Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 120072   Estimate Number: 0011 , Final     Spec Year: 2009
Primary JP: 28128(30)   Residency: OKLAHOMA CITY (04600)     Contract No: 711067
Date Created: 07/08/2013   Contractor FEI: 331085914     Account No: 400400

Project Number(s): BTOP-255N(002)
Contract Description: SAFETY IMPROVEMENTS (FIBER OPTIC CABLE) I-40: FROM THE EDUCATIONAL TELEVISION NETWORK BUILDING IN OKLAHOMA CITY (N.E. 14TH ST. & PHILLIPS AVE.), EXTEND EAST TO THE POTTAWATOMIE COUNTY LINE. PROJECT LENGTH = 22.9 MILES.
Primary County: OKLAHOMA              
Name of Road: I-40              
Prime Contractor: EWING SIGNAL CONSTRUCTION           Time Charged: 117.00
    1730 N. GREGORY DR.           Time Allowed: 125.00
    NIXA , MO   65714           Percent Time: 93.60 %

  Paid To Date: $1,192,250.88 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.                                
EWING SIGNAL CONSTRUCTION                               
 
_________________________________________________
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:    07/08/2013
Contract ID: 120072   Estimate Number: 0011     Contract No: 711067
Residency: OKLAHOMA CITY (04600)   Estimate Type: Final     Account No: 400400

Project Number(s): BTOP-255N(002)
Primary Job Piece No: 28128(30)
Contract Description: SAFETY IMPROVEMENTS (FIBER OPTIC CABLE) I-40: FROM THE EDUCATIONAL TELEVISION NETWORK BUILDING IN OKLAHOMA CITY (N.E. 14TH ST. & PHILLIPS AVE.), EXTEND EAST TO THE POTTAWATOMIE COUNTY LINE. PROJECT LENGTH = 22.9 MILES.
Primary County: OKLAHOMA              
Name of Road: I-40              
Prime Contractor: EWING SIGNAL CONSTRUCTION              
    1730 N. GREGORY DR.              
    NIXA , MO   65714              
Surety Company: OHIO CASUALTY INSURANCE COMPANY              

Date Let: 03/15/2012 NTP Effective Date: 06/04/2012 Pay Period: 07/01/2013  TO  07/08/2013
Date Awarded: 04/02/2012 Date Work Began: 06/04/2012 Original Contract Time: 70
Date Contract Executed: 04/10/2012 Date Time Stopped: 12/10/2012 Current Time Charged: 117.00
Date NTP Issued: 05/16/2012 Completion Date: 12/10/2012 Current Time Allowed: 125.00
General Liability Expires: 09/01/2013 Workman's Comp Expires: 09/01/2013 Percent Time Used: 93.60 %
Specification Year: 2009        

Current Contract Amount: $1,192,250.88 Total to Date Prev to Date This Estimate
Bid Amount: $999,031.60 Participating: $1,192,250.88 $1,192,250.88 $0.00
Percent Complete: 100 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $0.00 Total Earnings: $1,192,250.88 $1,192,250.88 $0.00
Unearned Balance: $-193,219.28 Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $1,192,250.88 $1,192,250.88 $0.00
Other Adjustments: $0.00 $0.00 $0.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $1,192,250.88 $1,192,250.88 $0.00

Estimate Adjustment Detail

Contract ID: 120072   Estimate Number: 0011     Primary JP: 28128(30)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Additional Time and Milestone Modification Approved 11/30/2012 110.0 $0.00
002 Incentive for early completion of Milestone No. 1 Approved 01/02/2013 0.0 $22,000.00
003 Additional Appropriations for Overruns Approved 04/01/2013 0.0 $140,745.00
004 Change Order Approved 07/01/2013 0.0 $30,474.28


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
System Application of Liquidated Damages 0005 --1.0 $500.00 $-500.00
System Application of Liquidated Damages 0006 --16 $500.00 $-8,000.00
System Application of Liquidated Damages 0007 --30 $500.00 $-15,000.00
System Application of Liquidated Damages 0008 -47.0 $500.00 $23,500.00
Subtotals For Liquidated Damages $0.00


