Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 120179   Estimate Number: 0003 , Final     Spec Year: 2009
Primary JP: 23274(09)   Residency: BUFFALO (06100)     Contract No: 810011
Date Created: 05/29/2014   Contractor FEI: 731307297     Account No: 404600

Project Number(s): SSP-202C(002)SS
Contract Description: BRIDGE WATERPROOF SEAL US-60/US-64/US-281/SH-8/SH-50: VARIOUS LOCATIONS IN DIVISION VI.
Primary County: ALFALFA              
Name of Road: MULTIPLE LOCATIONS              
Prime Contractor: GARY A. CRAIN, INC.           Time Charged: 28.00
    10347 S HWY 99           Time Allowed: 30.00
    PRAGUE , OK   74864           Percent Time: 93.33 %

  Paid To Date: $95,400.22 Payable This Statement: $-4,882.53

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.                                
GARY A. CRAIN, 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:    05/29/2014
Contract ID: 120179   Estimate Number: 0003     Contract No: 810011
Residency: BUFFALO (06100)   Estimate Type: Final     Account No: 404600

Project Number(s): SSP-202C(002)SS
Primary Job Piece No: 23274(09)
Contract Description: BRIDGE WATERPROOF SEAL US-60/US-64/US-281/SH-8/SH-50: VARIOUS LOCATIONS IN DIVISION VI.
Primary County: ALFALFA              
Name of Road: MULTIPLE LOCATIONS              
Prime Contractor: GARY A. CRAIN, INC.              
    10347 S HWY 99              
    PRAGUE , OK   74864              
Surety Company: EMPLOYERS MUTUAL CASUALTY COMPANY              

Date Let: 05/17/2012 NTP Effective Date: 04/15/2013 Pay Period: 05/16/2013  TO  05/29/2014
Date Awarded: 06/04/2012 Date Work Began: 04/15/2013 Original Contract Time: 30
Date Contract Executed: 06/19/2012 Date Time Stopped: 01/23/2014 Current Time Charged: 28.00
Date NTP Issued: 06/21/2012 Completion Date: 01/23/2014 Current Time Allowed: 30.00
General Liability Expires: 07/01/2014 Workman's Comp Expires: 07/01/2014 Percent Time Used: 93.33 %
Specification Year: 2009        

Bid Amount: $106,422.75 Total to Date Prev to Date This Estimate
Funds Available (Bid + Positive C/O): $106,422.75 Participating: $0.00 $0.00 $0.00
Percent Complete: 89.64 % Non Participating: $100,282.75 $100,282.75 $0.00
Unearned Balance: $11,022.53 Total Earnings: $100,282.75 $100,282.75 $0.00
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $100,282.75 $100,282.75 $0.00
Other Adjustments: $-4,882.53 $0.00 $-4,882.53
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $95,400.22 $100,282.75 $-4,882.53

Estimate Adjustment Detail

Contract ID: 120179   Estimate Number: 0003     Primary JP: 23274(09)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Change "Notice to proceed date". Approved 12/18/2012 0.0 $0.00
002 Finalizing Contract Item Quantities Approved 05/29/2014 0.0 $-6,140.02


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
23274(09) 0001 WATER REPELLENT (PERFORMANCE TESTED) * PENETRATION 0003 0.00 $0.00 $-4,882.53
Subtotals For Line Item Adjustments $-4,882.53
* = 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: 120179   Estimate Number: 0003     Primary JP: 23274(09)



