Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 120057   Estimate Number: 0012 , Final     Spec Year: 2009
Primary JP: 17045(04)   Residency: CIRCUIT ENGR. DISTRICT # 3 (02013)     Contract No: 710875
Date Created: 05/28/2013   Contractor FEI: 731427175     Account No: 436200

Project Number(s): BRF-164C(012)CI
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD (NS-409.5): OVER TENMILE CREEK, 1.8 MILE NORTH OF JUMBO. PROJECT LENGTH = 0.387 MILES.
Primary County: PUSHMATAHA              
Name of Road: COUNTY ROAD              
Prime Contractor: K & R BUILDERS, INC.           Time Charged: 170.00
    P.O. BOX 656           Time Allowed: 156.00
    WHEATLAND , OK   73097           Percent Time: 108.97 %

  Paid To Date: $767,008.02 Payable This Statement: $3,000.00

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.                                
K & R BUILDERS, 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:    05/28/2013
Contract ID: 120057   Estimate Number: 0012     Contract No: 710875
Residency: CIRCUIT ENGR. DISTRICT # 3 (02013)   Estimate Type: Final     Account No: 436200

Project Number(s): BRF-164C(012)CI
Primary Job Piece No: 17045(04)
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD (NS-409.5): OVER TENMILE CREEK, 1.8 MILE NORTH OF JUMBO. PROJECT LENGTH = 0.387 MILES.
Primary County: PUSHMATAHA              
Name of Road: COUNTY ROAD              
Prime Contractor: K & R BUILDERS, INC.              
    P.O. BOX 656              
    WHEATLAND , OK   73097              
Surety Company: OHIO CASUALTY INSURANCE COMPANY              

Date Let: 01/19/2012 NTP Effective Date: 05/07/2012 Pay Period: 02/01/2013  TO  05/15/2013
Date Awarded: 02/06/2012 Date Work Began: 07/16/2012 Original Contract Time: 150
Date Contract Executed: 02/23/2012 Date Time Stopped: 12/06/2012 Current Time Charged: 170.00
Date NTP Issued: 02/29/2012 Completion Date: 12/06/2012 Current Time Allowed: 156.00
General Liability Expires: 05/01/2014 Workman's Comp Expires: 07/01/2013 Percent Time Used: 108.97 %
Specification Year: 2009        

Current Contract Amount: $774,008.01 Total to Date Prev to Date This Estimate
Bid Amount: $809,066.74 Participating: $758,486.15 $758,486.15 $0.00
Percent Complete: 99.10 % Non Participating: $15,521.87 $15,521.87 $0.00
Funds Available: $6,999.99 Total Earnings: $774,008.02 $774,008.02 $0.00
Unearned Balance: $42,058.72 Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $774,008.02 $774,008.02 $0.00
Other Adjustments: $0.00 $0.00 $0.00
Liq Dam/Disincentive: $-7,000.00 $-10,000.00 $3,000.00
TOTAL: $767,008.02 $764,008.02 $3,000.00

Estimate Adjustment Detail

Contract ID: 120057   Estimate Number: 0012     Primary JP: 17045(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 TIME EXTENSION Approved 03/01/2013 6.0 $0.00
002 FINAL QUANTITY CHANGE ORDER Approved 03/28/2013 0.0 $-35,058.73


STOCKPILE PAYMENT HISTORY
Project Line Nbr Stockpile Description Adjustment Type Estimate Nbr Adjusted Amount
17045(04) 0028 Prestressed Beams & Bearing Pads Stockpiled Material Initial Payment 0001 $68,455.50
17045(04) 0028 Prestressed Beams & Bearing Pads Stockpiled Material Adjustment 0006 $-68,455.50
17045(04) 0031 Reinforcing Steel & Wire (Rail) Stockpiled Material Adjustment 0009 $-1,028.42
17045(04) 0031 Reinforcing Steel & Wire (Rail) Stockpiled Material Adjustment 0008 $-1,028.37
17045(04) 0031 Reinforcing Steel & Wire (Rail) Stockpiled Material Initial Payment 0003 $2,056.79
17045(04) 0037 Reinforcing Steel Stockpiled Material Initial Payment 0002 $9,893.38
17045(04) 0037 Reinforcing Steel Stockpiled Material Adjustment 0008 $-798.29
17045(04) 0037 Reinforcing Steel Stockpiled Material Adjustment 0006 $-7,535.93
17045(04) 0037 Reinforcing Steel Stockpiled Material Adjustment 0005 $-1,559.16
17045(04) 0037 Reinforcing Steel Bridge Deck Stockpiled Material Adjustment 0005 $-1,623.00
17045(04) 0037 Reinforcing Steel Bridge Deck Stockpiled Material Adjustment 0008 $-8,430.94
17045(04) 0037 Reinforcing Steel Bridge Deck Stockpiled Material Adjustment 0006 $-7,844.50
17045(04) 0037 Reinforcing Steel Bridge Deck Stockpiled Material Initial Payment 0003 $17,898.44
17045(04) 0038 10" Pile Encasement Stockpiled Material Initial Payment 0002 $176.36
17045(04) 0038 10" Pile Encasement Stockpiled Material Adjustment 0003 $-176.36
17045(04) 0040 Drilled Shafts Stockpiled Material Initial Payment 0002 $4,884.52
17045(04) 0040 Drilled Shafts Stockpiled Material Adjustment 0003 $-4,884.52
Subtotals For Stockpile Payments $0.00


