Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 120196   Estimate Number: 0016 , Final     Spec Year: 2009
Primary JP: 29079(04)   Residency: MADILL (02300)     Contract No: 810264
Date Created: 01/22/2015   Contractor FEI: 730960939     Account No: 400200

Project Number(s): HSIPG-013N(156)TR, HSIPG-013N(157)TR
Contract Description: SAFETY IMPROVEMENT (CABLE BARRIER AND INTERSECTION MODIFICATION) US-69: FROM JUST NORTH OF COLBERT EXTEND NORTH, AND FROM BLUE RIVER EXTEND NORTH. PROJECT LENGTH = 13.109 MILES.
Primary County: BRYAN              
Name of Road: US-69              
Prime Contractor: MIDSTATE TRAFFIC CONTROL, INC.           Time Charged: 267.00
    12501 N. SANTA FE AVE.           Time Allowed: 256.00
    OKLAHOMA CITY , OK   73114           Percent Time: 104.30 %

  Paid To Date: $1,800,521.92 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.                                
MIDSTATE TRAFFIC CONTROL, 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:    01/22/2015
Contract ID: 120196   Estimate Number: 0016     Contract No: 810264
Residency: MADILL (02300)   Estimate Type: Final     Account No: 400200

Project Number(s): HSIPG-013N(156)TR, HSIPG-013N(157)TR
Primary Job Piece No: 29079(04)
Contract Description: SAFETY IMPROVEMENT (CABLE BARRIER AND INTERSECTION MODIFICATION) US-69: FROM JUST NORTH OF COLBERT EXTEND NORTH, AND FROM BLUE RIVER EXTEND NORTH. PROJECT LENGTH = 13.109 MILES.
Primary County: BRYAN              
Name of Road: US-69              
Prime Contractor: MIDSTATE TRAFFIC CONTROL, INC.              
    12501 N. SANTA FE AVE.              
    OKLAHOMA CITY , OK   73114              
Surety Company: LIBERTY MUTUAL INSURANCE COMPANY              

Date Let: 07/19/2012 NTP Effective Date: 11/05/2012 Pay Period: 11/01/2014  TO  11/12/2014
Date Awarded: 08/06/2012 Date Work Began: 11/08/2012 Original Contract Time: 180
Date Contract Executed: 08/21/2012 Date Time Stopped: 10/31/2013 Current Time Charged: 267.00
Date NTP Issued: 08/24/2012 Completion Date: 10/31/2013 Current Time Allowed: 256.00
General Liability Expires: 03/01/2015 Workman's Comp Expires: 03/01/2015 Percent Time Used: 104.30 %
Specification Year: 2009        

Bid Amount: $2,115,063.70 Total to Date Prev to Date This Estimate
Funds Available (Bid + Positive C/O): $2,126,154.87 Participating: $1,807,181.07 $1,807,181.07 $0.00
Percent Complete: 84.68 % Non Participating: $0.00 $0.00 $0.00
Unearned Balance: $325,632.95 Total Earnings: $1,807,181.07 $1,807,181.07 $0.00
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $1,807,181.07 $1,807,181.07 $0.00
Other Adjustments: $-2,159.15 $-2,159.15 $0.00
Liq Dam/Disincentive: $-4,500.00 $-4,500.00 $0.00
TOTAL: $1,800,521.92 $1,800,521.92 $0.00

Estimate Adjustment Detail

Contract ID: 120196   Estimate Number: 0016     Primary JP: 29079(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Cable Barrier ( Safety Improvement ) Approved 07/14/2014 76.0 $0.00
002 Safety Improvement (Cable Barrier and Int. Modification US69 Approved 10/06/2014 0.0 $-318,968.80
003 SAFETY IMPROVEMENT (CABLE BARRIER AND INTERSECTION MODIFICAT Approved 10/03/2014 0.0 $11,091.17


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
System Application of Liquidated Damages 0010 --53 $750.00 $-39,750.00
System Application of Liquidated Damages 0011 --13 $750.00 $-9,750.00
System Application of Liquidated Damages 0012 --16 $750.00 $-12,000.00
System Application of Liquidated Damages 0014 --3.0 $750.00 $-2,250.00
System Application of Liquidated Damages 0015 -79.0 $750.00 $59,250.00
Subtotals For Liquidated Damages $-4,500.00


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
29080(04) 0030 SUPERPAVE, TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0011 791.68 $-1.56 $-1,242.74
29080(04) 0031 SUPERPAVE, TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0011 510.82 $-1.79 $-916.41
Subtotals For Line Item Adjustments $-2,159.15


