Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 120061   Estimate Number: 0010 , Final     Spec Year: 2009
Primary JP: 28128(36)   Residency: COBB ENGINEERING CO., INC. (06003)     Contract No: 710840
Date Created: 04/17/2014   Contractor FEI: 231535602     Account No: 404500

Project Number(s): BTOP-222N(001)
Contract Description: SAFETY IMPROVEMENTS (FIBER OPTIC CABLE) US-270: FROM THE CITY OF WOODWARD TO THE CITY OF SEILING. PROJECT LENGTH = 35.2 MILES.
Primary County: DEWEY              
Name of Road: US-270              
Prime Contractor: HENKELS & MCCOY, INC.           Time Charged: 93.00
    515 HUFFINES BLVD.           Time Allowed: 95.00
    LEWISVILLE , TX   75056           Percent Time: 97.89 %

  Paid To Date: $1,147,167.97 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.                                
HENKELS & MCCOY, 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:    04/17/2014
Contract ID: 120061   Estimate Number: 0010     Contract No: 710840
Residency: COBB ENGINEERING CO., INC. (06003)   Estimate Type: Final     Account No: 404500

Project Number(s): BTOP-222N(001)
Primary Job Piece No: 28128(36)
Contract Description: SAFETY IMPROVEMENTS (FIBER OPTIC CABLE) US-270: FROM THE CITY OF WOODWARD TO THE CITY OF SEILING. PROJECT LENGTH = 35.2 MILES.
Primary County: DEWEY              
Name of Road: US-270              
Prime Contractor: HENKELS & MCCOY, INC.              
    515 HUFFINES BLVD.              
    LEWISVILLE , TX   75056              
Surety Company: LIBERTY MUTUAL INSURANCE COMPANY              

Date Let: 01/19/2012 NTP Effective Date: 03/26/2012 Pay Period: 01/11/2014  TO  04/09/2014
Date Awarded: 02/06/2012 Date Work Began: 03/26/2012 Original Contract Time: 95
Date Contract Executed: 02/21/2012 Date Time Stopped: 10/19/2012 Current Time Charged: 93.00
Date NTP Issued: 02/24/2012 Completion Date: 10/19/2012 Current Time Allowed: 95.00
General Liability Expires: 10/01/2013 Workman's Comp Expires: 10/01/2013 Percent Time Used: 97.89 %
Specification Year: 2009        

Bid Amount: $1,090,231.56 Total to Date Prev to Date This Estimate
Funds Available (Bid + Positive C/O): $1,152,559.02 Participating: $1,144,625.22 $1,144,625.22 $0.00
Percent Complete: 99.53 % Non Participating: $2,542.75 $2,542.75 $0.00
Unearned Balance: $5,391.05 Total Earnings: $1,147,167.97 $1,147,167.97 $0.00
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $1,147,167.97 $1,147,167.97 $0.00
Other Adjustments: $0.00 $0.00 $0.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $1,147,167.97 $1,147,167.97 $0.00

Estimate Adjustment Detail

Contract ID: 120061   Estimate Number: 0010     Primary JP: 28128(36)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Overrun of Existing Contract Items Approved 05/29/2013 0.0 $41,440.00
002 Milestone Incentive Approved 07/01/2013 0.0 $20,000.00
003 Excess Materials into Warehouse Stock Approved 01/06/2014 0.0 $-5,391.07
004 Final Quantity Change Order Approved 04/08/2014 0.0 $887.46


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
01 Incentive/Disincentive Conduit & Ground Boxes 03/25/2012 05/21/2012 65.00 DYS $2,000.00 Y
02 Incentive/Disincentive Fiber Optic Cable Installation 05/28/2012 06/27/2012 30.00 DYS $2,000.00 Y


MILESTONE ADJUSTMENTS
Milestone Number Milestone Adjustment Description Estimate Nbr Total
01 System Application of Disincentive Adj 0005 $-4,000.00
01 System Application of Disincentive Adj 0006 $4,000.00
Subtotals For Milestones $0.00

Line Item Detail

Contract ID: 120061   Estimate Number: 0010     Primary JP: 28128(36)



