Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 120239   Estimate Number: 0009 , Final     Spec Year: 2009
Primary JP: 26851(04)   Residency: ANADARKO (07300)     Contract No: 810213
Date Created: 08/29/2013   Contractor FEI: 731269842     Account No: 436700

Project Number(s): BRO-126D(176)CI
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD (NS-285): OVER SALT CREEK, 1.7 MILES NORTH AND 2.0 MILES EAST OF POCASSET. PROJECT LENGTH = 0.340 MILES.
Primary County: GRADY              
Name of Road: COUNTY ROAD              
Prime Contractor: D. M. DOZERS, INC.           Time Charged: 101.00
    766 S. TERRY AVE.           Time Allowed: 90.00
    BRADLEY , OK   73011           Percent Time: 112.22 %

  Paid To Date: $471,398.60 Payable This Statement: $1,265.22

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.                                
D. M. DOZERS, 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:    08/29/2013
Contract ID: 120239   Estimate Number: 0009     Contract No: 810213
Residency: ANADARKO (07300)   Estimate Type: Final     Account No: 436700

Project Number(s): BRO-126D(176)CI
Primary Job Piece No: 26851(04)
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD (NS-285): OVER SALT CREEK, 1.7 MILES NORTH AND 2.0 MILES EAST OF POCASSET. PROJECT LENGTH = 0.340 MILES.
Primary County: GRADY              
Name of Road: COUNTY ROAD              
Prime Contractor: D. M. DOZERS, INC.              
    766 S. TERRY AVE.              
    BRADLEY , OK   73011              
Surety Company: INTERNATIONAL FIDELITY INSURANCE COMPANY              

Date Let: 06/21/2012 NTP Effective Date: 10/01/2012 Pay Period: 06/01/2013  TO  08/11/2013
Date Awarded: 07/02/2012 Date Work Began: 08/07/2012 Original Contract Time: 90
Date Contract Executed: 07/17/2012 Date Time Stopped: 03/14/2013 Current Time Charged: 101.00
Date NTP Issued: 07/18/2012 Completion Date: 03/14/2013 Current Time Allowed: 90.00
General Liability Expires: 01/01/2014 Workman's Comp Expires: 01/01/2014 Percent Time Used: 112.22 %
Specification Year: 2009        

Current Contract Amount: $476,898.59 Total to Date Prev to Date This Estimate
Bid Amount: $514,292.70 Participating: $476,898.60 $475,633.38 $1,265.22
Percent Complete: 98.85 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $5,499.99 Total Earnings: $476,898.60 $475,633.38 $1,265.22
Unearned Balance: $42,894.10 Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $476,898.60 $475,633.38 $1,265.22
Other Adjustments: $0.00 $0.00 $0.00
Liq Dam/Disincentive: $-5,500.00 $-5,500.00 $0.00
TOTAL: $471,398.60 $470,133.38 $1,265.22

Estimate Adjustment Detail

Contract ID: 120239   Estimate Number: 0009     Primary JP: 26851(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 105.03 Acceptance Concrete Beam Approved 11/29/2012 0.0 $-1,300.00
002 Final Quantity Change Order Approved 08/28/2013 0.0 $-36,094.11


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 0007 --11 $500.00 $-5,500.00
Subtotals For Liquidated Damages $-5,500.00


