Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 120048   Estimate Number: 0011 , Final     Spec Year: 2009
Primary JP: 21652(04)   Residency: CIRCUIT ENGR. DISTRICT # 3 (02013)     Contract No: 710839
Date Created: 05/12/2014   Contractor FEI: 731174172     Account No: 436200

Project Number(s): BRO-112D(058)CI
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD: OVER SALT CREEK 2.3 MILES NORTH AND 0.7 MILE WEST OF THE US-70/SH-93 JUNCTION. PROJECT LENGTH = 0.323 MILE.
Primary County: CHOCTAW              
Name of Road: COUNTY ROAD              
Prime Contractor: HUB CONSTRUCTION, INC.           Time Charged: 104.00
    ROUTE 1, BOX 350           Time Allowed: 104.00
    BOSWELL , OK   74727           Percent Time: 100.00 %

  Paid To Date: $730,621.19 Payable This Statement: $2,032.98

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.                                
HUB 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:    05/12/2014
Contract ID: 120048   Estimate Number: 0011     Contract No: 710839
Residency: CIRCUIT ENGR. DISTRICT # 3 (02013)   Estimate Type: Final     Account No: 436200

Project Number(s): BRO-112D(058)CI
Primary Job Piece No: 21652(04)
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD: OVER SALT CREEK 2.3 MILES NORTH AND 0.7 MILE WEST OF THE US-70/SH-93 JUNCTION. PROJECT LENGTH = 0.323 MILE.
Primary County: CHOCTAW              
Name of Road: COUNTY ROAD              
Prime Contractor: HUB CONSTRUCTION, INC.              
    ROUTE 1, BOX 350              
    BOSWELL , OK   74727              
Surety Company: OHIO CASUALTY INSURANCE COMPANY              

Date Let: 01/19/2012 NTP Effective Date: 05/07/2012 Pay Period: 10/16/2012  TO  04/30/2014
Date Awarded: 02/06/2012 Date Work Began: 05/21/2012 Original Contract Time: 90
Date Contract Executed: 02/17/2012 Date Time Stopped: 10/10/2012 Current Time Charged: 104.00
Date NTP Issued: 02/23/2012 Completion Date: 10/10/2012 Current Time Allowed: 104.00
General Liability Expires: 07/01/2014 Workman's Comp Expires: 12/31/2014 Percent Time Used: 100.00 %
Specification Year: 2009        

Bid Amount: $764,239.75 Total to Date Prev to Date This Estimate
Funds Available (Bid + Positive C/O): $764,239.75 Participating: $711,143.69 $709,110.71 $2,032.98
Percent Complete: 95.60 % Non Participating: $19,477.50 $19,477.50 $0.00
Unearned Balance: $33,618.56 Total Earnings: $730,621.19 $728,588.21 $2,032.98
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $730,621.19 $728,588.21 $2,032.98
Other Adjustments: $0.00 $0.00 $0.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $730,621.19 $728,588.21 $2,032.98

Estimate Adjustment Detail

Contract ID: 120048   Estimate Number: 0011     Primary JP: 21652(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 BRIDGE LEFT UNTIL SCHOOL OUT PER COMMISSIONER REQUEST Approved 06/20/2012 14.0 $0.00
002 Final Quantity Change Order Approved 04/29/2014 0.0 $-33,618.56


