Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 120055   Estimate Number: 0008 , Final     Spec Year: 2009
Primary JP: 25104(04)   Residency: JACOBS (06004)     Contract No: 710886
Date Created: 09/04/2013   Contractor FEI: 480664815     Account No: 434600

Project Number(s): CIRB-147C(135)RB, CIRB-147C(167)RB
Contract Description: RESURFACE (ASPHALT) COUNTY ROAD (EW-54): BEGIN AT SH-58, EXTEND EAST. PROJECT LENGTH = 8.905 MILES.
Primary County: MAJOR              
Name of Road: COUNTY ROAD              
Prime Contractor: J & R SAND COMPANY, INC.           Time Charged: 89.00
    P. O. BOX 2436           Time Allowed: 90.00
    LIBERAL , KS   67905-2436           Percent Time: 98.89 %

  Paid To Date: $4,138,548.37 Payable This Statement: $3,168.80

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.                                
J & R SAND COMPANY, 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:    09/04/2013
Contract ID: 120055   Estimate Number: 0008     Contract No: 710886
Residency: JACOBS (06004)   Estimate Type: Final     Account No: 434600

Project Number(s): CIRB-147C(135)RB, CIRB-147C(167)RB
Primary Job Piece No: 25104(04)
Contract Description: RESURFACE (ASPHALT) COUNTY ROAD (EW-54): BEGIN AT SH-58, EXTEND EAST. PROJECT LENGTH = 8.905 MILES.
Primary County: MAJOR              
Name of Road: COUNTY ROAD              
Prime Contractor: J & R SAND COMPANY, INC.              
    P. O. BOX 2436              
    LIBERAL , KS   67905-2436              
Surety Company: TRAVELERS INDEMNITY COMPANY              

Date Let: 01/19/2012 NTP Effective Date: 06/04/2012 Pay Period: 08/16/2013  TO  08/31/2013
Date Awarded: 02/06/2012 Date Work Began: 06/05/2012 Original Contract Time: 90
Date Contract Executed: 02/21/2012 Date Time Stopped: 11/30/2012 Current Time Charged: 89.00
Date NTP Issued: 02/28/2012 Completion Date: 11/30/2012 Current Time Allowed: 90.00
General Liability Expires: 08/31/2014 Workman's Comp Expires: 08/31/2014 Percent Time Used: 98.89 %
Specification Year: 2009        

Current Contract Amount: $4,090,539.61 Total to Date Prev to Date This Estimate
Bid Amount: $3,894,981.34 Participating: $0.00 $0.00 $0.00
Percent Complete: 101 % Non Participating: $4,090,546.61 $4,090,546.61 $0.00
Funds Available: $-48,008.76 Total Earnings: $4,090,546.61 $4,090,546.61 $0.00
Unearned Balance: $-243,567.03 Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $4,090,546.61 $4,090,546.61 $0.00
Other Adjustments: $48,001.76 $44,832.96 $3,168.80
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $4,138,548.37 $4,135,379.57 $3,168.80

Estimate Adjustment Detail

Contract ID: 120055   Estimate Number: 0008     Primary JP: 25104(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Add Subgrade Method B/Cold Milling Approved 12/04/2012 0.0 $121,854.49
002 Pavement Smoothness Approved 12/04/2012 0.0 $132,191.88
003 Final Quantity Change Order Approved 08/19/2013 0.0 $-58,488.10