CONTRACT ADJUSTMENTS HISTORY
Adjustment Description Estimate Nbr Adjustment Amount
LD Adjustment (Prog. Est. Only) 0005 $500.00
Milestone Adjust. (Prog. Est. Only) 0005 $8,000.00
LD Adjustment (Prog. Est. Only) 0006 $8,000.00
Milestone Adjust. (Prog. Est. Only) 0006 $40,000.00
LD Adjustment (Prog. Est. Only) 0007 $15,000.00
Milestone Adjust. (Prog. Est. Only) 0007 $60,000.00
LD Adjustment (Prog. Est. Only) 0008 $-131,500.00
Withhold to Funds Avail(Prog. Est. Only) 0008 $-174,290.79
Withhold to Funds Avail(Prog. Est. Only) 0009 $174,290.79
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
28128(30) 0020 CONSTRUCTION TRAFFIC CONTROL * Overrun 0003 -0.72 $6,370.00 $-4,586.40
28128(30) 0020 CONSTRUCTION TRAFFIC CONTROL * Overrun Re-adjustment 0004 0.72 $6,370.00 $4,586.40
28128(30) 0026 SWPPP DOCUMENTATION AND MANAGEMENT * Overrun 0001 -0.34 $7,250.00 $-2,465.00
28128(30) 0026 SWPPP DOCUMENTATION AND MANAGEMENT * Overrun Re-adjustment 0004 0.34 $7,250.00 $2,465.00
Subtotals For Line Item Adjustments $0.00
* = User applied Line Item Adjustments


MILESTONE INFORMATION
Milestone Number Milestone Description Start Date End Date Current Time Allowed Rate Milestone Closed
01 Conduit & Ground Boxes 06/04/2012 07/13/2012 50.00 DYS $2,000.00 Y
02 Fiber Optic Cable Installation 07/18/2012 10/01/2012 75.00 DYS $2,000.00 Y


MILESTONE ADJUSTMENTS
Milestone Number Milestone Adjustment Description Estimate Nbr Total
02 System Application of Disincentive Adj 0005 $-16,000.00
02 System Application of Disincentive Adj 0006 $-32,000.00
02 System Application of Disincentive Adj 0007 $-60,000.00
02 System Application of Disincentive Adj 0008 $60,000.00
02 System Application of Disincentive Adj 0008 $16,000.00
02 System Application of Disincentive Adj 0008 $32,000.00
Subtotals For Milestones $0.00

Line Item Detail

Contract ID: 120072   Estimate Number: 0011     Primary JP: 28128(30)