LIQUIDATED DAMAGES HISTORY
Adjustment Description Estimate Nbr Time Units Rate Adjustment Amount
System Application of Liquidated Damages 0008 --13 $500.00 $-6,500.00
System Application of Liquidated Damages 0009 --7.0 $500.00 $-3,500.00
System Application of Liquidated Damages 0012 -6.0 $500.00 $3,000.00
Subtotals For Liquidated Damages $-7,000.00


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: 120057   Estimate Number: 0012     Primary JP: 17045(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:    BRF-164C(012)CI Project:    17045(04) Category:    0100/ROADWAY
0001 CLEARING AND GRUBBING 201(A) 0102 LSUM 1.000 1.000   1.000 $14,000.00 $0.00 $14,000.00
0002 UNCLASSIFIED EXCAVATION 202(A) 0183 CY 2,362.000 2,362.000   2,362.000 $6.67 $0.00 $15,754.54
0003 UNCLASSIFIED BORROW 202(D) 0184 CY 10,019.000 10,019.000   10,019.000 $8.50 $0.00 $85,161.50
0004 TYPE A-SALVAGED TOPSOIL 205(A) 4229 LSUM 1.000 1.000   1.000 $8,750.00 $0.00 $8,750.00
0005 OBLITERATING ABANDONED ROAD 210 0121 LF 700.000 700.000   700.000 $6.50 $0.00 $4,550.00
0006 TEMPORARY SILT FENCE 221(C) 2801 LF 1,870.000 1,255.000   1,255.000 $1.80 $0.00 $2,259.00
0007 TEMPORARY SILT DIKE 221(F) 0100 LF 492.000 77.000   77.000 $11.00 $0.00 $847.00
0008 SOLID SLAB SODDING 230(A) 2806 SY 13,818.000 13,003.060   13,003.060 $1.73 $0.00 $22,495.29
0009 VEGETATIVE MULCHING 233(A) 2817 AC 5.800 0.000   0.000 $675.00 $0.00 $0.00
0010 TRAFFIC BOUND SURFACE COURSE TYPE E 402(E) 0225 TON 1,939.000 1,931.010   1,931.010 $20.46 $0.00 $39,508.47
0011 CLASS A CONCRETE 509(B) 0321 CY 8.800 8.710   8.710 $816.75 $0.00 $7,113.90
0012 CLASS C CONCRETE 509(D) 0325 CY 23.200 3.200   3.200 $300.00 $0.00 $960.00
0013 INLET (SMD-TYPE 2) 611(G) 6002 EA 1.000 1.000   1.000 $1,750.00 $0.00 $1,750.00
0014 24" R.C.PIPE CLASS III 613(A) 0492 LF 44.000 44.000   44.000 $55.00 $0.00 $2,420.00
0015 48" R.C.PIPE CLASS III 613(A) 0496 LF 210.000 210.000   210.000 $105.00 $0.00 $22,050.00
0016 28" X 20" CORR. GALV. STEEL PIPE ARCH 613(B) 4528 LF 34.000 34.000   34.000 $29.00 $0.00 $986.00
0017 35" X 24" CORR. GALV. STEEL PIPE ARCH 613(B) 4529 LF 30.000 30.000   30.000 $47.00 $0.00 $1,410.00
0018 42" X 29" CORR. GALV. STEEL PIPE ARCH 613(B) 4530 LF 36.000 36.000   36.000 $56.00 $0.00 $2,016.00
0019 24" PREFAB. CULVERT END SECTION, ROUND 613(L) 5730 EA 1.000 1.000   1.000 $1,000.00 $0.00 $1,000.00
0020 48" PREFAB. CULVERT END SECTION, ROUND 613(L) 5738 EA 6.000 6.000   6.000 $1,500.00 $0.00 $9,000.00
0021 28" X 20" GALV. STEEL CULVERT END SECTION ARCH 613(P) 4571 EA 2.000 2.000   2.000 $275.00 $0.00 $550.00
0022 35" X 24" GALV. STEEL CULVERT END SECTION ARCH 613(P) 4572 EA 2.000 2.000   2.000 $410.00 $0.00 $820.00
0023 42" X 29" GALV. STEEL CULVERT END SECTION ARCH 613(P) 4573 EA 2.000 2.000   2.000 $562.50 $0.00 $1,125.00
0024 SHEET ALUMINUM SIGNS 850(A) 8110 SF 17.000 17.000   17.000 $22.00 $0.00 $374.00
0025 FLANGE CHANNEL POSTS(4 LB/FT) 851(D) 8597 LF 34.000 58.000   58.000 $22.00 $0.00 $1,276.00