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
25104(04) 0012 SUPERPAVE, TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0001 703.88 $1.53 $1,077.57
25104(04) 0012 SUPERPAVE, TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0002 10,698.09 $1.53 $16,377.71
25104(04) 0012 SUPERPAVE, TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0003 4,147.02 $1.53 $6,348.67
25104(04) 0012 SUPERPAVE, TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0004 9,099.51 $0.48 $4,375.95
25104(04) 0013 SUPERPAVE, TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0003 5,480.25 $1.74 $9,588.25
25104(04) 0013 SUPERPAVE, TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0004 1,507.90 $0.54 $828.74
25104(04) 0013 SUPERPAVE, TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0005 1,455.32 $0.54 $799.84
25104(04) 0031 CONSTRUCTION TRAFFIC CONTROL * SUBSTANDARD ITEM 0001 -0.28 $1,450.00 $-408.90
25104(04) 0031 CONSTRUCTION TRAFFIC CONTROL * SUBSTANDARD ITEM 0002 -0.25 $4,300.00 $-1,075.00
25104(04) 0031 CONSTRUCTION TRAFFIC CONTROL * SUBSTANDARD ITEM 0003 -0.16 $1,450.00 $-240.70
25104(04) 0031 CONSTRUCTION TRAFFIC CONTROL * SUBSTANDARD ITEM 0004 -0.16 $1,450.00 $-240.70
25104(04) 0031 CONSTRUCTION TRAFFIC CONTROL * SUBSTANDARD ITEM 0005 -0.83 $1,450.00 $-1,203.50
25104(04) 0031 CONSTRUCTION TRAFFIC CONTROL * SUBSTANDARD ITEM 0008 0.00 $0.00 $240.70
25104(04) 0031 CONSTRUCTION TRAFFIC CONTROL * SUBSTANDARD ITEM 0008 0.00 $0.00 $240.70
25104(04) 0031 CONSTRUCTION TRAFFIC CONTROL * SUBSTANDARD ITEM 0008 0.00 $0.00 $1,075.00
25104(04) 0031 CONSTRUCTION TRAFFIC CONTROL * SUBSTANDARD ITEM 0008 0.00 $0.00 $408.90
25104(04) 0031 CONSTRUCTION TRAFFIC CONTROL * SUBSTANDARD ITEM 0008 0.00 $0.00 $1,203.50
25104(08) 0047 SUPERPAVE, TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0004 12,694.64 $0.48 $6,104.85
25104(08) 0048 SUPERPAVE, TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0004 2,215.87 $0.54 $1,217.84
25104(08) 0048 SUPERPAVE, TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0005 2,333.22 $0.54 $1,282.34
Subtotals For Line Item Adjustments $48,001.76
* = 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: 120055   Estimate Number: 0008     Primary JP: 25104(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:    CIRB-147C(135)RB Project:    25104(04) Category:    0100/ROADWAY - CIRB-147C(135)RB
0001 EARTHWORK 202(H) 0185 LSUM 1.000 1.000   1.000 $6,000.00 $0.00 $6,000.00
0002 TEMPORARY SILT FENCE 221(C) 2801 LF 1,000.000 798.000   798.000 $1.45 $0.00 $1,157.10
0003 TEMPORARY SILT DIKE 221(F) 0100 LF 878.000 0.000   0.000 $5.95 $0.00 $0.00
0004 SOLID SLAB SODDING 230(A) 2806 SY 24,368.000 18,809.740   18,809.740 $1.05 $0.00 $19,750.23
0005 VEGETATIVE MULCHING 233(A) 2817 AC 5.040 0.000   0.000 $325.00 $0.00 $0.00
0006 FLY ASH 307(A) 4200 TON 3,384.000 0.000   0.000 $45.00 $0.00 $0.00
0007 CEMENTITIOUS STABILIZED SUBGRADE 307(E) 4240 SY 83,548.000 0.000   0.000 $1.30 $0.00 $0.00
0008 PROCESSING EXISTING BASE & SURFACE, METHOD D 311(D) 0154 LF 31,330.430 0.000   0.000 $3.00 $0.00 $0.00
0009 TRAFFIC BOUND SURFACE COURSE TYPE E 402(E) 0225 TON 1,171.000 659.540   659.540 $28.00 $0.00 $18,467.12
0010 TACK COAT 407(B) 0250 GAL 6,087.000 6,925.000   6,925.000 $2.20 $0.00 $15,235.00
0011 PRIME COAT 408 5774 GAL 17,545.000 0.000   0.000 $5.50 $0.00 $0.00