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: 120196   Estimate Number: 0016     Primary JP: 29079(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:    HSIPG-013N(156)TR Project:    29079(04) Category:    0300/TRAFFIC CONTROL - HSIPG-013N(156)TR
0001 (PL)TRUCK MOUNTED ATTENUATOR 876(A) 8482 SD 60.000 0.000   0.000 $5.00 $0.00 $0.00
0002 ARROW DISPLAY(TYPE C) 880(A) 8812 SD 60.000 16.000   16.000 $5.00 $0.00 $80.00
0003 CONSTRUCTION SIGNS 0 TO 6.25 SF 880(B) 8818 SD 1,860.000 0.000   0.000 $0.10 $0.00 $0.00
0004 CONSTRUCTION SIGNS 6.26 SF TO 15.99 SF 880(B) 8821 SD 1,440.000 0.000   0.000 $0.10 $0.00 $0.00
0005 CONSTRUCTION SIGNS 16.0 SF TO 32.99 SF 880(B) 8824 SD 1,320.000 128.000   128.000 $3.00 $0.00 $384.00
0006 CONSTRUCTION BARRICADES(TYPE III) 880(C) 8842 SD 900.000 0.000   0.000 $0.10 $0.00 $0.00
0007 WING BARRICADES 880(C) 8848 SD 240.000 0.000   0.000 $2.00 $0.00 $0.00
0008 WARNING LIGHTS(TYPE A) 880(E) 8860 SD 2,460.000 0.000   0.000 $0.01 $0.00 $0.00
0009 DRUMS 880(F) 8878 SD 1,800.000 0.000   0.000 $0.01 $0.00 $0.00
0010 CHANNELIZER CONES 880(G) 8890 SD 17,100.000 1,440.000   1,440.000 $0.01 $0.00 $14.40
0011 TRAFFIC SURVEILLANCE, POLICE 880(L) 8911 HOUR 480.000 0.000   0.000 $68.00 $0.00 $0.00
0012 PORT.CHANGEABLE MESSAGE SIGN 882(A) 8306 SD 240.000 0.000   0.000 $5.00 $0.00 $0.00
Subtotals For Category     0300/TRAFFIC CONTROL - HSIPG-013N(156)TR    $0.00 $478.40
Fed/State Project Number:    HSIPG-013N(156)TR Project:    29079(04) Category:    0304/CABLE BARRIER - HSIPG-013N(156)TR
0013 TEMPORARY SILT FENCE 221(C) 2801 LF 1,150.000 0.000   0.000 $1.50 $0.00 $0.00
0014 TEMPORARY SEDIMENT FILTER 221(D) 2803 EA 20.000 0.000   0.000 $80.00 $0.00 $0.00
0015 TEMPORARY SILT DIKE 221(F) 0100 LF 1,456.000 0.000   0.000 $3.00 $0.00 $0.00
0016 SOLID SLAB SODDING 230(A) 2806 SY 26,270.000 0.000   0.000 $1.40 $0.00 $0.00
0017 MOWING 241 2832 AC 70.000 32.000   32.000 $50.00 $0.00 $1,600.00
0018 TRAFFIC BOUND SURFACE COURSE TYPE E 402(E) 0225 TON 7,936.000 296.720   296.720 $26.00 $0.00 $7,714.72
0019 CLASS AA CONCRETE 509(A) 0319 CY 314.000 410.500   410.500 $285.00 $0.00 $116,992.50
0020 CLASS C CONCRETE 509(D) 0325 CY 25.000 0.000   0.000 $250.00 $0.00 $0.00
0021 INLET ADJUST TO GRADE 612(C) 0645 EA 20.000 0.000   0.000 $1,700.00 $0.00 $0.00
0022 SAWING PAVEMENT 619(C) 0924 LF 100.000 0.000   0.000 $1.00 $0.00 $0.00
0023 HIGH-TENSION CABLE BARRIER(TL-4) 628(B) 5125 LF 33,744.000 33,744.000   33,744.000 $8.75 $0.00 $295,260.00
0024 END ANCHORS 628(C) 5110 EA 2.000 2.000   2.000 $1,100.00 $0.00 $2,200.00
0025 CABLE BARRIER TENSION METER 628(E) 5175 EA 1.000 1.000   1.000 $2,000.00 $0.00 $2,000.00
Subtotals For Category     0304/CABLE BARRIER - HSIPG-013N(156)TR    $0.00 $425,767.22
Subtotals For Project HSIPG-013N(156)TR /29079(04) $0.00 $426,245.62


