Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 120166   Estimate Number: 0006 , Final     Spec Year: 2009
Primary JP: 21926(04)   Residency: ADA (03100)     Contract No: 711166
Date Created: 06/11/2013   Contractor FEI: 731450620     Account No: 400300

Project Number(s): BRFY-162C(225)
Contract Description: JOINT SEAL/REPAIR US-270/SH-3/SH-18: AT MULTIPLE LOCATIONS IN DIVISION III.
Primary County: PONTOTOC              
Name of Road: MULTIPLE LOCATIONS              
Prime Contractor: C-P INTEGRATED SERVICES, INC.           Time Charged: 118.00
    3007 NW 63RD, BLDG."B", STE 205           Time Allowed: 120.00
    OKLAHOMA CITY , OK   73116-3614           Percent Time: 98.33 %

  Paid To Date: $303,397.96 Payable This Statement: $0.01

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.                                
C-P INTEGRATED SERVICES, 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:    06/11/2013
Contract ID: 120166   Estimate Number: 0006     Contract No: 711166
Residency: ADA (03100)   Estimate Type: Final     Account No: 400300

Project Number(s): BRFY-162C(225)
Primary Job Piece No: 21926(04)
Contract Description: JOINT SEAL/REPAIR US-270/SH-3/SH-18: AT MULTIPLE LOCATIONS IN DIVISION III.
Primary County: PONTOTOC              
Name of Road: MULTIPLE LOCATIONS              
Prime Contractor: C-P INTEGRATED SERVICES, INC.              
    3007 NW 63RD, BLDG."B", STE 205              
    OKLAHOMA CITY , OK   73116-3614              
Surety Company: PHILADELPHIA INDEMITY INSURANCE COMPANY              

Date Let: 04/19/2012 NTP Effective Date: 09/04/2012 Pay Period: 05/01/2013  TO  05/31/2013
Date Awarded: 05/07/2012 Date Work Began: 09/04/2012 Original Contract Time: 120
Date Contract Executed: 05/18/2012 Date Time Stopped: 12/31/2012 Current Time Charged: 118.00
Date NTP Issued: 05/23/2012 Completion Date: 12/31/2012 Current Time Allowed: 120.00
General Liability Expires: 01/31/2014 Workman's Comp Expires: 01/31/2014 Percent Time Used: 98.33 %
Specification Year: 2009        

Current Contract Amount: $303,397.93 Total to Date Prev to Date This Estimate
Bid Amount: $261,403.96 Participating: $303,397.96 $303,397.96 $0.00
Percent Complete: 100 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $-0.03 Total Earnings: $303,397.96 $303,397.96 $0.00
Unearned Balance: $-41,994.00 Stockpiled Materials: $0.00 $-0.01 $0.01
Gross Earnings: $303,397.96 $303,397.95 $0.01
Other Adjustments: $0.00 $0.00 $0.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $303,397.96 $303,397.95 $0.01

Estimate Adjustment Detail

Contract ID: 120166   Estimate Number: 0006     Primary JP: 21926(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 CO for OverRun of Exsisting Contract Items Approved 04/25/2013 0.0 $42,152.84
002 Finalizing Contract Item Qtys Approved 05/24/2013 0.0 $-158.87