0012 SUPERPAVE, TYPE S3(PG 64-22 OK) 411(B) 5945 TON 18,284.000 24,649.360   24,649.360 $64.70 $0.00 $1,594,813.59
0013 SUPERPAVE, TYPE S4(PG 64-22 OK) 411(C) 5960 TON 8,907.000 8,443.340   8,443.340 $70.00 $0.00 $591,033.80
0014 RUMBLE STRIP-METHOD HMA-CYC GROUP 413(B) 4862 EAGP 4.000 4.000   4.000 $437.50 $0.00 $1,750.00
0015 18" R.C.PIPE CLASS III 613(A) 0491 LF 152.000 163.600   163.600 $29.50 $0.00 $4,826.20
0016 24" R.C.PIPE CLASS III 613(A) 0492 LF 56.000 52.000   52.000 $41.00 $0.00 $2,132.00
0017 30" R.C.PIPE CLASS III 613(A) 0493 LF 62.000 64.600   64.600 $50.50 $0.00 $3,262.30
0018 36" R.C.PIPE CLASS III 613(A) 0494 LF 186.000 185.600   185.600 $67.00 $0.00 $12,435.20
0019 28" X 18" R.C.PIPE ARCH CLASS A-III 613(A) 4496 LF 262.000 273.400   273.400 $55.00 $0.00 $15,037.00
0020 36" X 22" R.C.PIPE ARCH CLASS A-III 613(A) 4497 LF 55.000 56.500   56.500 $67.00 $0.00 $3,785.50
0021 18" CORR. GALV. STEEL PIPE 613(B) 0689 LF 665.000 733.600   733.600 $22.00 $0.00 $16,139.20
0022 24" CORR. GALV. STEEL PIPE 613(B) 0690 LF 115.000 171.000   171.000 $29.00 $0.00 $4,959.00
0023 30" CORR. GALV. STEEL PIPE 613(B) 0691 LF 60.000 60.000   60.000 $37.00 $0.00 $2,220.00
0024 TYPE A4 CULVERT END TREATMENT 613(M) 7186 EA 34.000 34.000   34.000 $850.00 $0.00 $28,900.00
0025 TYPE B4 CULVERT END TREATMENT 613(M) 7187 EA 18.000 18.000   18.000 $1,000.00 $0.00 $18,000.00
0026 TYPE C4 CULVERT END TREATMENT 613(M) 7188 EA 4.000 4.000   4.000 $1,200.00 $0.00 $4,800.00
0027 TYPE D4 CULVERT END TREATMENT 613(M) 7189 EA 6.000 6.000   6.000 $1,700.00 $0.00 $10,200.00
0028 SAWING PAVEMENT 619(C) 0924 LF 183.540 360.000   360.000 $2.50 $0.00 $900.00
0029 SHEET ALUMINUM SIGNS 850(A) 8110 SF 156.980 165.520   165.520 $30.00 $0.00 $4,965.60
0030 TRAFFIC STRIPE(PLASTIC)(4" WIDE) 855(A) 8812 LF 109,656.000 84,550.000   84,550.000 $0.32 $0.00 $27,056.00
0031 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 0.000 0.000 0.000 $1,450.00 $0.00 $0.00
8001 SUBGRADE, METHOD B 310(B) 0149 SY 0.000 51,714.220   51,714.220 $1.26 $0.00 $65,159.92
8003 COLD MILLING PAVEMENT 412 5267 SY 0.000 77,180.370   77,180.370 $0.98 $0.00 $75,636.76
8004 UNCLASSIFIED BORROW 202(D) 0184 CY 0.000 3,514.840   3,514.840 $11.65 $0.00 $40,947.89
8005 PAVEMENT/BRIDGE SMOOTHNESS ADJUSTMENT 430 5010 LSUM 0.000 1.000   1.000 $87,368.01 $0.00 $87,368.01
Subtotals For Category     0100/ROADWAY - CIRB-147C(135)RB    $0.00 $2,676,937.42
Fed/State Project Number:    CIRB-147C(135)RB Project:    25104(04) Category:    0600/STAKING - CIRB-147C(135)RB
0032 CONSTRUCTION STAKING LEVEL II 642(B) 0096 LSUM 1.000 1.000   1.000 $4,300.00 $0.00 $4,300.00
Subtotals For Category     0600/STAKING - CIRB-147C(135)RB    $0.00 $4,300.00
Fed/State Project Number:    CIRB-147C(135)RB Project:    25104(04) Category:    0640/CONSTRUCTION - CIRB-147C(135)RB
0033 SWPPP DOCUMENTATION AND MANAGEMENT 220 2800 LSUM 1.000 1.000   1.000 $3,000.00 $0.00 $3,000.00
0034 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $60,000.00 $0.00 $60,000.00
0035 (SP)CONTRACTORS QUALITY CONTROL 643 0087 LSUM 1.000 1.000   1.000 $36,000.00 $0.00 $36,000.00
Subtotals For Category     0640/CONSTRUCTION - CIRB-147C(135)RB    $0.00 $99,000.00
Subtotals For Project CIRB-147C(135)RB /25104(04) $0.00 $2,780,237.42


