Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 120240   Estimate Number: 0011 , Final     Spec Year: 2009
Primary JP: 26627(04)   Residency: CIRCUIT ENGR. DISTRICT # 7 (05005)     Contract No: 810139
Date Created: 10/03/2013   Contractor FEI: 731427175     Account No: 436500

Project Number(s): BRF-133C(105)CI
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD (EW-169): OVER UNNAMED CREEK, 4.5 MILES EAST OF US-283. PROJECT LENGTH = 0.189 MILES.
Primary County: JACKSON              
Name of Road: COUNTY ROAD              
Prime Contractor: K & R BUILDERS, INC.           Time Charged: 131.00
    P.O. BOX 656           Time Allowed: 122.00
    WHEATLAND , OK   73097           Percent Time: 107.38 %

  Paid To Date: $540,614.31 Payable This Statement: $58.93

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.                                
K & R BUILDERS, 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:    10/03/2013
Contract ID: 120240   Estimate Number: 0011     Contract No: 810139
Residency: CIRCUIT ENGR. DISTRICT # 7 (05005)   Estimate Type: Final     Account No: 436500

Project Number(s): BRF-133C(105)CI
Primary Job Piece No: 26627(04)
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD (EW-169): OVER UNNAMED CREEK, 4.5 MILES EAST OF US-283. PROJECT LENGTH = 0.189 MILES.
Primary County: JACKSON              
Name of Road: COUNTY ROAD              
Prime Contractor: K & R BUILDERS, INC.              
    P.O. BOX 656              
    WHEATLAND , OK   73097              
Surety Company: OHIO CASUALTY INSURANCE COMPANY              

Date Let: 06/21/2012 NTP Effective Date: 11/05/2012 Pay Period: 05/01/2013  TO  09/18/2013
Date Awarded: 07/02/2012 Date Work Began: 11/05/2012 Original Contract Time: 120
Date Contract Executed: 07/20/2012 Date Time Stopped: 06/13/2013 Current Time Charged: 131.00
Date NTP Issued: 07/24/2012 Completion Date: 06/13/2013 Current Time Allowed: 122.00
General Liability Expires: 05/01/2014 Workman's Comp Expires: 07/01/2014 Percent Time Used: 107.38 %
Specification Year: 2009        

Current Contract Amount: $545,674.49 Total to Date Prev to Date This Estimate
Bid Amount: $584,381.51 Participating: $545,674.49 $545,615.56 $58.93
Percent Complete: 99.07 % Non Participating: $0.00 $0.00 $0.00
Funds Available: $5,060.18 Total Earnings: $545,674.49 $545,615.56 $58.93
Unearned Balance: $43,767.20 Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $545,674.49 $545,615.56 $58.93
Other Adjustments: $-560.18 $-560.18 $0.00
Liq Dam/Disincentive: $-4,500.00 $-4,500.00 $0.00
TOTAL: $540,614.31 $540,555.38 $58.93

Estimate Adjustment Detail

Contract ID: 120240   Estimate Number: 0011     Primary JP: 26627(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Piling Splices Approved 12/18/2012 2.0 $5,600.00
002 Add Special Provision Approved 04/24/2013 0.0 $0.00
003 Final Quantity Change Order Approved 07/08/2013 0.0 $-43,307.02
004 Waive Smoothness Provision Approved 09/06/2013 0.0 $-1,000.00


STOCKPILE PAYMENT HISTORY
Project Line Nbr Stockpile Description Adjustment Type Estimate Nbr Adjusted Amount
26627(04) 0013 PC BR ITM FABS (AML) Stockpiled Material Initial Payment 0001 $54,723.20
26627(04) 0013 PC BR ITM FABS (AML) Stockpiled Material Adjustment 0006 $-54,723.20
26627(04) 0023 FIELD WELDING Stockpiled Material Initial Payment 0002 $2,270.00
26627(04) 0023 FIELD WELDING Stockpiled Material Adjustment 0003 $-2,270.00
26627(04) 0024 FIELD WELDING Stockpiled Material Adjustment 0003 $-8,022.00
26627(04) 0024 FIELD WELDING Stockpiled Material Initial Payment 0002 $8,022.00
Subtotals For Stockpile Payments $0.00


LIQUIDATED DAMAGES HISTORY
Adjustment Description Estimate Nbr Time Units Rate Adjustment Amount
System Application of Liquidated Damages 0009 --9.0 $500.00 $-4,500.00
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
26627(04) 0007 SUPERPAVE, TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0009 469.16 $-1.19 $-560.18
Subtotals For Line Item Adjustments $-560.18


