92