Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 120126   Estimate Number: 0006 , Final     Spec Year: 2009
Primary JP: 29194(04)   Residency: ENID (04300)     Contract No: 710965
Date Created: 11/05/2013   Contractor FEI: 730731258     Account No: 400400

Project Number(s): STPY-224C(003)3P, STPY-224C(004)3P
Contract Description: RESURFACE (ASPHALT) SH-74: FROM THE LOGAN COUNTY LINE, EXTEND NORTH. PROJECT LENGTH = 9.34 MILES.
Primary County: GARFIELD              
Name of Road: SH-74              
Prime Contractor: HASKELL LEMON CONSTRUCTION CO.           Time Charged: 53.00
    P. O. BOX 75608           Time Allowed: 60.00
    OKLAHOMA CITY , OK   73147-0608           Percent Time: 88.33 %

  Paid To Date: $1,658,442.14 Payable This Statement: $8,052.76

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.                                
HASKELL LEMON CONSTRUCTION CO.                               
 
_________________________________________________
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:    11/05/2013
Contract ID: 120126   Estimate Number: 0006     Contract No: 710965
Residency: ENID (04300)   Estimate Type: Final     Account No: 400400

Project Number(s): STPY-224C(003)3P, STPY-224C(004)3P
Primary Job Piece No: 29194(04)
Contract Description: RESURFACE (ASPHALT) SH-74: FROM THE LOGAN COUNTY LINE, EXTEND NORTH. PROJECT LENGTH = 9.34 MILES.
Primary County: GARFIELD              
Name of Road: SH-74              
Prime Contractor: HASKELL LEMON CONSTRUCTION CO.              
    P. O. BOX 75608              
    OKLAHOMA CITY , OK   73147-0608              
Surety Company: WESTERN SURETY COMPANY              

Date Let: 02/16/2012 NTP Effective Date: 07/02/2012 Pay Period: 03/01/2013  TO  11/05/2013
Date Awarded: 03/05/2012 Date Work Began: 06/05/2012 Original Contract Time: 60
Date Contract Executed: 03/19/2012 Date Time Stopped: 10/11/2012 Current Time Charged: 53.00
Date NTP Issued: 03/21/2012 Completion Date: 10/11/2012 Current Time Allowed: 60.00
General Liability Expires: 07/01/2014 Workman's Comp Expires: 07/01/2014 Percent Time Used: 88.33 %
Specification Year: 2009        

Bid Amount: $1,740,529.00 Total to Date Prev to Date This Estimate
Funds Available (Bid + Positive C/O): $1,772,252.24 Participating: $1,658,442.14 $1,652,168.72 $6,273.42
Percent Complete: 93.58 % Non Participating: $0.00 $0.00 $0.00
Unearned Balance: $113,810.10 Total Earnings: $1,658,442.14 $1,652,168.72 $6,273.42
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $1,658,442.14 $1,652,168.72 $6,273.42
Other Adjustments: $0.00 $-1,779.34 $1,779.34
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $1,658,442.14 $1,650,389.38 $8,052.76

Estimate Adjustment Detail

Contract ID: 120126   Estimate Number: 0006     Primary JP: 29194(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Asphalt Binder Adjustment Approved 10/08/2012 0.0 $31,723.24
002 Asphalt Deductions Approved 06/03/2013 0.0 $-3,999.23
003 FQCO Approved 10/15/2013 0.0 $-109,810.87