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:    HSIPG-013N(157)TR Project:    29080(04) Category:    0100/ROADWAY - HSIPG-013N(157)TR
0026 AGGREGATE BASE TYPE A 303(A) 2100 CY 402.000 908.960   908.960 $26.00 $0.00 $23,632.96
0027 SEPARATOR FABRIC 325 5271 SY 1,560.000 4,500.000   4,500.000 $1.25 $0.00 $5,625.00
0028 TACK COAT 407(B) 0250 GAL 195.000 250.000   250.000 $6.00 $0.00 $1,500.00
0029 PRIME COAT 408 5774 GAL 465.000 650.000   650.000 $11.00 $0.00 $7,150.00
0030 SUPERPAVE, TYPE S3(PG 64-22 OK) 411(B) 5945 TON 297.000 791.680   791.680 $150.00 $0.00 $118,752.00
0031 SUPERPAVE, TYPE S4(PG 64-22 OK) 411(C) 5960 TON 147.000 510.820   510.820 $235.00 $0.00 $120,042.70
0032 EDGE DRAIN CONDUIT-PERFORATED 613(J) 5915 LF 1,050.000 0.000   0.000 $10.00 $0.00 $0.00
0033 EDGE DRAIN OUTLET LATERAL-NONPERFORATED 613(K) 5916 LF 300.000 0.000   0.000 $15.00 $0.00 $0.00
0034 PIPE UNDERDRAIN COVER MAT'L. 613(U) 1100 CY 69.000 0.000   0.000 $45.00 $0.00 $0.00
0035 REMOVAL OF ASPHALT PAVEMENT 619(B) 4728 SY 402.000 1,270.700   1,270.700 $20.00 $0.00 $25,414.00
0036 SAWING PAVEMENT 619(C) 0924 LF 1,200.000 0.000   0.000 $1.00 $0.00 $0.00
8000 SOLID SLAB SODDING 230(A) 2806 SY 0.000 79,222.670   79,222.670 $0.14 $0.00 $11,091.17
Subtotals For Category     0100/ROADWAY - HSIPG-013N(157)TR    $0.00 $313,207.83
Fed/State Project Number:    HSIPG-013N(157)TR Project:    29080(04) Category:    0300/TRAFFIC CONTROL - HSIPG-013N(157)TR
0037 TRAFFIC STRIPE(PLASTIC)(4" WIDE) 855(A) 8812 LF 3,500.000 4,421.000   4,421.000 $2.00 $0.00 $8,842.00
0038 PAVEMENT MARKING REMOVAL(TRAFFIC STRIPE) 857(F) 8006 LF 1,000.000 1,407.000   1,407.000 $1.20 $0.00 $1,688.40
0039 (PL)TRUCK MOUNTED ATTENUATOR 876(A) 8482 SD 120.000 1.000   0.000 $5.00 $0.00 $0.00
0040 ARROW DISPLAY(TYPE C) 880(A) 8812 SD 120.000 84.000   84.000 $5.00 $0.00 $420.00
0041 CONSTRUCTION SIGNS 0 TO 6.25 SF 880(B) 8818 SD 3,720.000 124.000   124.000 $0.10 $0.00 $12.40
0042 CONSTRUCTION SIGNS 6.26 SF TO 15.99 SF 880(B) 8821 SD 2,880.000 304.000   304.000 $0.10 $0.00 $30.40
0043 CONSTRUCTION SIGNS 16.0 SF TO 32.99 SF 880(B) 8824 SD 2,640.000 1,401.000   1,401.000 $3.00 $0.00 $4,203.00
0044 CONSTRUCTION BARRICADES(TYPE III) 880(C) 8842 SD 1,800.000 474.000   474.000 $0.10 $0.00 $47.40
0045 WING BARRICADES 880(C) 8848 SD 480.000 0.000   0.000 $2.00 $0.00 $0.00
0046 WARNING LIGHTS(TYPE A) 880(E) 8860 SD 4,920.000 0.000   0.000 $0.01 $0.00 $0.00
0047 DRUMS 880(F) 8878 SD 3,600.000 768.000   768.000 $0.01 $0.00 $7.68
0048 CHANNELIZER CONES 880(G) 8890 SD 34,200.000 31,510.000   31,510.000 $0.01 $0.00 $315.10
0049 TRAFFIC SURVEILLANCE, POLICE 880(L) 8911 HOUR 200.000 0.000   0.000 $68.00 $0.00 $0.00
0050 PORT.CHANGEABLE MESSAGE SIGN 882(A) 8306 SD 480.000 0.000   0.000 $5.00 $0.00 $0.00
Subtotals For Category     0300/TRAFFIC CONTROL - HSIPG-013N(157)TR    $0.00 $15,566.38
