Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 120154   Estimate Number: 0008 , Final     Spec Year: 2009
Primary JP: 29176(04)   Residency: ARDMORE (07200)     Contract No: 711188
Date Created: 11/05/2013   Contractor FEI: 752057660     Account No: 404700

Project Number(s): SBR-210N(004)SB
Contract Description: BRIDGE REHABILITATION I-35: OVER SH-142 AND COUNTY ROAD (EW-189), 2.1 MILES AND 7.2 MILES NORTH OF US-70.
Primary County: CARTER              
Name of Road: I-35              
Prime Contractor: GIBSON & ASSOCIATES, INC.           Time Charged: 82.00
    P.O. BOX 800579           Time Allowed: 120.00
    BALCH SPRINGS , TX   75180-0579           Percent Time: 68.33 %

  Paid To Date: $526,684.83 Payable This Statement: $478.17

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.                                
GIBSON & ASSOCIATES, 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:    11/05/2013
Contract ID: 120154   Estimate Number: 0008     Contract No: 711188
Residency: ARDMORE (07200)   Estimate Type: Final     Account No: 404700

Project Number(s): SBR-210N(004)SB
Primary Job Piece No: 29176(04)
Contract Description: BRIDGE REHABILITATION I-35: OVER SH-142 AND COUNTY ROAD (EW-189), 2.1 MILES AND 7.2 MILES NORTH OF US-70.
Primary County: CARTER              
Name of Road: I-35              
Prime Contractor: GIBSON & ASSOCIATES, INC.              
    P.O. BOX 800579              
    BALCH SPRINGS , TX   75180-0579              
Surety Company: FEDERAL INSURANCE COMPANY              

Date Let: 04/19/2012 NTP Effective Date: 09/04/2012 Pay Period: 10/01/2013  TO  10/31/2013
Date Awarded: 05/07/2012 Date Work Began: 09/04/2012 Original Contract Time: 120
Date Contract Executed: 05/22/2012 Date Time Stopped: 03/14/2013 Current Time Charged: 82.00
Date NTP Issued: 06/19/2012 Completion Date: 03/14/2013 Current Time Allowed: 120.00
General Liability Expires: 06/30/2014 Workman's Comp Expires: 06/30/2014 Percent Time Used: 68.33 %
Specification Year: 2009        

Bid Amount: $526,159.58 Total to Date Prev to Date This Estimate
Funds Available (Bid + Positive C/O): $532,961.90 Participating: $0.00 $0.00 $0.00
Percent Complete: 98.82 % Non Participating: $526,684.83 $526,206.66 $478.17
Unearned Balance: $6,277.07 Total Earnings: $526,684.83 $526,206.66 $478.17
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $526,684.83 $526,206.66 $478.17
Other Adjustments: $0.00 $0.00 $0.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $526,684.83 $526,206.66 $478.17

Estimate Adjustment Detail

Contract ID: 120154   Estimate Number: 0008     Primary JP: 29176(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 CO#1 Class AA Concrete Approved 09/30/2013 0.0 $6,802.32
002 Final Contract Item Quantities Approved 11/04/2013 0.0 $-6,277.09