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: 120240   Estimate Number: 0011     Primary JP: 26627(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:    BRF-133C(105)CI Project:    26627(04) Category:    0100/ROADWAY
0001 EARTHWORK 202(H) 0185 LSUM 1.000 1.000   1.000 $42,500.00 $0.00 $42,500.00
0002 TEMPORARY SILT DIKE 221(F) 0100 LF 400.000 231.000   231.000 $9.20 $0.00 $2,125.20
0003 SOLID SLAB SODDING 230(A) 2806 SY 7,800.000 6,996.320 -0.190 6,996.320 $2.14 $-0.41 $14,972.12
0004 VEGETATIVE MULCHING 233(A) 2817 AC 1.620 0.000   0.000 $425.00 $0.00 $0.00
0005 AGGREGATE BASE TYPE A 303(A) 2100 CY 464.000 490.330   490.330 $57.00 $0.00 $27,948.81
0006 TRAFFIC BOUND SURFACE COURSE TYPE E 402(E) 0225 TON 13.000 0.000   0.000 $30.77 $0.00 $0.00
0007 SUPERPAVE, TYPE S4(PG 64-22 OK) 411(C) 5960 TON 440.000 469.160   469.160 $111.63 $0.00 $52,372.33
0008 CLASS C CONCRETE 509(D) 0325 CY 10.000 0.000   0.000 $275.00 $0.00 $0.00
0009 28" X 20" CORR. GALV. STEEL PIPE ARCH 613(B) 4528 LF 48.000 48.000   48.000 $28.09 $0.00 $1,348.32
0010 TYPE B4 CULVERT END TREATMENT 613(M) 7187 EA 2.000 2.000   2.000 $1,250.00 $0.00 $2,500.00
Subtotals For Category     0100/ROADWAY    $-0.41 $143,766.78
Fed/State Project Number:    BRF-133C(105)CI Project:    26627(04) Category:    0200/BRIDGE
0011 SUBSTRUCTURE EXCAVATION COMMON 501(B) 1307 CY 250.000 250.000   250.000 $9.00 $0.00 $2,250.00
0012 GRANULAR BACKFILL 501(F) 6352 CY 126.000 126.000   126.000 $62.50 $0.00 $7,875.00
0013 PRESTRESSED CONCRETE BEAMS (TYPE IV) 503(A) 1313 LF 378.670 378.670   378.670 $207.50 $0.00 $78,574.03
0014 CONCRETE RAIL (TR3) 504(D) 6239 LF 271.300 271.300   271.300 $73.50 $0.00 $19,940.55
0015 STRUCTURAL STEEL 506(A) 1322 LB 702.000 702.000   702.000 $3.10 $0.00 $2,176.20
0016 WEATHERING STEEL FIXED BEARING ASSEMBLY 507(A) 6172 EA 4.000 4.000   4.000 $1,325.00 $0.00 $5,300.00
0017 WEATHERING STEEL EXPANSION BEARING ASSEMBLY 507(B) 6176 EA 4.000 4.000   4.000 $1,325.00 $0.00 $5,300.00
0018 CLASS AA CONCRETE 509(A) 1326 CY 96.600 96.600   96.600 $557.50 $0.00 $53,854.50
0019 CLASS A CONCRETE 509(B) 1328 CY 91.600 91.600   91.600 $575.00 $0.00 $52,670.00
0020 REINFORCING STEEL 511(A) 1332 LB 36,180.000 36,180.000   36,180.000 $0.89 $0.00 $32,200.20
0021 PILES, FURNISHED (HP 10X42) 514(A) 6010 LF 100.000 100.000   100.000 $32.20 $0.00 $3,220.00
0022 PILES, FURNISHED (HP 12X53) 514(A) 6011 LF 280.000 378.640   378.640 $37.10 $0.00 $14,047.54
0023 PILES, DRIVEN (HP 10X42) 514(B) 6292 LF 100.000 100.000   100.000 $13.80 $0.00 $1,380.00
0024 PILES, DRIVEN (HP 12X53) 514(B) 6294 LF 280.000 378.640   378.640 $15.90 $0.00 $6,020.38
0025 TYPE I-A PLAIN RIPRAP 601(B) 1353 TON 1,725.000 744.090 -0.080 744.090 $39.52 $-3.16 $29,406.44
0026 TYPE I-A FILTER BLANKET 601(C) 1355 TON 575.000 313.790   313.790 $30.52 $0.00 $9,576.87
0027 6" PERFORATED PIPE UNDERDRAIN ROUND 613(H) 6204 LF 75.000 75.000   75.000 $28.00 $0.00 $2,100.00
0028 6" NON-PERF.PIPE UNDERDRAIN RND. 613(I) 6207 LF 28.000 44.000   44.000 $35.00 $0.00 $1,540.00
0029 REMOVAL OF EXISTING BRIDGE STRUCTURE 619(D) 1397 LSUM 1.000 1.000   1.000 $11,000.00 $0.00 $11,000.00
0030 GUARDRAIL ANCHOR UNIT (TYPE II) 623(F) 6033 EA 4.000 4.000   4.000 $2,392.00 $0.00 $9,568.00
0031 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $3,583.00 $0.00 $3,583.00
8000 PILE SPLICE, H-PILE (NON-BIDDABLE) 514(L) 6220 EA 0.000 14.000   14.000 $400.00 $0.00 $5,600.00
8002 PAVEMENT/BRIDGE SMOOTHNESS ADJUSTMENT 430 5010 LSUM 0.000 1.000 1.000 1.000 $-1,000.00 $-1,000.00 $-1,000.00
Subtotals For Category     0200/BRIDGE    $-1,003.16 $356,182.71
Fed/State Project Number:    BRF-133C(105)CI Project:    26627(04) Category:    0600/STAKING
0032 CONSTRUCTION STAKING LEVEL II 642(B) 0096 LSUM 1.000 1.000   1.000 $7,475.00 $0.00 $7,475.00
Subtotals For Category     0600/STAKING    $0.00 $7,475.00
Fed/State Project Number:    BRF-133C(105)CI Project:    26627(04) Category:    0640/CONSTRUCTION
0033 SWPPP DOCUMENTATION AND MANAGEMENT 220 2800 LSUM 1.000 1.000 0.250 1.000 $4,250.00 $1,062.50 $4,250.00
0034 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $34,000.00 $0.00 $34,000.00
Subtotals For Category     0640/CONSTRUCTION    $1,062.50 $38,250.00
Subtotals For Project BRF-133C(105)CI /26627(04) $58.93 $545,674.49