STOCKPILE PAYMENT HISTORY
Project Line Nbr Stockpile Description Adjustment Type Estimate Nbr Adjusted Amount
21926(04) 0001 MOH SEJ Br A Stockpiled Material Initial Payment 0001 $17,075.50
21926(04) 0001 MOH SEJ Br A Stockpiled Material Adjustment 0002 $-17,075.50
21926(04) 0005 Stockpiled Material Closure 0006 $0.01
21926(04) 0005 MOH SEJ Br B Stockpiled Material Adjustment 0002 $-12,806.63
21926(04) 0005 MOH SEJ Br B Stockpiled Material Adjustment 0001 $-4,268.88
21926(04) 0005 MOH SEJ Br B Stockpiled Material Initial Payment 0001 $17,075.50
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: 120166   Estimate Number: 0006     Primary JP: 21926(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:    BRFY-162C(225) Project:    21926(04) Category:    0200/BRIDGE 'A'
0001 SEALED EXPANSION JOINT 504(C) 6250 LF 114.500 115.380   115.380 $244.70 $0.00 $28,233.49
0002 CONCRETE PARAPET 504(E) 1381 LF 12.000 12.000   12.000 $104.23 $0.00 $1,250.76
0003 CLASS AA CONCRETE 509(A) 0319 CY 8.500 8.460   8.460 $607.00 $0.00 $5,135.22
0004 REINFORCING STEEL 511(A) 0332 LB 1,900.000 2,187.000   2,187.000 $1.04 $0.00 $2,274.48
Subtotals For Category     0200/BRIDGE 'A'    $0.00 $36,893.95
Fed/State Project Number:    BRFY-162C(225) Project:    21926(04) Category:    0201/BRIDGE 'B'
0005 SEALED EXPANSION JOINT 504(C) 6250 LF 114.500 115.380 0.000 115.380 $244.70 $0.00 $28,233.49
0006 CONCRETE PARAPET 504(E) 1381 LF 12.000 12.000   12.000 $104.23 $0.00 $1,250.76
0007 CLASS AA CONCRETE 509(A) 0319 CY 8.500 8.460   8.460 $607.00 $0.00 $5,135.22
0008 REINFORCING STEEL 511(A) 0332 LB 1,900.000 2,187.000   2,187.000 $1.04 $0.00 $2,274.48
Subtotals For Category     0201/BRIDGE 'B'    $0.00 $36,893.95
Fed/State Project Number:    BRFY-162C(225) Project:    21926(04) Category:    0202/BRIDGE 'C'
0009 RAPID CURE JOINT SEALANT 504(G) 6390 LF 88.000 87.400   87.400 $10.61 $0.00 $927.31
0010 SEALER CRACK PREPARATION 523(A) 6550 LF 250.000 375.000   375.000 $6.55 $0.00 $2,456.25
0011 SEALER RESIN 523(B) 6560 GAL 5.000 5.000   5.000 $223.35 $0.00 $1,116.75
0012 DECK AREA SEALED (FLOODCOATS) 523(C) 6570 SY 521.100 522.930   522.930 $25.89 $0.00 $13,538.66
Subtotals For Category     0202/BRIDGE 'C'    $0.00 $18,038.97
Fed/State Project Number:    BRFY-162C(225) Project:    21926(04) Category:    0203/BRIDGE 'D'
0013 CLSM BACKFILL 501(G) 6309 CY 10.000 40.490   40.490 $364.81 $0.00 $14,771.16
0014 SEALED EXPANSION JOINT 504(C) 6250 LF 82.500 82.500   82.500 $244.20 $0.00 $20,146.50
0015 CONCRETE PARAPET 504(E) 1381 LF 12.000 12.000   12.000 $104.23 $0.00 $1,250.76
0016 RAPID CURE JOINT SEALANT 504(G) 6390 LF 156.000 153.000   153.000 $9.99 $0.00 $1,528.47
0017 SPECIAL CONCRETE FINISH 509 6152 SY 133.500 133.360   133.360 $29.78 $0.00 $3,971.47
0018 CLASS AA CONCRETE 509(A) 0319 CY 6.100 6.020   6.020 $658.96 $0.00 $3,966.94
0019 REINFORCING STEEL 511(A) 0332 LB 1,020.000 1,245.000   1,245.000 $1.04 $0.00 $1,294.80
0020 PNEUMATICALLY PLACED MORTAR 521(A) 6210 SY 13.500 42.630   42.630 $670.06 $0.00 $28,564.65
0021 SEALER CRACK PREPARATION 523(A) 6550 LF 250.000 276.000   276.000 $7.86 $0.00 $2,169.36
0022 SEALER RESIN 523(B) 6560 GAL 5.000 5.000   5.000 $260.58 $0.00 $1,302.90
0023 DECK AREA SEALED (FLOODCOATS) 523(C) 6570 SY 696.200 696.140   696.140 $28.26 $0.00 $19,672.91
Subtotals For Category     0203/BRIDGE 'D'    $0.00 $98,639.92
Fed/State Project Number:    BRFY-162C(225) Project:    21926(04) Category:    0204/BRIDGE 'E'
0024 CLSM BACKFILL 501(G) 6309 CY 10.000 26.490   26.490 $275.47 $0.00 $7,297.21
0025 SEALED EXPANSION JOINT 504(C) 6250 LF 82.500 82.500   82.500 $244.20 $0.00 $20,146.50
0026 CONCRETE PARAPET 504(E) 1381 LF 12.000 12.000   12.000 $91.82 $0.00 $1,101.84
0027 RAPID CURE JOINT SEALANT 504(G) 6390 LF 156.000 153.000   153.000 $10.12 $0.00 $1,548.36
0028 SPECIAL CONCRETE FINISH 509 6152 SY 133.500 133.360   133.360 $29.78 $0.00 $3,971.47
0029 CLASS AA CONCRETE 509(A) 0319 CY 6.100 6.020   6.020 $712.66 $0.00 $4,290.22
0030 REINFORCING STEEL 511(A) 0332 LB 1,020.000 1,245.000   1,245.000 $1.04 $0.00 $1,294.80
0031 CLASS B BRIDGE DECK REPAIR 513(B) 6019 SY 10.000 8.370   8.370 $271.75 $0.00 $2,274.55
0032 PNEUMATICALLY PLACED MORTAR 521(A) 6210 SY 20.500 32.300   32.300 $521.16 $0.00 $16,833.47
0033 SEALER CRACK PREPARATION 523(A) 6550 LF 250.000 340.000   340.000 $5.31 $0.00 $1,805.40
0034 SEALER RESIN 523(B) 6560 GAL 5.000 5.000   5.000 $223.35 $0.00 $1,116.75
0035 DECK AREA SEALED (FLOODCOATS) 523(C) 6570 SY 696.200 696.140   696.140 $27.73 $0.00 $19,303.96
Subtotals For Category     0204/BRIDGE 'E'    $0.00 $80,984.53
Fed/State Project Number:    BRFY-162C(225) Project:    21926(04) Category:    0300/TRAFFIC CONTROL
0036 (PL)TRUCK MOUNTED ATTENUATOR 876(A) 8482 SD 150.000 90.000   90.000 $11.91 $0.00 $1,071.90
0037 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $11,167.74 $0.00 $11,167.74
0038 PORT.CHANGEABLE MESSAGE SIGN 882(A) 8306 SD 200.000 105.000   105.000 $10.42 $0.00 $1,094.10
Subtotals For Category     0300/TRAFFIC CONTROL    $0.00 $13,333.74
Fed/State Project Number:    BRFY-162C(225) Project:    21926(04) Category:    0640/CONSTRUCTION
0039 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $18,612.90 $0.00 $18,612.90
Subtotals For Category     0640/CONSTRUCTION    $0.00 $18,612.90
Subtotals For Project BRFY-162C(225) /21926(04) $0.00 $303,397.96