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:    SSP-202C(002)SS Project:    23274(09) Category:    0200/BRIDGE A
0001 WATER REPELLENT (PERFORMANCE TESTED) 515(B) 6014 SY 703.000 686.220 0.000 686.220 $4.50 $0.00 $3,087.99
0002 SEALER CRACK PREPARATION 523(A) 6550 LF 432.300 586.000   586.000 $2.50 $0.00 $1,465.00
0003 SEALER RESIN 523(B) 6560 GAL 3.500 2.000   2.000 $50.00 $0.00 $100.00
Subtotals For Category     0200/BRIDGE A    $0.00 $4,652.99
Fed/State Project Number:    SSP-202C(002)SS Project:    23274(09) Category:    0201/BRIDGE B
0004 WATER REPELLENT (PERFORMANCE TESTED) 515(B) 6014 SY 3,226.000 3,160.000   3,160.000 $4.50 $0.00 $14,220.00
0005 SEALER CRACK PREPARATION 523(A) 6550 LF 1,982.800 4,760.300   4,760.300 $2.50 $0.00 $11,900.75
0006 SEALER RESIN 523(B) 6560 GAL 15.900 9.000   9.000 $50.00 $0.00 $450.00
Subtotals For Category     0201/BRIDGE B    $0.00 $26,570.75
Fed/State Project Number:    SSP-202C(002)SS Project:    23274(09) Category:    0202/BRIDGE C
0007 WATER REPELLENT (PERFORMANCE TESTED) 515(B) 6014 SY 419.000 417.800   417.800 $4.50 $0.00 $1,880.10
0008 SEALER CRACK PREPARATION 523(A) 6550 LF 259.000 346.000   346.000 $2.50 $0.00 $865.00
0009 SEALER RESIN 523(B) 6560 GAL 2.100 1.000   1.000 $50.00 $0.00 $50.00
Subtotals For Category     0202/BRIDGE C    $0.00 $2,795.10
Fed/State Project Number:    SSP-202C(002)SS Project:    23274(09) Category:    0203/BRIDGE D
0010 WATER REPELLENT (PERFORMANCE TESTED) 515(B) 6014 SY 1,040.000 1,022.200   1,022.200 $4.50 $0.00 $4,599.90
0011 SEALER CRACK PREPARATION 523(A) 6550 LF 642.600 1,478.800   1,478.800 $2.50 $0.00 $3,697.00
0012 SEALER RESIN 523(B) 6560 GAL 5.200 3.000   3.000 $50.00 $0.00 $150.00
Subtotals For Category     0203/BRIDGE D    $0.00 $8,446.90
Fed/State Project Number:    SSP-202C(002)SS Project:    23274(09) Category:    0204/BRIDGE E
0013 WATER REPELLENT (PERFORMANCE TESTED) 515(B) 6014 SY 517.000 0.000   0.000 $4.50 $0.00 $0.00
0014 SEALER CRACK PREPARATION 523(A) 6550 LF 321.700 0.000   0.000 $2.50 $0.00 $0.00
0015 SEALER RESIN 523(B) 6560 GAL 2.600 0.000   0.000 $50.00 $0.00 $0.00
Subtotals For Category     0204/BRIDGE E    $0.00 $0.00
Fed/State Project Number:    SSP-202C(002)SS Project:    23274(09) Category:    0205/BRIDGE F
0016 WATER REPELLENT (PERFORMANCE TESTED) 515(B) 6014 SY 1,583.000 1,555.500   1,555.500 $4.50 $0.00 $6,999.75
0017 SEALER CRACK PREPARATION 523(A) 6550 LF 978.700 244.900   244.900 $2.50 $0.00 $612.25
0018 SEALER RESIN 523(B) 6560 GAL 7.900 1.000   1.000 $50.00 $0.00 $50.00
Subtotals For Category     0205/BRIDGE F    $0.00 $7,662.00
Fed/State Project Number:    SSP-202C(002)SS Project:    23274(09) Category:    0206/BRIDGE G
0019 WATER REPELLENT (PERFORMANCE TESTED) 515(B) 6014 SY 305.000 263.840   263.840 $4.50 $0.00 $1,187.28
0020 SEALER CRACK PREPARATION 523(A) 6550 LF 191.800 177.800   177.800 $2.50 $0.00 $444.50
0021 SEALER RESIN 523(B) 6560 GAL 1.600 1.000   1.000 $50.00 $0.00 $50.00
Subtotals For Category     0206/BRIDGE G    $0.00 $1,681.78
Fed/State Project Number:    SSP-202C(002)SS Project:    23274(09) Category:    0207/BRIDGE H
0022 WATER REPELLENT (PERFORMANCE TESTED) 515(B) 6014 SY 705.000 691.110   691.110 $4.50 $0.00 $3,110.00
0023 SEALER CRACK PREPARATION 523(A) 6550 LF 435.400 521.700   521.700 $2.50 $0.00 $1,304.25
0024 SEALER RESIN 523(B) 6560 GAL 3.500 1.000   1.000 $50.00 $0.00 $50.00
Subtotals For Category     0207/BRIDGE H    $0.00 $4,464.25
Fed/State Project Number:    SSP-202C(002)SS Project:    23274(09) Category:    0208/BRIDGE I
0025 WATER REPELLENT (PERFORMANCE TESTED) 515(B) 6014 SY 4,807.000 4,718.530 0.000 4,718.530 $4.50 $0.00 $21,233.39
0026 SEALER CRACK PREPARATION 523(A) 6550 LF 2,972.700 863.100   863.100 $2.50 $0.00 $2,157.75
0027 SEALER RESIN 523(B) 6560 GAL 23.800 3.500   3.500 $50.00 $0.00 $175.00
Subtotals For Category     0208/BRIDGE I    $0.00 $23,566.14
Fed/State Project Number:    SSP-202C(002)SS Project:    23274(09) Category:    0209/BRIDGE J
0028 WATER REPELLENT (PERFORMANCE TESTED) 515(B) 6014 SY 1,629.000 1,598.130   1,598.130 $4.50 $0.00 $7,191.59
0029 SEALER CRACK PREPARATION 523(A) 6550 LF 1,006.900 460.500   460.500 $2.50 $0.00 $1,151.25
0030 SEALER RESIN 523(B) 6560 GAL 8.100 2.000   2.000 $50.00 $0.00 $100.00
Subtotals For Category     0209/BRIDGE J    $0.00 $8,442.84
Fed/State Project Number:    SSP-202C(002)SS Project:    23274(09) Category:    0300/TRAFFIC CONTROL
0031 (PL)TRUCK MOUNTED ATTENUATOR 876(A) 8482 SD 30.000 0.000   0.000 $5.00 $0.00 $0.00
0032 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $2,000.00 $0.00 $2,000.00
0033 PORT.CHANGEABLE MESSAGE SIGN 882(A) 8306 SD 60.000 0.000   0.000 $5.00 $0.00 $0.00
Subtotals For Category     0300/TRAFFIC CONTROL    $0.00 $2,000.00
Fed/State Project Number:    SSP-202C(002)SS Project:    23274(09) Category:    0640/CONSTRUCTION
0034 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $10,000.00 $0.00 $10,000.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $10,000.00
Subtotals For Project SSP-202C(002)SS /23274(09) $0.00 $100,282.75