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
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: 120048   Estimate Number: 0011     Primary JP: 21652(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-112D(058)CI Project:    21652(04) Category:    0100/ROADWAY
0001 CLEARING AND GRUBBING 201(A) 0102 LSUM 1.000 1.000   1.000 $5,000.00 $0.00 $5,000.00
0002 UNCLASSIFIED EXCAVATION 202(A) 0183 CY 3,676.000 3,676.000   3,676.000 $7.00 $0.00 $25,732.00
0003 UNCLASSIFIED BORROW 202(D) 0184 CY 9,544.000 9,544.000   9,544.000 $7.00 $0.00 $66,808.00
0004 TYPE A-SALVAGED TOPSOIL 205(A) 4229 LSUM 1.000 1.000   1.000 $5,000.00 $0.00 $5,000.00
0005 TEMPORARY SILT FENCE 221(C) 2801 LF 1,166.000 0.000   0.000 $3.00 $0.00 $0.00
0006 TEMPORARY SILT DIKE 221(F) 0100 LF 384.000 0.000   0.000 $6.00 $0.00 $0.00
0007 SOLID SLAB SODDING 230(A) 2806 SY 8,940.000 10,753.330   10,753.330 $3.00 $0.00 $32,259.99
0008 VEGETATIVE MULCHING 233(A) 2817 AC 4.400 0.000   0.000 $100.00 $0.00 $0.00
0009 AGGREGATE BASE TYPE A 303(A) 2100 CY 982.000 964.090 -17.910 964.090 $40.00 $-716.40 $38,563.60
0010 SEPARATOR FABRIC 325 5271 SY 4,996.000 4,996.490 0.490 4,996.490 $2.00 $0.98 $9,992.98
0011 TRAFFIC BOUND SURFACE COURSE TYPE E 402(E) 0225 TON 68.000 27.130   27.130 $25.00 $0.00 $678.25
0012 PRIME COAT 408 5774 GAL 2,018.000 0.000   0.000 $8.00 $0.00 $0.00
0013 SUPERPAVE, TYPE S4(PG 64-22 OK) 411(C) 5960 TON 730.000 730.620   730.620 $120.00 $0.00 $87,674.40
0014 CLASS C CONCRETE 509(D) 0325 CY 166.500 0.000   0.000 $275.00 $0.00 $0.00
0015 28" X 20" CORR. GALV. STEEL PIPE ARCH 613(B) 4528 LF 28.000 28.000   28.000 $40.00 $0.00 $1,120.00
0016 42" X 29" CORR. GALV. STEEL PIPE ARCH 613(B) 4530 LF 92.000 92.000   92.000 $60.00 $0.00 $5,520.00
0017 28" X 20" GALV. STEEL CULVERT END SECTION ARCH 613(P) 4571 EA 2.000 2.000   2.000 $200.00 $0.00 $400.00
0018 42" X 29" GALV. STEEL CULVERT END SECTION ARCH 613(P) 4573 EA 4.000 4.000   4.000 $500.00 $0.00 $2,000.00
0019 SHEET ALUMINUM SIGNS 850(A) 8110 SF 23.250 23.250   23.250 $15.00 $0.00 $348.75
0020 FLANGE CHANNEL POSTS(4 LB/FT) 851(D) 8597 LF 48.000 48.000   48.000 $12.00 $0.00 $576.00
0021 DELINEATORS(TYPE 2, CODE 1) 853 9033 EA 10.000 10.000 10.000 10.000 $25.00 $250.00 $250.00
0022 TRAFFIC STRIPE(PLASTIC)(4" WIDE) 855(A) 8812 LF 6,844.000 6,890.000   6,890.000 $1.25 $0.00 $8,612.50
Subtotals For Category     0100/ROADWAY    $-465.42 $290,536.47
Fed/State Project Number:    BRO-112D(058)CI Project:    21652(04) Category:    0200/BRIDGE 'A'
0023 SUBSTRUCTURE EXCAVATION COMMON 501(B) 1307 CY 190.000 190.000   190.000 $12.00 $0.00 $2,280.00
0024 CLSM BACKFILL 501(G) 6309 CY 88.000 88.000   88.000 $125.00 $0.00 $11,000.00
0025 PRESTRESSED CONCRETE BEAMS (TYPE IV) 503(A) 1313 LF 269.000 269.000   269.000 $250.00 $0.00 $67,250.00
0026 APPROACH SLAB 504(A) 1304 SY 115.000 115.000   115.000 $160.00 $0.00 $18,400.00
