Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 120153   Estimate Number: 0009 , Final     Spec Year: 2009
Primary JP: 21654(04)   Residency: CIRCUIT ENGR. DISTRICT # 3 (02013)     Contract No: 711187
Date Created: 04/10/2013   Contractor FEI: 731174172     Account No: 436200

Project Number(s): BRO-107D(087)CI
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD (NS-381) : OVER J-N CREEK, 2.5 MILES NORTH OF US-70E. PROJECT LENGTH = 0.283 MILES.
Primary County: BRYAN              
Name of Road: COUNTY ROAD              
Prime Contractor: HUB CONSTRUCTION, INC.           Time Charged: 88.00
    ROUTE 1, BOX 350           Time Allowed: 90.00
    BOSWELL , OK   74727           Percent Time: 97.78 %

  Paid To Date: $555,318.53 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.                                
HUB CONSTRUCTION, 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:    04/10/2013
Contract ID: 120153   Estimate Number: 0009     Contract No: 711187
Residency: CIRCUIT ENGR. DISTRICT # 3 (02013)   Estimate Type: Final     Account No: 436200

Project Number(s): BRO-107D(087)CI
Primary Job Piece No: 21654(04)
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD (NS-381) : OVER J-N CREEK, 2.5 MILES NORTH OF US-70E. PROJECT LENGTH = 0.283 MILES.
Primary County: BRYAN              
Name of Road: COUNTY ROAD              
Prime Contractor: HUB CONSTRUCTION, INC.              
    ROUTE 1, BOX 350              
    BOSWELL , OK   74727              
Surety Company: OHIO CASUALTY INSURANCE COMPANY              

Date Let: 04/19/2012 NTP Effective Date: 08/06/2012 Pay Period: 02/01/2013  TO  04/10/2013
Date Awarded: 05/07/2012 Date Work Began: 08/09/2012 Original Contract Time: 90
Date Contract Executed: 05/18/2012 Date Time Stopped: 11/28/2012 Current Time Charged: 88.00
Date NTP Issued: 05/23/2012 Completion Date: 11/28/2012 Current Time Allowed: 90.00
General Liability Expires: 07/01/2013 Workman's Comp Expires: 12/31/2013 Percent Time Used: 97.78 %
Specification Year: 2009        

Current Contract Amount: $555,318.52 Total to Date Prev to Date This Estimate
Bid Amount: $580,850.90 Participating: $539,936.53 $539,936.53 $0.00
Percent Complete: 100 % Non Participating: $15,382.00 $15,382.00 $0.00
Funds Available: $-0.01 Total Earnings: $555,318.53 $555,318.53 $0.00
Unearned Balance: $25,532.37 Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $555,318.53 $555,318.53 $0.00
Other Adjustments: $0.00 $0.00 $0.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $555,318.53 $555,318.53 $0.00

Estimate Adjustment Detail

Contract ID: 120153   Estimate Number: 0009     Primary JP: 21654(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 FINAL QUANTITY CHANGE ORDER Approved 03/12/2013 0.0 $-25,532.38


