Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 120172   Estimate Number: 0003 , Final     Spec Year: 2009
Primary JP: 28006(04)   Residency: DUNCAN (07100)     Contract No: 711177
Date Created: 09/26/2013   Contractor FEI: 202096326     Account No: 404700

Project Number(s): SAP-216A(005)
Contract Description: BRIDGE REPAIR US-62: OVER COUNTY ROAD NS-247, 3.0 MILES EAST OF SH-115.
Primary County: COMANCHE              
Name of Road: US-62              
Prime Contractor: B & B CONSTRUCTION SERVICE J.T., INC.           Time Charged: 14.00
    1125 W. BRESHEARS ST.           Time Allowed: 15.00
    CLAYTON , OK   74536           Percent Time: 93.33 %

  Paid To Date: $69,625.05 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.                                
B & B CONSTRUCTION SERVICE J.T., 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:    09/26/2013
Contract ID: 120172   Estimate Number: 0003     Contract No: 711177
Residency: DUNCAN (07100)   Estimate Type: Final     Account No: 404700

Project Number(s): SAP-216A(005)
Primary Job Piece No: 28006(04)
Contract Description: BRIDGE REPAIR US-62: OVER COUNTY ROAD NS-247, 3.0 MILES EAST OF SH-115.
Primary County: COMANCHE              
Name of Road: US-62              
Prime Contractor: B & B CONSTRUCTION SERVICE J.T., INC.              
    1125 W. BRESHEARS ST.              
    CLAYTON , OK   74536              
Surety Company: GRANITE RE, INC.              

Date Let: 04/19/2012 NTP Effective Date: 06/18/2012 Pay Period: 11/01/2012  TO  09/15/2013
Date Awarded: 05/07/2012 Date Work Began: 09/10/2012 Original Contract Time: 15
Date Contract Executed: 05/18/2012 Date Time Stopped: 10/23/2012 Current Time Charged: 14.00
Date NTP Issued: 05/23/2012 Completion Date: 10/23/2012 Current Time Allowed: 15.00
General Liability Expires: 08/23/2014 Workman's Comp Expires: 11/01/2013 Percent Time Used: 93.33 %
Specification Year: 2009        

Current Contract Amount: $69,625.05 Total to Date Prev to Date This Estimate
Bid Amount: $79,568.20 Participating: $0.00 $0.00 $0.00
Percent Complete: 100 % Non Participating: $69,625.05 $68,425.05 $1,200.00
Funds Available: $0.00 Total Earnings: $69,625.05 $68,425.05 $1,200.00
Unearned Balance: $9,943.15 Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $69,625.05 $68,425.05 $1,200.00
Other Adjustments: $0.00 $1,200.00 $-1,200.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $69,625.05 $69,625.05 $0.00

Estimate Adjustment Detail

Contract ID: 120172   Estimate Number: 0003     Primary JP: 28006(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Changes Work Start Date Approved 09/25/2012 0.0 $0.00
002 FINAL QUANTITY CHANGE ORDER Approved 09/11/2013 0.0 $-11,143.15
003 Milestone Compensation Approved 09/24/2013 0.0 $1,200.00


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
Milestone Adjust. (Prog. Est. Only) 0002 $1,200.00
Milstone Adjust. (C/O) 0003 $-1,200.00
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
01 Incentive/Disincentive for Early/Late Completion 09/03/2012 09/17/2012 15.00 DYS $1,200.00 Y


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: 120172   Estimate Number: 0003     Primary JP: 28006(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:    SAP-216A(005) Project:    28006(04) Category:    0200/BRIDGE 'A'
0001 (PL)FALSEWORK JACKING 502 6116 LSUM 1.000 1.000   1.000 $20,500.00 $0.00 $20,500.00
0002 (PL)REPAIR BRIDGE ITEM (TYPE A) 540 4510 LSUM 1.000 1.000   1.000 $31,000.00 $0.00 $31,000.00
Subtotals For Category     0200/BRIDGE 'A'    $0.00 $51,500.00
Fed/State Project Number:    SAP-216A(005) Project:    28006(04) Category:    0300/TRAFFIC CONTROL
0003 (SP)CONST.ZONE IMPACT ATTEN. 871(B) 8705 SD 14.000 0.000   0.000 $40.00 $0.00 $0.00
0004 (PL)TRUCK MOUNTED ATTENUATOR 876(A) 8482 SD 14.000 12.000   12.000 $40.00 $0.00 $480.00
0005 DELIVER PORTABLE LONGITUDINAL BARRIER 877(B) 8484 LF 600.000 600.000   600.000 $15.00 $0.00 $9,000.00
0006 RELOCATION OF PORTABLE LONGITUDINAL BARRIER 877(C) 8486 LF 600.000 0.000   0.000 $4.00 $0.00 $0.00
0007 ARROW DISPLAY(TYPE C) 880(A) 8812 SD 28.000 11.000   11.000 $5.00 $0.00 $55.00
0008 CONSTRUCTION SIGNS 0 TO 6.25 SF 880(B) 8818 SD 84.000 55.000   55.000 $1.50 $0.00 $82.50
0009 CONSTRUCTION SIGNS 6.26 SF TO 15.99 SF 880(B) 8821 SD 112.000 42.000   42.000 $1.50 $0.00 $63.00
0010 CONSTRUCTION SIGNS 16.0 SF TO 32.99 SF 880(B) 8824 SD 280.000 133.000   133.000 $1.50 $0.00 $199.50
0011 CONSTRUCTION BARRICADES(TYPE III) 880(C) 8842 SD 126.000 42.000   42.000 $1.20 $0.00 $50.40
0012 WING BARRICADES 880(C) 8848 SD 42.000 35.000   35.000 $5.70 $0.00 $199.50
0013 WARNING LIGHTS(TYPE A) 880(E) 8860 SD 392.000 49.000   49.000 $0.75 $0.00 $36.75
0014 DRUMS 880(F) 8878 SD 560.000 205.000   205.000 $0.40 $0.00 $82.00
0015 CHANNELIZER CONES 880(G) 8890 SD 826.000 294.000   294.000 $0.60 $0.00 $176.40
0016 FLAGGER 880(I) 8902 SD 28.000 0.000   0.000 $150.00 $0.00 $0.00
0017 TRAFFIC SURVEILLANCE, POLICE 880(L) 8911 HOUR 28.000 0.000   0.000 $75.00 $0.00 $0.00
0018 PORT.CHANGEABLE MESSAGE SIGN 882(A) 8306 SD 14.000 0.000   0.000 $35.00 $0.00 $0.00
Subtotals For Category     0300/TRAFFIC CONTROL    $0.00 $10,425.05
Fed/State Project Number:    SAP-216A(005) Project:    28006(04) Category:    0640/CONSTRUCTION
0019 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $6,500.00 $0.00 $6,500.00
8000 MILESTONE INCENTIVE COMPENSATION 644 7215 LSUM 0.000 1.000 1.000 1.000 $1,200.00 $1,200.00 $1,200.00
Subtotals For Category     0640/CONSTRUCTION    $1,200.00 $7,700.00
Subtotals For Project SAP-216A(005) /28006(04) $1,200.00 $69,625.05