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-255N(002) Project:    28128(30) Category:    0300/TRAFFIC
0001 CLEARING AND GRUBBING 201(A) 0102 LSUM 1.000 1.000   1.000 $6,275.00 $0.00 $6,275.00
0002 TEMPORARY SILT FENCE 221(C) 2801 LF 2,000.000 0.000   0.000 $2.65 $0.00 $0.00
0003 SOLID SLAB SODDING 230(A) 2806 SY 2,000.000 0.000   0.000 $3.15 $0.00 $0.00
0004 CLASS A CONCRETE 509(B) 0321 CY 12.000 5.070   5.070 $275.00 $0.00 $1,394.25
0005 3" GALV. STEEL ELECTRICAL CONDUIT EXPOSED 802(A) 8316 LF 500.000 15.000   15.000 $80.00 $0.00 $1,200.00
0006 1 1/2" HIGH DENSITY PE PIPE - BORED 802(C) 8551 LF 4,051.000 9,728.000   9,728.000 $16.50 $0.00 $160,512.00
0007 1 1/2" HIGH DENSITY PE PIPE - TRENCHED 802(C) 8556 LF 18,052.000 13,634.000   13,634.000 $5.50 $0.00 $74,987.00
0008 1 1/2" HIGH DENSITY PE PIPE - PLOWED 802(C) 8565 LF 73,475.000 72,335.000   72,335.000 $3.00 $0.00 $217,005.00
0009 GROUND BOX (R3248) 803(B) 8135 EA 27.000 27.000   27.000 $815.00 $0.00 $22,005.00
0010 GROUND BOX (B2-48) 803(B) 8150 EA 15.000 15.000   15.000 $1,118.00 $0.00 $16,770.00
0011 REINFORCING STEEL 804(B) 2916 LB 360.000 159.120   159.120 $19.00 $0.00 $3,023.28
0012 (SP)FIBER OPTIC CABLE, 144 SMF 818(A) 8733 LF 140,785.000 140,726.500   140,726.500 $0.50 $0.00 $70,363.25
0013 (SP)FIBER OPTIC PATCH PANEL, 144 PORT 818(B) 8760 EA 1.000 1.000   1.000 $10,500.00 $0.00 $10,500.00
0014 (SP)FIBER OPTIC CABLE TERMINATION 818(D) 8740 EA 144.000 144.000   144.000 $45.15 $0.00 $6,501.60
0015 (SP) SHIELD ISOLATION PEDESTAL 818(F) 8370 EA 5.000 5.000   5.000 $1,040.00 $0.00 $5,200.00
0016 (SP) SHIELD ISOLATION PEDESTAL (MINI) 818(F) 8375 EA 14.000 14.000   14.000 $1,040.00 $0.00 $14,560.00
0017 (SP)FIBER OPTIC ROUTE SIGN & INSTALLATION 818(G) 5570 EA 183.000 183.000   183.000 $80.00 $0.00 $14,640.00
Subtotals For Category     0300/TRAFFIC    $0.00 $624,936.38
Fed/State Project Number:    BTOP-255N(002) Project:    28128(30) Category:    0301/TRAFFIC CONTROL
0018 (PL)TRUCK MOUNTED ATTENUATOR 876(A) 8482 SD 140.000 0.000   0.000 $130.00 $0.00 $0.00
0019 FLAGGER 880(I) 8902 SD 35.000 0.000   0.000 $41.00 $0.00 $0.00
0020 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $6,370.00 $0.00 $6,370.00
0021 PORT.CHANGEABLE MESSAGE SIGN 882(A) 8306 SD 140.000 1.000   1.000 $31.50 $0.00 $31.50
Subtotals For Category     0301/TRAFFIC CONTROL    $0.00 $6,401.50
Fed/State Project Number:    BTOP-255N(002) Project:    28128(30) Category:    0305/FHWA PARTICIPATING
0022 3" GALV. STEEL ELECTRICAL CONDUIT EXPOSED 802(A) 8316 LF 550.000 567.500   567.500 $65.00 $0.00 $36,887.50
0023 1 1/2" HIGH DENSITY PE PIPE - BORED 802(C) 8551 LF 3,138.000 16,316.000   16,316.000 $16.50 $0.00 $269,214.00
0024 1 1/2" HIGH DENSITY PE PIPE - TRENCHED 802(C) 8556 LF 45,156.000 36,549.000   36,549.000 $4.50 $0.00 $164,470.50
0025 GROUND BOX (B2-48) 803(B) 8150 EA 7.000 12.000   12.000 $1,118.00 $0.00 $13,416.00
Subtotals For Category     0305/FHWA PARTICIPATING    $0.00 $483,988.00
Fed/State Project Number:    BTOP-255N(002) Project:    28128(30) Category:    0640/CONSTRUCTION
0026 SWPPP DOCUMENTATION AND MANAGEMENT 220 2800 LSUM 1.000 1.000   1.000 $7,250.00 $0.00 $7,250.00
0027 MOBILIZATION 641 1552 LSUM 1.000 1.000   1.000 $47,675.00 $0.00 $47,675.00
8005 MILESTONE INCENTIVE COMPENSATION 644 7215 LSUM 0.000 1.000   1.000 $22,000.00 $0.00 $22,000.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $76,925.00
Subtotals For Project BTOP-255N(002) /28128(30) $0.00 $1,192,250.88