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
29194(04) 0004 SOLID SLAB SODDING * Missing Material Certification 0005 -990.20 $1.70 $-1,683.34
29194(04) 0004 SOLID SLAB SODDING * Missing Material Certification 0006 0.00 $0.00 $1,683.34
29194(04) 0006 SUPERPAVE, TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0001 125.11 $1.62 $203.43
29194(04) 0006 SUPERPAVE, TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0002 761.83 $1.62 $1,238.74
29194(04) 0006 SUPERPAVE, TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0003 7,744.55 $1.62 $12,592.64
29194(04) 0006 SUPERPAVE, TYPE S4(PG 64-22 OK) * Asphalt Binder Adjustment 0005 0.00 $0.00 $-203.43
29194(04) 0006 SUPERPAVE, TYPE S4(PG 64-22 OK) * Asphalt Binder Adjustment 0005 0.00 $0.00 $-12,592.64
29194(04) 0006 SUPERPAVE, TYPE S4(PG 64-22 OK) * Asphalt Binder Adjustment 0005 0.00 $0.00 $-1,238.74
29194(04) 0007 SUPERPAVE, TYPE S6(PG 64-22 OK) Asphalt Binder Adjustment 0001 974.93 $1.96 $1,915.49
29194(04) 0007 SUPERPAVE, TYPE S6(PG 64-22 OK) Asphalt Binder Adjustment 0002 2,496.03 $1.96 $4,904.08
29194(04) 0007 SUPERPAVE, TYPE S6(PG 64-22 OK) * Asphalt Binder Adjustment 0005 0.00 $0.00 $-4,904.08
29194(04) 0007 SUPERPAVE, TYPE S6(PG 64-22 OK) * Asphalt Binder Adjustment 0005 0.00 $0.00 $-1,915.49
29194(04) 0012 BEAM GUARDRAIL W-BEAM SINGLE * Missing Material Certification 0004 -100.00 $20.70 $-2,070.00
29194(04) 0012 BEAM GUARDRAIL W-BEAM SINGLE * Missing Material Certification 0005 100.00 $20.70 $2,070.00
29194(04) 0016 GUARDRAIL DELINEATORS(TYPE 2, CODE 1) * Missing Material Certification 0005 -16.00 $6.00 $-96.00
29194(04) 0016 GUARDRAIL DELINEATORS(TYPE 2, CODE 1) * Missing Material Certification 0006 0.00 $0.00 $96.00
29194(05) 0022 SUPERPAVE, TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0003 4,329.40 $1.62 $7,039.60
29194(05) 0022 SUPERPAVE, TYPE S4(PG 64-22 OK) * Asphalt Binder Adjustment 0005 0.00 $0.00 $-7,039.60
29194(05) 0023 SUPERPAVE, TYPE S6(PG 64-22 OK) Asphalt Binder Adjustment 0002 1,948.98 $1.96 $3,829.26
29194(05) 0023 SUPERPAVE, TYPE S6(PG 64-22 OK) * Asphalt Binder Adjustment 0005 0.00 $0.00 $-3,829.26
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
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: 120126   Estimate Number: 0006     Primary JP: 29194(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:    STPY-224C(003)3P Project:    29194(04) Category:    0100/ROADWAY - STPY-224C(003)3P
0001 UNCLASSIFIED BORROW (TOPSOIL) 202(D) 4781 CY 3,000.000 1,000.000   1,000.000 $3.00 $0.00 $3,000.00
0002 EARTHWORK 202(H) 0185 LSUM 1.000 1.000   1.000 $56,000.00 $0.00 $56,000.00
0003 TEMPORARY SILT FENCE 221(C) 2801 LF 50.000 0.000   0.000 $100.00 $0.00 $0.00
0004 SOLID SLAB SODDING 230(A) 2806 SY 3,500.000 990.200 0.000 990.200 $1.70 $0.00 $1,683.34
0005 TRAFFIC BOUND SURFACE COURSE TYPE A 402(A) 0217 TON 200.000 0.000   0.000 $50.00 $0.00 $0.00
0006 SUPERPAVE, TYPE S4(PG 64-22 OK) 411(C) 5960 TON 9,300.000 8,631.490   8,631.490 $78.00 $0.00 $673,256.22
0007 SUPERPAVE, TYPE S6(PG 64-22 OK) 411(E) 5990 TON 3,900.000 3,470.960   3,470.960 $76.00 $0.00 $263,792.96
0008 SUPERPAVE, TYPE S3(PATCH)(PG64-22OK) 411(H) 6210 TON 500.000 413.940   413.940 $51.00 $0.00 $21,110.94
0009 COLD MILLING PAVEMENT 412 5267 SY 2,000.000 2,372.220 -961.640 2,372.220 $5.00 $-4,808.20 $11,861.10
0010 REMOVAL OF ASPHALT PAVEMENT 619(B) 4728 SY 400.000 962.440 962.440 962.440 $10.00 $9,624.40 $9,624.40
0011 REMOVAL OF GUARDRAIL 619(B) 4780 LF 100.000 100.000   100.000 $2.75 $0.00 $275.00
0012 BEAM GUARDRAIL W-BEAM SINGLE 623(A) 0932 LF 100.000 100.000   100.000 $20.70 $0.00 $2,070.00
8000 ASPHALT BINDER PRICE ADJUSTMENT 109 1150 LSUM 0.000 1.000   1.000 $20,854.38 $0.00 $20,854.38
8002 DEDUCTION FOR FAILING MATERIAL 105 2325 EA 0.000 1.000 1.000 1.000 $-3,999.23 $-3,999.23 $-3,999.23
Subtotals For Category     0100/ROADWAY - STPY-224C(003)3P    $816.97 $1,059,529.11
Fed/State Project Number:    STPY-224C(003)3P Project:    29194(04) Category:    0300/TRAFFIC - STPY-224C(003)3P
0013 SHEET ALUMINUM SIGNS 850(A) 8110 SF 100.000 100.000 40.000 100.000 $19.00 $760.00 $1,900.00
0014 2 1/4" SQUARE TUBE POST 851(C) 8327 LF 120.000 120.000   120.000 $10.00 $0.00 $1,200.00
0015 BARRIER DELINEATORS(TYPE 2, CODE 1) 853 9063 EA 20.000 0.000   0.000 $6.00 $0.00 $0.00
0016 GUARDRAIL DELINEATORS(TYPE 2, CODE 1) 853 9069 EA 32.000 16.000 0.000 16.000 $6.00 $0.00 $96.00
0017 TRAFFIC STRIPE(PLASTIC)(THIN LINE)(4" WIDE) 855(A) 8840 LF 106,700.000 93,146.000 -22.000 93,146.000 $0.34 $-7.48 $31,669.64
0018 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $15,000.00 $0.00 $15,000.00
0019 PORT.CHANGEABLE MESSAGE SIGN 882(A) 8306 SD 30.000 27.000 1.000 27.000 $33.00 $33.00 $891.00
Subtotals For Category     0300/TRAFFIC - STPY-224C(003)3P    $785.52 $50,756.64
Subtotals For Project STPY-224C(003)3P /29194(04) $1,602.49 $1,110,285.75