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:    CIRB-147C(167)RB Project:    25104(08) Category:    0100/ROADWAY - CIRB-147C(167)RB
0036 EARTHWORK 202(H) 0185 LSUM 1.000 1.000   1.000 $3,000.00 $0.00 $3,000.00
0037 TEMPORARY SILT FENCE 221(C) 2801 LF 500.000 250.000   250.000 $1.45 $0.00 $362.50
0038 TEMPORARY SILT DIKE 221(F) 0100 LF 1,316.000 0.000   0.000 $5.95 $0.00 $0.00
0039 SOLID SLAB SODDING 230(A) 2806 SY 12,200.000 11,962.220   11,962.220 $1.05 $0.00 $12,560.33
0040 VEGETATIVE MULCHING 233(A) 2817 AC 2.520 0.000   0.000 $325.00 $0.00 $0.00
0041 FLY ASH 307(A) 4200 TON 1,694.000 0.000   0.000 $45.00 $0.00 $0.00
0042 CEMENTITIOUS STABILIZED SUBGRADE 307(E) 4240 SY 41,829.000 0.000   0.000 $1.30 $0.00 $0.00
0043 PROCESSING EXISTING BASE & SURFACE, METHOD D 311(D) 0154 LF 15,685.750 0.000   0.000 $3.00 $0.00 $0.00
0044 TRAFFIC BOUND SURFACE COURSE TYPE E 402(E) 0225 TON 696.000 303.400   303.400 $28.00 $0.00 $8,495.20
0045 TACK COAT 407(B) 0250 GAL 3,215.000 4,450.000   4,450.000 $2.20 $0.00 $9,790.00
0046 PRIME COAT 408 5774 GAL 8,785.000 0.000   0.000 $5.50 $0.00 $0.00
0047 SUPERPAVE, TYPE S3(PG 64-22 OK) 411(B) 5945 TON 9,223.000 12,649.210   12,649.210 $64.70 $0.00 $818,403.89
0048 SUPERPAVE, TYPE S4(PG 64-22 OK) 411(C) 5960 TON 4,944.000 4,527.260   4,527.360 $70.00 $0.00 $316,915.20
0049 RUMBLE STRIP-METHOD HMA-CYC GROUP 413(B) 4862 EAGP 4.000 4.000   4.000 $437.50 $0.00 $1,750.00
0050 24" R.C.PIPE CLASS III 613(A) 0492 LF 56.000 120.000   120.000 $41.00 $0.00 $4,920.00
0051 28" X 18" R.C.PIPE ARCH CLASS A-III 613(A) 4496 LF 156.000 175.000   175.000 $55.00 $0.00 $9,625.00
0052 18" CORR. GALV. STEEL PIPE 613(B) 0689 LF 110.000 118.000   118.000 $22.00 $0.00 $2,596.00
0053 30" CORR. GALV. STEEL PIPE 613(B) 0691 LF 54.000 54.000   54.000 $33.00 $0.00 $1,782.00
0054 18" PREFAB. CULVERT END SECTION, ROUND 613(L) 5726 EA 6.000 6.000   6.000 $600.00 $0.00 $3,600.00
0055 TYPE A4 CULVERT END TREATMENT 613(M) 7186 EA 4.000 4.000   4.000 $850.00 $0.00 $3,400.00
0056 TYPE B4 CULVERT END TREATMENT 613(M) 7187 EA 10.000 10.000   10.000 $1,000.00 $0.00 $10,000.00
0057 TYPE C4 CULVERT END TREATMENT 613(M) 7188 EA 2.000 2.000   2.000 $1,200.00 $0.00 $2,400.00
0058 SAWING PAVEMENT 619(C) 0924 LF 177.650 300.000   300.000 $2.50 $0.00 $750.00
0059 SHEET ALUMINUM SIGNS 850(A) 8110 SF 135.680 135.680   135.680 $30.00 $0.00 $4,070.40
0060 TRAFFIC STRIPE(PLASTIC)(4" WIDE) 855(A) 8812 LF 54,900.000 37,840.600   37,840.600 $0.32 $0.00 $12,108.99
0061 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 0.000   0.000 $2,900.00 $0.00 $0.00
8002 COLD MILLING PAVEMENT 412 5267 SY 0.000 39,750.830   39,750.830 $0.98 $0.00 $38,955.81
8006 PAVEMENT/BRIDGE SMOOTHNESS ADJUSTMENT 430 5010 LSUM 0.000 1.000   1.000 $44,823.87 $0.00 $44,823.87
Subtotals For Category     0100/ROADWAY - CIRB-147C(167)RB    $0.00 $1,310,309.19
Subtotals For Project CIRB-147C(167)RB /25104(08) $0.00 $1,310,309.19


1 CURRENT QUANTITIES DO NOT MATCH THE QUANTITY PAID TO DATE