Subtotals For Category     0100/ROADWAY    $0.00 $246,176.70
Fed/State Project Number:    BRF-164C(012)CI Project:    17045(04) Category:    0200/BRIDGE
0026 SUBSTRUCTURE EXCAVATION COMMON 501(B) 1307 CY 103.000 103.000   103.000 $7.67 $0.00 $790.01
0027 UNCLASSIFIED BACKFILL 501(D) 6353 CY 84.000 84.000   84.000 $10.25 $0.00 $861.00
0028 PRESTRESSED CONCRETE BEAMS (TYPE II) 503(A) 1311 LF 530.000 530.000   530.000 $170.00 $0.00 $90,100.00
0029 SAW-CUT GROOVING 504(B) 1305 SY 416.200 416.200   416.200 $6.60 $0.00 $2,746.92
0030 SEALED EXPANSION JOINT 504(C) 6250 LF 38.600 38.600   38.600 $265.00 $0.00 $10,229.00
0031 CONCRETE RAIL (TR1) 504(E) 1380 LF 354.670 354.670   354.670 $67.00 $0.00 $23,762.89
0032 STRUCTURAL STEEL 506(A) 1322 LB 1,480.000 1,480.000   1,480.000 $3.00 $0.00 $4,440.00
0033 WEATHERING STEEL FIXED BEARING ASSEMBLY 507(A) 6172 EA 12.000 12.000   12.000 $1,000.00 $0.00 $12,000.00
0034 WEATHERING STEEL EXPANSION BEARING ASSEMBLY 507(B) 6176 EA 12.000 12.000   12.000 $1,000.00 $0.00 $12,000.00
0035 CLASS AA CONCRETE 509(A) 1326 CY 112.000 112.000   112.000 $504.00 $0.00 $56,448.00
0036 CLASS A CONCRETE 509(B) 1328 CY 131.100 131.100   131.100 $525.00 $0.00 $68,827.50
0037 REINFORCING STEEL 511(A) 1332 LB 52,120.000 52,120.000   52,120.000 $0.92 $0.00 $47,950.40
0038 PILES, FURNISHED (HP 10X42) 514(A) 6010 LF 391.000 393.870   393.870 $34.30 $0.00 $13,509.74
0039 PILES, DRIVEN (HP 10X42) 514(B) 6292 LF 391.000 380.450   380.450 $14.70 $0.00 $5,592.61
0040 DRILLED SHAFTS 54" DIAMETER 516(A) 6095 LF 66.000 66.000   66.000 $1,100.00 $0.00 $72,600.00
0041 TYPE I-A PLAIN RIPRAP 601(B) 1353 TON 1,370.000 895.320   895.320 $32.88 $0.00 $29,438.12
0042 TYPE I-A FILTER BLANKET 601(C) 1355 TON 280.000 183.300   183.300 $27.35 $0.00 $5,013.26
0043 GUARDRAIL ANCHOR UNIT (TYPE II) 623(F) 6033 EA 4.000 4.000   4.000 $2,250.00 $0.00 $9,000.00
0044 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $7,500.00 $0.00 $7,500.00
Subtotals For Category     0200/BRIDGE    $0.00 $472,809.45
Fed/State Project Number:    BRF-164C(012)CI Project:    17045(04) Category:    0600/CONSTRUCTION STAKING
0045 CONSTRUCTION STAKING LEVEL II 642(B) 0096 LSUM 1.000 1.000   1.000 $11,500.00 $0.00 $11,500.00
Subtotals For Category     0600/CONSTRUCTION STAKING    $0.00 $11,500.00
Fed/State Project Number:    BRF-164C(012)CI Project:    17045(04) Category:    0640/CONSTRUCTION
0046 SWPPP DOCUMENTATION AND MANAGEMENT 220 2800 LSUM 1.000 1.000   1.000 $3,500.00 $0.00 $3,500.00
0047 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $24,500.00 $0.00 $24,500.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $28,000.00
Fed/State Project Number:    BRF-164C(012)CI Project:    17045(04) Category:    0900/NON-PARTICIPATING
0048 FENCE-STYLE SWF (5 BARBED WIRE) 624(C) 4459 LF 3,005.000 2,996.500   2,996.500 $5.18 $0.00 $15,521.87
Subtotals For Category     0900/NON-PARTICIPATING    $0.00 $15,521.87
Subtotals For Project BRF-164C(012)CI /17045(04) $0.00 $774,008.02