STOCKPILE PAYMENT HISTORY
Project Line Nbr Stockpile Description Adjustment Type Estimate Nbr Adjusted Amount
21654(04) 0021 Prestressed Beams & Bearing Pads Stockpiled Material Initial Payment 0003 $49,920.16
21654(04) 0021 Prestressed Beams & Bearing Pads Stockpiled Material Adjustment 0003 $-49,920.16
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
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: 120153   Estimate Number: 0009     Primary JP: 21654(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:    BRO-107D(087)CI Project:    21654(04) Category:    0100/ROADWAY
0001 CLEARING AND GRUBBING 201(A) 0102 LSUM 1.000 1.000   1.000 $10,000.00 $0.00 $10,000.00
0002 UNCLASSIFIED EXCAVATION 202(A) 0183 CY 5,452.000 5,452.000   5,452.000 $7.00 $0.00 $38,164.00
0003 UNCLASSIFIED BORROW 202(D) 0184 CY 6,356.000 6,356.000   6,356.000 $8.00 $0.00 $50,848.00
0004 TYPE A-SALVAGED TOPSOIL 205(A) 4229 LSUM 1.000 1.000   1.000 $5,500.00 $0.00 $5,500.00
0005 TEMPORARY SILT FENCE 221(C) 2801 LF 1,970.000 634.000   634.000 $3.00 $0.00 $1,902.00
0006 TEMPORARY SILT DIKE 221(F) 0100 LF 360.000 105.000   105.000 $6.00 $0.00 $630.00
0007 SOLID SLAB SODDING 230(A) 2806 SY 9,024.000 9,678.050   9,678.050 $2.50 $0.00 $24,195.13
0008 VEGETATIVE MULCHING 233(A) 2817 AC 4.200 0.000   0.000 $300.00 $0.00 $0.00
0009 TRAFFIC BOUND SURFACE COURSE TYPE E 402(E) 0225 TON 1,287.000 1,226.120   1,226.120 $25.00 $0.00 $30,653.00
0010 CLASS C CONCRETE 509(D) 0325 CY 88.700 0.000   0.000 $250.00 $0.00 $0.00
0011 28" X 20" CORR. GALV. STEEL PIPE ARCH 613(B) 4528 LF 42.000 42.000   42.000 $30.00 $0.00 $1,260.00
0012 42" X 29" CORR. GALV. STEEL PIPE ARCH 613(B) 4530 LF 314.000 314.000   314.000 $50.00 $0.00 $15,700.00
0013 TYPE B4 CULVERT END TREATMENT 613(M) 7187 EA 2.000 2.000   2.000 $750.00 $0.00 $1,500.00
0014 TYPE C4 CULVERT END TREATMENT 613(M) 7188 EA 2.000 2.000   2.000 $1,205.00 $0.00 $2,410.00
0015 TYPE CC4 CULVERT END TREATMENT 613(M) 7193 EA 4.000 4.000   4.000 $1,800.00 $0.00 $7,200.00
0016 SHEET ALUMINUM SIGNS 850(A) 8110 SF 17.000 17.000   17.000 $20.00 $0.00 $340.00
0017 FLANGE CHANNEL POSTS(4 LB/FT) 851(D) 8597 LF 36.000 36.000   36.000 $15.00 $0.00 $540.00
0018 DELINEATORS(TYPE 2, CODE 1) 853 9033 EA 9.000 9.000   9.000 $15.00 $0.00 $135.00
Subtotals For Category     0100/ROADWAY    $0.00 $190,977.13
Fed/State Project Number:    BRO-107D(087)CI Project:    21654(04) Category:    0200/BRIDGE
0019 SUBSTRUCTURE EXCAVATION COMMON 501(B) 1307 CY 84.000 84.000   84.000 $12.00 $0.00 $1,008.00
0020 UNCLASSIFIED BACKFILL 501(D) 6353 CY 82.000 82.000   82.000 $12.00 $0.00 $984.00
0021 PRESTRESSED CONCRETE BEAMS (TYPE IV) 503(A) 1313 LF 356.670 356.670   356.670 $220.00 $0.00 $78,467.40
0022 SAW-CUT GROOVING 504(B) 1305 SY 275.000 275.000   275.000 $10.00 $0.00 $2,750.00
0023 CONCRETE RAIL (TR1) 504(E) 1380 LF 245.000 245.000   245.000 $75.00 $0.00 $18,375.00
0024 STRUCTURAL STEEL 506(A) 1322 LB 350.000 350.000   350.000 $2.50 $0.00 $875.00
0025 WEATHERING STEEL FIXED BEARING ASSEMBLY 507(A) 6172 EA 4.000 4.000   4.000 $500.00 $0.00 $2,000.00
0026 WEATHERING STEEL EXPANSION BEARING ASSEMBLY 507(B) 6176 EA 4.000 4.000   4.000 $500.00 $0.00 $2,000.00
0027 CLASS AA CONCRETE 509(A) 1326 CY 69.800 69.800   69.800 $550.00 $0.00 $38,390.00
0028 CLASS A CONCRETE 509(B) 1328 CY 53.800 53.800   53.800 $600.00 $0.00 $32,280.00
0029 REINFORCING STEEL 511(A) 1332 LB 23,180.000 23,180.000   23,180.000 $1.00 $0.00 $23,180.00
0030 PILES, FURNISHED (HP 10X42) 514(A) 6010 LF 762.000 754.340   754.340 $40.00 $0.00 $30,173.60
0031 PILES, DRIVEN (HP 10X42) 514(B) 6292 LF 762.000 656.230   656.230 $10.00 $0.00 $6,562.30
0032 TYPE I-A PLAIN RIPRAP 601(B) 1353 TON 1,430.000 1,617.120   1,617.120 $35.00 $0.00 $56,599.20
0033 TYPE I-A FILTER BLANKET 601(C) 1355 TON 380.000 303.830   303.830 $30.00 $0.00 $9,114.90
0034 REMOVAL OF EXISTING BRIDGE STRUCTURE 619(D) 1397 LSUM 1.000 1.000   1.000 $5,000.00 $0.00 $5,000.00
0035 GUARDRAIL ANCHOR UNIT (TYPE II) 623(F) 6033 EA 3.000 3.000   3.000 $2,500.00 $0.00 $7,500.00
0036 GUARDRAIL ANCHOR UNIT (TYPE III) 623(F) 6034 EA 1.000 1.000   1.000 $2,200.00 $0.00 $2,200.00
0037 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $5,000.00 $0.00 $5,000.00
Subtotals For Category     0200/BRIDGE    $0.00 $322,459.40
Fed/State Project Number:    BRO-107D(087)CI Project:    21654(04) Category:    0600/STAKING
0038 CONSTRUCTION STAKING LEVEL II 642(B) 0096 LSUM 1.000 1.000   1.000 $5,000.00 $0.00 $5,000.00
Subtotals For Category     0600/STAKING    $0.00 $5,000.00
Fed/State Project Number:    BRO-107D(087)CI Project:    21654(04) Category:    0640/CONSTRUCTION
0039 SWPPP DOCUMENTATION AND MANAGEMENT 220 2800 LSUM 1.000 1.000   1.000 $1,500.00 $0.00 $1,500.00
0040 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $20,000.00 $0.00 $20,000.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $21,500.00
Fed/State Project Number:    BRO-107D(087)CI Project:    21654(04) Category:    0900/NON-PARTICIPATING
0041 FENCE-STYLE SWF (5 BARBED WIRE) 624(C) 4459 LF 3,022.000 3,112.000   3,112.000 $4.75 $0.00 $14,782.00
0042 GATE, GALVANIZED STEEL 624(D) 4470 EA 4.000 4.000   4.000 $150.00 $0.00 $600.00
Subtotals For Category     0900/NON-PARTICIPATING    $0.00 $15,382.00
Subtotals For Project BRO-107D(087)CI /21654(04) $0.00 $555,318.53