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
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: 120154   Estimate Number: 0008     Primary JP: 29176(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:    SBR-210N(004)SB Project:    29176(04) Category:    0200/BRIDGE 'A'
0001 SAW-CUT GROOVING 504(B) 1305 SY 376.300 388.440   388.440 $5.10 $0.00 $1,981.05
0002 RAPID CURE JOINT SEALANT 504(G) 6390 LF 154.000 155.000   155.000 $30.00 $0.00 $4,650.00
0003 BRIDGE DECK CONCRETE OVERLAY 505(A) 6065 SY 376.300 388.450   388.450 $88.00 $0.00 $34,183.60
0004 REMOVING EXISTING OVERLAY 505(B) 6070 SY 376.300 388.440   388.440 $31.50 $0.00 $12,235.86
0005 HYDRODEMOLITION 505(E) 1000 SY 376.300 388.440   388.440 $36.00 $0.00 $13,983.84
0006 PREPARATION OF CRACKS, ABOVE WATER 520(A) 6058 LF 10.000 8.000   8.000 $40.00 $0.00 $320.00
0007 EPOXY RESIN, ABOVE WATER 520(C) 6060 GAL 1.000 0.500   0.500 $66.00 $0.00 $33.00
0008 SEALER CRACK PREPARATION 523(A) 6550 LF 218.500 269.500   269.500 $11.00 $0.00 $2,964.50
0009 SEALER RESIN 523(B) 6560 GAL 2.600 3.100   3.100 $105.00 $0.00 $325.50
8000 BRIDGE DECK CONCRETE OVERLAY 505(A) 6066 CY 0.000 5.230   5.230 $784.80 $0.00 $4,104.50
Subtotals For Category     0200/BRIDGE 'A'    $0.00 $74,781.85
Fed/State Project Number:    SBR-210N(004)SB Project:    29176(04) Category:    0201/BRIDGE 'B'
0010 CLSM BACKFILL 501(G) 6309 CY 14.000 14.060 0.000 14.060 $445.00 $0.00 $6,256.70
0011 APPROACH SLAB 504(A) 1304 SY 168.900 168.890   168.890 $210.00 $0.00 $35,466.90
0012 SAW-CUT GROOVING 504(B) 1305 SY 898.300 898.280   898.280 $5.10 $0.00 $4,581.24
0013 RAPID CURE JOINT SEALANT 504(G) 6390 LF 203.000 240.170   240.170 $30.00 $0.00 $7,205.10
0014 BRIDGE DECK CONCRETE OVERLAY 505(A) 6065 SY 733.800 733.840   733.840 $88.00 $0.00 $64,577.92
0015 REMOVING EXISTING OVERLAY 505(B) 6070 SY 733.800 733.840   733.840 $31.50 $0.00 $23,115.97
0016 HYDRODEMOLITION 505(E) 1000 SY 733.800 733.840   733.840 $36.00 $0.00 $26,418.24
0017 CLASS C CONCRETE 509(D) 1331 CY 5.000 0.910 0.000 0.910 $625.00 $0.00 $568.75
0018 PREPARATION OF CRACKS, ABOVE WATER 520(A) 6058 LF 15.000 15.000   15.000 $40.00 $0.00 $600.00
0019 EPOXY RESIN, ABOVE WATER 520(C) 6060 GAL 2.000 2.000   2.000 $66.00 $0.00 $132.00
0020 SEALER CRACK PREPARATION 523(A) 6550 LF 218.500 218.500   218.500 $11.00 $0.00 $2,403.50
0021 SEALER RESIN 523(B) 6560 GAL 2.600 2.600   2.600 $105.00 $0.00 $273.00
0022 REMOVAL OF BRIDGE ITEMS 619(B) 2505 EA 2.000 2.000   2.000 $6,300.00 $0.00 $12,600.00
8001 BRIDGE DECK CONCRETE OVERLAY 505(A) 6066 CY 0.000 7.840   7.840 $784.80 $0.00 $6,152.83
Subtotals For Category     0201/BRIDGE 'B'    $0.00 $190,352.15
Fed/State Project Number:    SBR-210N(004)SB Project:    29176(04) Category:    0202/BRIDGE 'C'
0023 SAW-CUT GROOVING 504(B) 1305 SY 250.600 258.670   258.670 $5.10 $0.00 $1,319.21
0024 RAPID CURE JOINT SEALANT 504(G) 6390 LF 154.000 155.000   155.000 $25.00 $0.00 $3,875.00
0025 BRIDGE DECK CONCRETE OVERLAY 505(A) 6065 SY 250.600 258.660   258.660 $122.00 $0.00 $31,556.52
0026 REMOVING EXISTING OVERLAY 505(B) 6070 SY 250.600 258.670   258.670 $31.50 $0.00 $8,148.11
0027 HYDRODEMOLITION 505(E) 1000 SY 250.600 258.670   258.670 $36.00 $0.00 $9,312.12
0028 PNEUMATICALLY PLACED MORTAR 521(A) 6210 SY 5.000 4.040   4.040 $600.00 $0.00 $2,424.00
0029 SEALER CRACK PREPARATION 523(A) 6550 LF 145.500 230.500   230.500 $16.50 $0.00 $3,803.25
0030 SEALER RESIN 523(B) 6560 GAL 1.800 2.800   2.800 $105.00 $0.00 $294.00
8002 BRIDGE DECK CONCRETE OVERLAY 505(A) 6066 CY 0.000 6.090   6.090 $784.80 $0.00 $4,779.43
Subtotals For Category     0202/BRIDGE 'C'    $0.00 $65,511.64
