Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 120208   Estimate Number: 0005 , Final     Spec Year: 2009
Primary JP: 28320(04)   Residency: ENGINEERING SERVICES & TESTING (08001)     Contract No: 810144
Date Created: 03/20/2013   Contractor FEI: 208746250     Account No: 432800

Project Number(s): STP-121C(152)CO
Contract Description: RESURFACE (ASPHALT) COUNTY ROAD (OLD SH-33/E 580): BEGIN AT US-412 EXTEND EAST. PROJECT LENGTH = 2.42 MILES.
Primary County: DELAWARE              
Name of Road: COUNTY ROAD              
Prime Contractor: GLOVER & ASSOCIATES, INC.           Time Charged: N/A
    2832 N. COUNTRY CLUB           Time Allowed: N/A
    MUSKOGEE , OK   74403           Percent Time: N/A

  Paid To Date: $442,104.08 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.                                
GLOVER & 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:    03/20/2013
Contract ID: 120208   Estimate Number: 0005     Contract No: 810144
Residency: ENGINEERING SERVICES & TESTING (08001)   Estimate Type: Final     Account No: 432800

Project Number(s): STP-121C(152)CO
Primary Job Piece No: 28320(04)
Contract Description: RESURFACE (ASPHALT) COUNTY ROAD (OLD SH-33/E 580): BEGIN AT US-412 EXTEND EAST. PROJECT LENGTH = 2.42 MILES.
Primary County: DELAWARE              
Name of Road: COUNTY ROAD              
Prime Contractor: GLOVER & ASSOCIATES, INC.              
    2832 N. COUNTRY CLUB              
    MUSKOGEE , OK   74403              
Surety Company: WESTFIELD INSURANCE COMPANY              

Date Let: 06/21/2012 NTP Effective Date: 10/15/2012 Pay Period: 03/01/2013  TO  03/20/2013
Date Awarded: 07/02/2012 Date Work Began: 09/10/2012 Original Contract Time: N/A
Date Contract Executed: 07/17/2012 Date Time Stopped: 10/26/2012 Current Time Charged: N/A
Date NTP Issued: 07/18/2012 Completion Date: 10/26/2012 Current Time Allowed: N/A
General Liability Expires: 02/01/2014 Workman's Comp Expires: 02/01/2014 Percent Time Used: N/A
Specification Year: 2009 FIXED COMPLETION DATE: 10/31/2012    

Current Contract Amount: $451,036.62 Total to Date Prev to Date This Estimate
Bid Amount: $498,118.77 Participating: $451,036.62 $451,036.62 $0.00
Percent Complete: 98.02 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $8,932.54 Total Earnings: $451,036.62 $451,036.62 $0.00
Unearned Balance: $56,014.69 Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $451,036.62 $451,036.62 $0.00
Other Adjustments: $-8,932.54 $-8,932.54 $0.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $442,104.08 $442,104.08 $0.00

Estimate Adjustment Detail

Contract ID: 120208   Estimate Number: 0005     Primary JP: 28320(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Final Quantity Change Order Approved 03/19/2013 0.0 $-47,082.15


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
28320(04) 0007 SUPERPAVE, TYPE S4(PG 64-22 OK) * HMA Deduction as per Sec. 411 0002 0.00 $0.00 $-5,040.00
28320(04) 0007 SUPERPAVE, TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0002 4,080.23 $-0.95 $-3,892.54
Subtotals For Line Item Adjustments $-8,932.54
* = 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: 120208   Estimate Number: 0005     Primary JP: 28320(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:    STP-121C(152)CO Project:    28320(04) Category:    0100/ROADWAY
0001 UNCLASSIFIED EXCAVATION 202(A) 0183 CY 1,700.000 1,700.000   1,700.000 $9.00 $0.00 $15,300.00
0002 SELECT BORROW 202(E) 0186 CY 2,000.000 0.000   0.000 $4.00 $0.00 $0.00
0003 TYPE A-SALVAGED TOPSOIL 205(A) 4229 LSUM 1.000 1.000   1.000 $5,000.00 $0.00 $5,000.00
0004 SEEDING METHOD A 232(A) 2813 AC 3.500 0.000   0.000 $2,400.00 $0.00 $0.00
0005 TRAFFIC BOUND SURFACE COURSE TYPE D 402(D) 0223 TON 2,883.000 1,716.020   1,716.020 $21.00 $0.00 $36,036.42
0006 PRIME COAT 408 5774 GAL 5,400.000 0.000   0.000 $0.50 $0.00 $0.00
0007 SUPERPAVE, TYPE S4(PG 64-22 OK) 411(C) 5960 TON 4,033.000 4,080.230   4,080.230 $73.00 $0.00 $297,856.79
0008 COLD MILLING PAVEMENT 412 5267 SY 31,306.000 31,271.780   31,271.780 $0.95 $0.00 $29,708.19
0009 REMOVAL OF GUARDRAIL 619(B) 4780 LF 400.000 400.000   400.000 $6.00 $0.00 $2,400.00
0010 BEAM GUARDRAIL W-BEAM SINGLE 623(A) 0932 LF 600.000 487.500   487.500 $17.00 $0.00 $8,287.50
0011 GUARDRAIL END TREATMENT (GET) 623(G) 8571 EA 12.000 10.000   10.000 $2,400.00 $0.00 $24,000.00
0012 MAILBOX INSTALLATION-SINGLE 629(A) 4958 EA 22.000 22.000   22.000 $110.00 $0.00 $2,420.00
0013 MAILBOX INSTALLATION-MULTIPLE 629(B) 4959 EA 3.000 3.000   3.000 $155.00 $0.00 $465.00
0014 MAILBOX 629(C) 4960 EA 28.000 28.000   28.000 $26.00 $0.00 $728.00
0015 REMOVAL OF MAILBOX INSTALLATION 629(D) 4961 EA 27.000 27.000   27.000 $39.00 $0.00 $1,053.00
0016 SHEET ALUMINUM SIGNS 850(A) 8110 SF 20.000 20.000   20.000 $21.00 $0.00 $420.00
0017 2 1/4" SQUARE TUBE POST 851(C) 8327 LF 48.000 48.000   48.000 $11.00 $0.00 $528.00
0018 DELINEATORS(TYPE 2, CODE 1) 853 9033 EA 20.000 16.000   16.000 $15.00 $0.00 $240.00
0019 TRAFFIC STRIPE(PAINT)(4" WIDE) 854(A) 8800 LF 50,437.000 50,152.000   50,152.000 $0.11 $0.00 $5,516.72
0020 TRAFFIC STRIPE(PLASTIC)(24" WIDE) 855(A) 8825 LF 16.000 13.000   13.000 $29.00 $0.00 $377.00
0021 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $1,700.00 $0.00 $1,700.00
Subtotals For Category     0100/ROADWAY    $0.00 $432,036.62
Fed/State Project Number:    STP-121C(152)CO Project:    28320(04) Category:    0600/STAKING
0022 CONSTRUCTION STAKING LEVEL II 642(B) 0096 LSUM 1.000 1.000   1.000 $7,000.00 $0.00 $7,000.00
Subtotals For Category     0600/STAKING    $0.00 $7,000.00
Fed/State Project Number:    STP-121C(152)CO Project:    28320(04) Category:    0640/CONSTRUCTION
0023 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $12,000.00 $0.00 $12,000.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $12,000.00
Subtotals For Project STP-121C(152)CO /28320(04) $0.00 $451,036.62