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
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: 120239   Estimate Number: 0009     Primary JP: 26851(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:    BRO-126D(176)CI Project:    26851(04) Category:    0100/ROADWAY
0001 CLEARING AND GRUBBING 201(A) 0102 LSUM 1.000 1.000   1.000 $3,000.00 $0.00 $3,000.00
0002 EARTHWORK 202(H) 0185 LSUM 1.000 1.000   1.000 $55,000.00 $0.00 $55,000.00
0003 TEMPORARY SILT FENCE 221(C) 2801 LF 3,600.000 1,321.000   1,321.000 $1.80 $0.00 $2,377.80
0004 TEMPORARY SILT DIKE 221(F) 0100 LF 600.000 154.000 154.000 154.000 $8.00 $1,232.00 $1,232.00
0005 SOLID SLAB SODDING 230(A) 2806 SY 16,400.000 13,942.620 0.010 13,942.620 $1.50 $0.02 $20,913.94
0006 VEGETATIVE MULCHING 233(A) 2817 AC 6.500 0.000   0.000 $500.00 $0.00 $0.00
0007 AGGREGATE BASE TYPE A 303(A) 2100 CY 860.000 917.870 0.830 917.870 $40.00 $33.20 $36,714.80
0008 PRIME COAT 408 5774 GAL 1,135.000 0.000   0.000 $6.00 $0.00 $0.00
0009 CLASS C CONCRETE 509(D) 0325 CY 10.000 0.000   0.000 $200.00 $0.00 $0.00
0010 TYPE I PLAIN RIPRAP 601(A) 0297 TON 170.000 157.850   157.850 $38.00 $0.00 $5,998.30
0011 48" R.C.PIPE CLASS III 613(A) 0496 LF 44.000 48.000   48.000 $130.00 $0.00 $6,240.00
0012 18" CORR. GALV. STEEL PIPE 613(B) 0689 LF 46.000 0.000   0.000 $18.00 $0.00 $0.00
0013 18" PREFAB. CULVERT END SECTION, ROUND 613(L) 5726 EA 2.000 0.000   0.000 $140.00 $0.00 $0.00
0014 SPECIAL END SECTION OF 48" RCP ROUND 613(O) 4383 EA 2.000 2.000   2.000 $1,400.00 $0.00 $2,800.00
Subtotals For Category     0100/ROADWAY    $1,265.22 $134,276.84
Fed/State Project Number:    BRO-126D(176)CI Project:    26851(04) Category:    0200/BRIDGE
0015 SUBSTRUCTURE EXCAVATION COMMON 501(B) 1307 CY 100.000 100.000   100.000 $15.00 $0.00 $1,500.00
0016 GRANULAR BACKFILL 501(F) 6352 CY 70.000 70.000   70.000 $50.00 $0.00 $3,500.00
0017 PRESTRESSED CONCRETE BEAMS (TYPE IV) 503(A) 1313 LF 269.000 269.000   269.000 $240.00 $0.00 $64,560.00
0018 CONCRETE RAIL (TR3) 504(D) 6239 LF 244.600 244.600   244.600 $82.00 $0.00 $20,057.20
0019 STRUCTURAL STEEL 506(A) 1322 LB 320.000 320.000   320.000 $4.00 $0.00 $1,280.00
0020 WEATHERING STEEL FIXED BEARING ASSEMBLY 507(A) 6172 EA 6.000 6.000   6.000 $650.00 $0.00 $3,900.00
0021 CLASS AA CONCRETE 509(A) 1326 CY 93.800 93.800   93.800 $575.00 $0.00 $53,935.00
0022 CLASS A CONCRETE 509(B) 1328 CY 41.800 41.800   41.800 $575.00 $0.00 $24,035.00
0023 REINFORCING STEEL 511(A) 1332 LB 23,730.000 23,730.000   23,730.000 $0.95 $0.00 $22,543.50
0024 PILES, FURNISHED (HP 10X42) 514(A) 6010 LF 966.000 966.000   966.000 $44.00 $0.00 $42,504.00
0025 PILES, DRIVEN (HP 10X42) 514(B) 6292 LF 966.000 913.610   913.610 $20.00 $0.00 $18,272.20
0026 TYPE I-A PLAIN RIPRAP 601(B) 1353 TON 1,365.000 1,188.210   1,188.210 $36.00 $0.00 $42,775.56
0027 TYPE I-A FILTER BLANKET 601(C) 1355 TON 400.000 182.310   182.310 $30.00 $0.00 $5,469.30
0028 6" PERFORATED PIPE UNDERDRAIN ROUND 613(H) 6204 LF 52.000 52.000   52.000 $20.00 $0.00 $1,040.00
0029 6" NON-PERF.PIPE UNDERDRAIN RND. 613(I) 6207 LF 60.000 60.000   60.000 $20.00 $0.00 $1,200.00
0030 REMOVAL OF EXISTING BRIDGE STRUCTURE 619(D) 1397 LSUM 1.000 1.000   1.000 $3,000.00 $0.00 $3,000.00
0031 BEAM GUARDRAIL W-BEAM SINGLE 623(A) 1418 LF 200.000 200.000   200.000 $14.00 $0.00 $2,800.00
0032 GUARDRAIL ANCHOR UNIT (TYPE D-BF) 623(F) 5686 EA 4.000 4.000   4.000 $1,175.00 $0.00 $4,700.00
0033 GUARDRAIL ANCHOR UNIT (TYPE B) 623(F) 6030 EA 3.000 3.000   3.000 $550.00 $0.00 $1,650.00
0034 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $1,700.00 $0.00 $1,700.00
9000 DEDUCTION FOR FAILING MATERIAL 105 2325 EA 0.000 1.000   1.000 $-1,300.00 $0.00 $-1,300.00
Subtotals For Category     0200/BRIDGE    $0.00 $319,121.76
Fed/State Project Number:    BRO-126D(176)CI Project:    26851(04) Category:    0600/STAKING
0035 CONSTRUCTION STAKING LEVEL II 642(B) 0096 LSUM 1.000 1.000   1.000 $5,000.00 $0.00 $5,000.00
Subtotals For Category     0600/STAKING    $0.00 $5,000.00
Fed/State Project Number:    BRO-126D(176)CI Project:    26851(04) Category:    0640/CONSTRUCTION
0036 SWPPP DOCUMENTATION AND MANAGEMENT 220 2800 LSUM 1.000 1.000   1.000 $500.00 $0.00 $500.00
0037 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $18,000.00 $0.00 $18,000.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $18,500.00
Subtotals For Project BRO-126D(176)CI /26851(04) $1,265.22 $476,898.60