Fed/State Project Number:    SBR-210N(004)SB Project:    29176(04) Category:    0203/BRIDGE 'D'
0031 SAW-CUT GROOVING 504(B) 1305 SY 250.600 258.670   258.670 $5.10 $0.00 $1,319.21
0032 RAPID CURE JOINT SEALANT 504(G) 6390 LF 154.000 155.000   155.000 $25.00 $0.00 $3,875.00
0033 BRIDGE DECK CONCRETE OVERLAY 505(A) 6065 SY 250.600 258.660   258.660 $122.00 $0.00 $31,556.52
0034 REMOVING EXISTING OVERLAY 505(B) 6070 SY 250.600 258.670   258.670 $31.50 $0.00 $8,148.11
0035 HYDRODEMOLITION 505(E) 1000 SY 250.600 258.670   258.670 $36.00 $0.00 $9,312.12
0036 PNEUMATICALLY PLACED MORTAR 521(A) 6210 SY 5.000 3.420   3.420 $600.00 $0.00 $2,052.00
0037 SEALER CRACK PREPARATION 523(A) 6550 LF 145.500 166.500   166.500 $16.50 $0.00 $2,747.25
0038 SEALER RESIN 523(B) 6560 GAL 1.800 2.300   2.300 $105.00 $0.00 $241.50
8003 BRIDGE DECK CONCRETE OVERLAY 505(A) 6066 CY 0.000 1.740   1.740 $784.80 $0.00 $1,365.55
Subtotals For Category     0203/BRIDGE 'D'    $0.00 $60,617.26
Fed/State Project Number:    SBR-210N(004)SB Project:    29176(04) Category:    0300/TRAFFIC
0039 TRAFFIC STRIPE(MULTI-POLYMER)(4" WIDE) 856(A) 8530 LF 1,940.000 5,582.500 107.000 5,582.500 $1.55 $165.85 $8,652.88
0040 TRAFFIC STRIPE(MULTI-POLY.)(6" WIDE) 856(A) 8535 LF 540.000 450.000 50.000 450.000 $1.60 $80.00 $720.00
0041 CONSTRUCTION TRAFFIC STRIPE(PAINT)(4" WIDE) 857(A) 8839 LF 2,500.000 4,982.000   4,982.000 $0.41 $0.00 $2,042.62
0042 (PL)CONSTRUCTION ZONE PAVEMENT MARKERS(FLEX TAB)TYPE 2-1 857(E) 8887 EA 500.000 300.000   300.000 $0.48 $0.00 $144.00
0043 PAVEMENT MARKING REMOVAL(TRAFFIC STRIPE) 857(F) 8006 LF 2,500.000 9,948.000   9,948.000 $0.26 $0.00 $2,586.48
0044 (SP)CONST.ZONE IMPACT ATTEN. 871(B) 8705 SD 480.000 180.000   180.000 $19.25 $0.00 $3,465.00
0045 (PL)TRUCK MOUNTED ATTENUATOR 876(A) 8482 SD 120.000 27.000   27.000 $8.80 $0.00 $237.60
0046 DELIVER PORTABLE LONGITUDINAL BARRIER 877(B) 8484 LF 2,650.000 2,676.880   2,676.880 $19.40 $0.00 $51,931.47
0047 RELOCATION OF PORTABLE LONGITUDINAL BARRIER 877(C) 8486 LF 675.000 708.390   708.390 $6.05 $0.00 $4,285.76
0048 ARROW DISPLAY(TYPE C) 880(A) 8812 SD 480.000 176.000   176.000 $3.30 $0.00 $580.80
0049 CONSTRUCTION SIGNS 0 TO 6.25 SF 880(B) 8818 SD 18,000.000 3,041.000   3,041.000 $0.11 $0.00 $334.51
0050 CONSTRUCTION SIGNS 6.26 SF TO 15.99 SF 880(B) 8821 SD 1,800.000 936.000   936.000 $2.42 $0.00 $2,265.12
0051 CONSTRUCTION SIGNS 16.0 SF TO 32.99 SF 880(B) 8824 SD 3,600.000 1,602.000 -72.000 1,602.000 $2.42 $-174.24 $3,876.84
0052 CONSTRUCTION SIGNS 33.0 SF & OVER 880(B) 8827 SD 480.000 168.000 168.000 168.000 $2.42 $406.56 $406.56
0053 CONSTRUCTION BARRICADES(TYPE III) 880(C) 8842 SD 2,880.000 805.000   805.000 $0.03 $0.00 $24.15
0054 WING BARRICADES 880(C) 8848 SD 480.000 352.000   352.000 $0.03 $0.00 $10.56
0055 WARNING LIGHTS(TYPE A) 880(E) 8860 SD 6,720.000 3,106.000   3,106.000 $0.17 $0.00 $528.02
0056 DRUMS 880(F) 8878 SD 6,000.000 8,078.000   8,078.000 $0.44 $0.00 $3,554.32
0057 CHANNELIZER CONES 880(G) 8890 SD 6,000.000 851.000   851.000 $0.44 $0.00 $374.44
0058 TRAFFIC SURVEILLANCE, POLICE 880(L) 8911 HOUR 160.000 0.000   0.000 $60.00 $0.00 $0.00
0059 PORT.CHANGEABLE MESSAGE SIGN 882(A) 8306 SD 240.000 104.000   104.000 $7.70 $0.00 $800.80
Subtotals For Category     0300/TRAFFIC    $478.17 $86,821.93
Fed/State Project Number:    SBR-210N(004)SB Project:    29176(04) Category:    0640/CONSTRUCTION
0060 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $48,600.00 $0.00 $48,600.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $48,600.00
Subtotals For Project SBR-210N(004)SB /29176(04) $478.17 $526,684.83