Fed/State Project Number:    HSIPG-013N(157)TR Project:    29080(04) Category:    0304/CABLE BARRIER - HSIPG-013N(157)TR
0051 UNCLASSIFIED EXCAVATION 202(A) 0183 CY 5,158.000 5,158.000   5,158.000 $10.00 $0.00 $51,580.00
0052 UNCLASSIFIED BORROW 202(D) 0184 CY 14,080.000 14,080.000   14,080.000 $15.00 $0.00 $211,200.00
0053 TEMPORARY SILT FENCE 221(C) 2801 LF 1,150.000 0.000   0.000 $1.50 $0.00 $0.00
0054 TEMPORARY SEDIMENT FILTER 221(D) 2803 EA 17.000 0.000   0.000 $80.00 $0.00 $0.00
0055 TEMPORARY SILT DIKE 221(F) 0100 LF 1,484.000 0.000   0.000 $3.00 $0.00 $0.00
0056 SOLID SLAB SODDING 230(A) 2806 SY 104,656.000 25,433.300   25,433.300 $1.40 $0.00 $35,606.62
0057 MOWING 241 2832 AC 58.000 0.000   0.000 $50.00 $0.00 $0.00
0058 TRAFFIC BOUND SURFACE COURSE TYPE E 402(E) 0225 TON 6,606.000 6,832.620   6,832.620 $26.00 $0.00 $177,648.12
0059 CLASS AA CONCRETE 509(A) 0319 CY 446.000 439.500   439.500 $285.00 $0.00 $125,257.50
0060 CLASS C CONCRETE 509(D) 0325 CY 337.000 0.000   0.000 $220.00 $0.00 $0.00
0061 INLET (SMD-TYPE 2) 611(G) 6002 EA 1.000 0.000   0.000 $5,000.00 $0.00 $0.00
0062 ADDITIONAL DEPTH IN INLET 611(H) 5196 VF 0.480 0.000   0.000 $350.00 $0.00 $0.00
0063 INLET ADJUST TO GRADE 612(C) 0645 EA 16.000 11.000   11.000 $1,700.00 $0.00 $18,700.00
0064 17" X 13" CORR. GALV. STEEL PIPE ARCH 613(B) 4525 LF 40.000 0.000   0.000 $28.00 $0.00 $0.00
0065 21" X 15" CORR. GALV. STEEL PIPE ARCH 613(B) 4527 LF 120.000 320.000   320.000 $35.00 $0.00 $11,200.00
0066 24" X 18" CORR. GALV. STEEL PIPE ARCH 613(B) 5168 LF 40.000 0.000   0.000 $40.00 $0.00 $0.00
0067 17" X 13" PREFAB. CULVERT END SECTION, ARCH 613(L) 4501 EA 4.000 0.000   0.000 $235.00 $0.00 $0.00
0068 TYPE A6 CULVERT END TREATMENT 613(M) 7196 EA 8.000 16.000   16.000 $1,700.00 $0.00 $27,200.00
0069 REMOVAL OF EXISTING PIPE 619(B) 5918 LF 7.000 0.000   0.000 $20.00 $0.00 $0.00
0070 SAWING PAVEMENT 619(C) 0924 LF 100.000 3,012.000   3,012.000 $1.00 $0.00 $3,012.00
0071 HIGH-TENSION CABLE BARRIER(TL-4) 628(B) 5125 LF 33,414.000 33,128.000   33,128.000 $8.75 $0.00 $289,870.00
0072 END ANCHORS 628(C) 5110 EA 44.000 52.000   52.000 $1,100.00 $0.00 $57,200.00
0073 CABLE BARRIER TENSION METER 628(E) 5175 EA 1.000 1.000   1.000 $2,000.00 $0.00 $2,000.00
Subtotals For Category     0304/CABLE BARRIER - HSIPG-013N(157)TR    $0.00 $1,010,474.24
Fed/State Project Number:    HSIPG-013N(157)TR Project:    29080(04) Category:    0600/STAKING
0074 CONSTRUCTION STAKING LEVEL II 642(B) 0096 LSUM 1.000 1.000   1.000 $6,000.00 $0.00 $6,000.00
Subtotals For Category     0600/STAKING    $0.00 $6,000.00
Fed/State Project Number:    HSIPG-013N(157)TR Project:    29080(04) Category:    0640/CONSTRUCTION
0075 MOBILIZATION 641 1552 LSUM 1.000 1.000   1.000 $35,687.00 $0.00 $35,687.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $35,687.00
Subtotals For Project HSIPG-013N(157)TR /29080(04) $0.00 $1,380,935.45


1 CURRENT QUANTITIES DO NOT MATCH THE QUANTITY PAID TO DATE