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:    STPY-224C(004)3P Project:    29194(05) Category:    0100/ROADWAY - STPY-224C(004)3P
0020 UNCLASSIFIED BORROW (TOPSOIL) 202(D) 4781 CY 1,000.000 851.200   851.200 $3.00 $0.00 $2,553.60
0021 TRAFFIC BOUND SURFACE COURSE TYPE A 402(A) 0217 TON 100.000 0.000   0.000 $50.00 $0.00 $0.00
0022 SUPERPAVE, TYPE S4(PG 64-22 OK) 411(C) 5960 TON 4,400.000 4,329.400   4,329.400 $78.00 $0.00 $337,693.20
0023 SUPERPAVE, TYPE S6(PG 64-22 OK) 411(E) 5990 TON 1,900.000 1,948.980   1,948.980 $76.00 $0.00 $148,122.48
0024 SUPERPAVE, TYPE S3(PATCH)(PG64-22OK) 411(H) 6210 TON 100.000 158.450   158.450 $51.00 $0.00 $8,080.95
0025 COLD MILLING PAVEMENT 412 5267 SY 350.000 337.440 -874.450 337.440 $5.00 $-4,372.25 $1,687.20
0026 REMOVAL OF ASPHALT PAVEMENT 619(B) 4728 SY 200.000 880.890 880.890 880.890 $10.00 $8,808.90 $8,808.90
8001 ASPHALT BINDER PRICE ADJUSTMENT 109 1150 LSUM 0.000 1.000   1.000 $10,868.86 $0.00 $10,868.86
Subtotals For Category     0100/ROADWAY - STPY-224C(004)3P    $4,436.65 $517,815.19
Fed/State Project Number:    STPY-224C(004)3P Project:    29194(05) Category:    0300/TRAFFIC - STPY-224C(004)3P
0027 TRAFFIC STRIPE(PLASTIC)(THIN LINE)(4" WIDE) 855(A) 8840 LF 42,100.000 41,030.000 592.000 41,030.000 $0.34 $201.28 $13,950.20
0028 TRAFFIC STRIPE(PLASTIC)(SYMBOLS) 855(B) 8824 EA 1.000 1.000   1.000 $500.00 $0.00 $500.00
0029 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $15,000.00 $0.00 $15,000.00
0030 PORT.CHANGEABLE MESSAGE SIGN 882(A) 8306 SD 30.000 27.000 1.000 27.000 $33.00 $33.00 $891.00
Subtotals For Category     0300/TRAFFIC - STPY-224C(004)3P    $234.28 $30,341.20
Subtotals For Project STPY-224C(004)3P /29194(05) $4,670.93 $548,156.39