0027 SAW-CUT GROOVING 504(B) 1305 SY 384.200 384.200   384.200 $7.50 $0.00 $2,881.50
0028 CONCRETE RAIL (TR3) 504(D) 6239 LF 246.400 246.400   246.400 $75.00 $0.00 $18,480.00
0029 STRUCTURAL STEEL 506(A) 1322 LB 290.000 290.000   290.000 $5.00 $0.00 $1,450.00
0030 WEATHERING STEEL FIXED BEARING ASSEMBLY 507(A) 6172 EA 3.000 3.000   3.000 $1,150.00 $0.00 $3,450.00
0031 WEATHERING STEEL EXPANSION BEARING ASSEMBLY 507(B) 6176 EA 3.000 3.000   3.000 $1,150.00 $0.00 $3,450.00
0032 CLASS AA CONCRETE 509(A) 1326 CY 71.900 71.900   71.900 $500.00 $0.00 $35,950.00
0033 CLASS A CONCRETE 509(B) 1328 CY 71.800 73.410   73.410 $500.00 $0.00 $36,705.00
0034 REINFORCING STEEL 511(A) 1332 LB 27,250.000 27,250.000   27,250.000 $1.00 $0.00 $27,250.00
0035 DRILLED SHAFTS 18" DIAMETER 516(A) 6089 LF 67.000 67.000   67.000 $325.00 $0.00 $21,775.00
0036 DRILLED SHAFTS 30" DIAMETER 516(A) 6091 LF 88.500 88.500   88.500 $500.00 $0.00 $44,250.00
0037 TYPE I-A PLAIN RIPRAP 601(B) 1353 TON 900.000 1,723.640   1,723.640 $40.00 $0.00 $68,945.60
0038 TYPE I-A FILTER BLANKET 601(C) 1355 TON 240.000 179.410 -0.050 179.410 $32.00 $-1.60 $5,741.12
0039 6" PERFORATED PIPE UNDERDRAIN ROUND 613(H) 6204 LF 52.000 52.000   52.000 $22.00 $0.00 $1,144.00
0040 6" NON-PERF.PIPE UNDERDRAIN RND. 613(I) 6207 LF 80.000 41.000   41.000 $5.00 $0.00 $205.00
0041 REMOVAL OF EXISTING BRIDGE STRUCTURE 619(D) 1397 LSUM 1.000 1.000   1.000 $5,500.00 $0.00 $5,500.00
0042 GUARDRAIL ANCHOR UNIT (TYPE A) 623(F) 4446 EA 4.000 4.000   4.000 $2,200.00 $0.00 $8,800.00
0043 GUARDRAIL ANCHOR UNIT (TYPE D-BF) 623(F) 5686 EA 4.000 4.000   4.000 $1,800.00 $0.00 $7,200.00
0044 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000 0.250 1.000 $2,000.00 $500.00 $2,000.00
Subtotals For Category     0200/BRIDGE 'A'    $498.40 $394,107.22
Fed/State Project Number:    BRO-112D(058)CI Project:    21652(04) Category:    0600/STAKING
0045 CONSTRUCTION STAKING LEVEL II 642(B) 0096 LSUM 1.000 1.000 0.250 1.000 $5,000.00 $1,250.00 $5,000.00
Subtotals For Category     0600/STAKING    $1,250.00 $5,000.00
Fed/State Project Number:    BRO-112D(058)CI Project:    21652(04) Category:    0640/CONSTRUCTION
0046 SWPPP DOCUMENTATION AND MANAGEMENT 220 2800 LSUM 1.000 1.000 0.500 1.000 $1,500.00 $750.00 $1,500.00
0047 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $20,000.00 $0.00 $20,000.00
Subtotals For Category     0640/CONSTRUCTION    $750.00 $21,500.00
Fed/State Project Number:    BRO-112D(058)CI Project:    21652(04) Category:    0900/NON-PARTICIPATING
0048 FENCE-STYLE WWF 624(A) 4281 LF 3,568.000 3,405.000   3,405.000 $5.50 $0.00 $18,727.50
0049 GATES-STYLE WWF (4.5'HIGH X 16'LONG) 624(B) 4466 EA 3.000 3.000   3.000 $250.00 $0.00 $750.00
Subtotals For Category     0900/NON-PARTICIPATING    $0.00 $19,477.50
Subtotals For Project BRO-112D(058)CI /21652(04) $2,032.98 $730,621.19