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:    BTOP-222N(001) Project:    28128(36) Category:    0300/TRAFFIC
0001 CLEARING AND GRUBBING 201(A) 0102 LSUM 1.000 1.000   1.000 $1,927.48 $0.00 $1,927.48
0002 TEMPORARY SILT FENCE 221(C) 2801 LF 2,000.000 2,134.000   2,134.000 $8.75 $0.00 $18,672.50
0003 SOLID SLAB SODDING 230(A) 2806 SY 2,000.000 0.000   0.000 $9.09 $0.00 $0.00
0004 CLASS A CONCRETE 509(B) 0321 CY 15.360 13.440   13.440 $1,062.55 $0.00 $14,280.67
0005 3" GALV. STEEL ELECTRICAL CONDUIT EXPOSED 802(A) 8316 LF 100.000 20.000   20.000 $67.19 $0.00 $1,343.80
0006 3" GALV. STEEL ELECTRICAL CONDUIT PUSHED OR BORED 802(A) 8318 LF 100.000 0.000   0.000 $32.23 $0.00 $0.00
0007 1 1/2" HIGH DENSITY PE PIPE - BORED 802(C) 8551 LF 15,755.000 34,618.000   34,618.000 $10.36 $0.00 $358,642.48
0008 1 1/2" HIGH DENSITY PE PIPE - TRENCHED 802(C) 8556 LF 29,099.000 20,584.000   20,584.000 $4.50 $0.00 $92,628.00
0009 1 1/2" HIGH DENSITY PE PIPE - PLOWED 802(C) 8565 LF 169,252.000 153,555.000   153,555.000 $2.50 $0.00 $383,887.50
0010 GROUND BOX (R3248) 803(B) 8135 EA 48.000 45.000   45.000 $841.38 $0.00 $37,862.10
0011 GROUND BOX (B2-48) 803(B) 8150 EA 24.000 21.000   21.000 $1,257.94 $0.00 $26,416.74
0012 REINFORCING STEEL 804(B) 2916 LB 288.000 252.000   252.000 $3.66 $0.00 $922.32
0013 (SP)FIBER OPTIC CABLE, 24 SMF 818(A) 8715 LF 3,453.000 3,315.000   3,315.000 $0.34 $0.00 $1,127.10
0014 (SP)FIBER OPTIC CABLE, 96 SMF 818(A) 8730 LF 227,736.000 199,299.000   199,299.000 $0.52 $0.00 $103,635.48
0015 (SP) FIBER OPTIC CABLE, 24 INDOOR/OUTDOOR PLENUM 818(A) 8738 LF 200.000 200.000   200.000 $7.29 $0.00 $1,458.00
0016 (SP) FIBER OPTIC CABLE, 48 INDOOR/OUTDOOR PLENUM 818(A) 8739 LF 500.000 360.000   360.000 $6.80 $0.00 $2,448.00
0017 (SP)FIBER OPTIC PATCH PANEL, 24 PORT 818(B) 8745 EA 1.000 1.000   1.000 $506.58 $0.00 $506.58
0018 (SP)FIBER OPTIC PATCH PANEL, 96 PORT 818(B) 8755 EA 2.000 2.000   2.000 $2,445.10 $0.00 $4,890.20
0019 (SP)FIBER OPTIC CABLE SPLICE 818(C) 8735 EA 8.000 8.000   8.000 $24.39 $0.00 $195.12
0020 (SP)FIBER OPTIC CABLE TERMINATION 818(D) 8740 EA 200.000 216.000   216.000 $24.39 $0.00 $5,268.24
0021 (SP) SHIELD ISOLATION PEDESTAL 818(F) 8370 EA 5.000 15.000   15.000 $184.52 $0.00 $2,767.80
0022 (SP) SHIELD ISOLATION PEDESTAL (MINI) 818(F) 8375 EA 10.000 0.000   0.000 $111.15 $0.00 $0.00
0023 (SP)FIBER OPTIC ROUTE SIGN & INSTALLATION 818(G) 5570 EA 295.000 260.000   260.000 $82.68 $0.00 $21,496.80
Subtotals For Category     0300/TRAFFIC    $0.00 $1,080,376.91
Fed/State Project Number:    BTOP-222N(001) Project:    28128(36) Category:    0301/TRAFFIC CONTROL
0024 (PL)TRUCK MOUNTED ATTENUATOR 876(A) 8482 SD 140.000 0.000   0.000 $103.66 $0.00 $0.00
0025 FLAGGER 880(I) 8902 SD 30.000 0.000   0.000 $93.69 $0.00 $0.00
0026 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $6,371.95 $0.00 $6,371.95
0027 PORT.CHANGEABLE MESSAGE SIGN 882(A) 8306 SD 140.000 0.000   0.000 $103.66 $0.00 $0.00
Subtotals For Category     0301/TRAFFIC CONTROL    $0.00 $6,371.95
Fed/State Project Number:    BTOP-222N(001) Project:    28128(36) Category:    0640/CONSTRUCTION
0028 SWPPP DOCUMENTATION AND MANAGEMENT 220 2800 LSUM 1.000 1.000   1.000 $9,365.85 $0.00 $9,365.86
0029 MOBILIZATION 641 1552 LSUM 1.000 1.000   1.000 $28,510.49 $0.00 $28,510.50
8000 MILESTONE INCENTIVE COMPENSATION 644 7215 LSUM 0.000 1.000   1.000 $18,000.00 $0.00 $18,000.00
8001 MILESTONE INCENTIVE COMPENSATION 644 7215 LSUM 0.000 1.000   1.000 $2,000.00 $0.00 $2,000.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $57,876.36
Fed/State Project Number:    BTOP-222N(001) Project:    28128(36) Category:    0900/FEDERAL NON PARTICIPATING
8002 GROUND BOX (R3248) 803(B) 8135 EA 0.000 3.000   3.000 $432.40 $0.00 $1,297.20
8003 GROUND BOX (B2-48) 803(B) 8150 EA 0.000 2.000   2.000 $559.95 $0.00 $1,119.90
8004 (SP)FIBER OPTIC ROUTE SIGN & INSTALLATIO 818(G) 5570 EA 0.000 35.000   35.000 $3.59 $0.00 $125.65
Subtotals For Category     0900/FEDERAL NON PARTICIPATING    $0.00 $2,542.75
Subtotals For Project BTOP-222N(001) /28128(36) $0.00 $1,147,167.97