Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 120251   Estimate Number: 0012 , Final     Spec Year: 2009
Primary JP: 25901(04)   Residency: ENGINEERING SERVICES & TESTING (08001)     Contract No: 810222
Date Created: 02/11/2014   Contractor FEI: 208746250     Account No: 436800

Project Number(s): BRF-121C(122)CI
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD (NS-468/EW-028): OVER CARR CREEK 1.0 MILE NORTH AND 3.0 MILES EAST OF SH-10/SH-25 JUNCTION. PROJECT LENGTH = 0.256 MILES.
Primary County: DELAWARE              
Name of Road: COUNTY ROAD              
Prime Contractor: GLOVER & ASSOCIATES, INC.           Time Charged: 154.00
    2832 N. COUNTRY CLUB           Time Allowed: 90.00
    MUSKOGEE , OK   74403           Percent Time: 171.11 %

  Paid To Date: $520,888.84 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:    02/11/2014
Contract ID: 120251   Estimate Number: 0012     Contract No: 810222
Residency: ENGINEERING SERVICES & TESTING (08001)   Estimate Type: Final     Account No: 436800

Project Number(s): BRF-121C(122)CI
Primary Job Piece No: 25901(04)
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD (NS-468/EW-028): OVER CARR CREEK 1.0 MILE NORTH AND 3.0 MILES EAST OF SH-10/SH-25 JUNCTION. PROJECT LENGTH = 0.256 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: 07/19/2012 NTP Effective Date: 11/15/2012 Pay Period: 01/16/2014  TO  02/11/2014
Date Awarded: 08/06/2012 Date Work Began: 11/15/2012 Original Contract Time: 90
Date Contract Executed: 08/21/2012 Date Time Stopped: 08/27/2013 Current Time Charged: 154.00
Date NTP Issued: 08/24/2012 Completion Date: 08/27/2013 Current Time Allowed: 90.00
General Liability Expires: 02/01/2015 Workman's Comp Expires: 02/01/2015 Percent Time Used: 171.11 %
Specification Year: 2009        

Bid Amount: $565,597.19 Total to Date Prev to Date This Estimate
Funds Available (Bid + Positive C/O): $565,597.19 Participating: $554,581.54 $554,581.54 $0.00
Percent Complete: 92.10 % Non Participating: $0.00 $0.00 $0.00
Unearned Balance: $44,708.35 Total Earnings: $554,581.54 $554,581.54 $0.00
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $554,581.54 $554,581.54 $0.00
Other Adjustments: $-1,692.70 $-1,692.70 $0.00
Liq Dam/Disincentive: $-32,000.00 $-32,000.00 $0.00
TOTAL: $520,888.84 $520,888.84 $0.00

Estimate Adjustment Detail

Contract ID: 120251   Estimate Number: 0012     Primary JP: 25901(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Method of Measurement on Structural Excavation Unclassified Approved 06/28/2013 0.0 $0.00
002 Final Quantity Change Order Approved 02/11/2014 0.0 $-11,015.67


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 0004 --3.0 $500.00 $-1,500.00
System Application of Liquidated Damages 0005 --14 $500.00 $-7,000.00
System Application of Liquidated Damages 0006 --13 $500.00 $-6,500.00
System Application of Liquidated Damages 0007 --19 $500.00 $-9,500.00
System Application of Liquidated Damages 0008 --10 $500.00 $-5,000.00
System Application of Liquidated Damages 0009 --5.0 $500.00 $-2,500.00
Subtotals For Liquidated Damages $-32,000.00


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
25901(04) 0011 SUPERPAVE, TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0008 666.35 $-1.25 $-836.10
25901(04) 0012 SUPERPAVE, TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0008 597.35 $-1.43 $-856.60
Subtotals For Line Item Adjustments $-1,692.70


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: 120251   Estimate Number: 0012     Primary JP: 25901(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-121C(122)CI Project:    25901(04) Category:    0100/ROADWAY
0001 CLEARING AND GRUBBING 201(A) 0102 LSUM 1.000 1.000   1.000 $10,773.72 $0.00 $10,773.72
0002 UNCLASSIFIED EXCAVATION 202(A) 0183 CY 7,336.000 7,336.000   7,336.000 $7.00 $0.00 $51,352.00
0003 TYPE A-SALVAGED TOPSOIL 205(A) 4229 LSUM 1.000 1.000   1.000 $9,245.40 $0.00 $9,245.40
0004 TEMPORARY SILT FENCE 221(C) 2801 LF 366.000 495.000   495.000 $7.32 $0.00 $3,623.40
0005 TEMPORARY SILT DIKE 221(F) 0100 LF 260.000 270.000   270.000 $8.24 $0.00 $2,224.80
0006 SOLID SLAB SODDING 230(A) 2806 SY 5,645.000 7,836.560   7,836.560 $1.84 $0.00 $14,419.27
0007 AGGREGATE BASE TYPE B 303(B) 2110 CY 490.000 484.240   484.240 $38.06 $0.00 $18,430.18
0008 TRAFFIC BOUND SURFACE COURSE TYPE D 402(D) 0223 TON 158.000 230.360   230.360 $23.55 $0.00 $5,424.98
0009 TACK COAT 407(B) 0250 GAL 213.000 225.000   225.000 $2.00 $0.00 $450.00
0010 PRIME COAT 408 5774 GAL 659.000 675.000   675.000 $2.00 $0.00 $1,350.00
0011 SUPERPAVE, TYPE S3(PG 64-22 OK) 411(B) 5945 TON 731.000 666.350   666.350 $69.00 $0.00 $45,978.15
0012 SUPERPAVE, TYPE S4(PG 64-22 OK) 411(C) 5960 TON 602.000 597.350   597.350 $82.00 $0.00 $48,982.70
0013 STRUCTURAL EXCAVATION UNCLASSIFIED 501(A) 0313 CY 1,390.000 1,390.000   1,390.000 $7.08 $0.00 $9,841.20
0014 CLASS AA CONCRETE 509(A) 0319 CY 282.000 281.600   281.600 $315.00 $0.00 $88,704.00
0015 CLASS A CONCRETE 509(B) 0321 CY 127.000 115.210   115.210 $485.00 $0.00 $55,876.85
0016 REINFORCING STEEL 511(A) 0332 LB 67,170.000 67,834.000   67,834.000 $0.99 $0.00 $67,155.66
0017 TYPE I-A PLAIN RIPRAP 601(B) 0536 TON 1,365.000 1,102.210   1,102.210 $27.67 $0.00 $30,498.15
0018 TYPE I-A FILTER BLANKET 601(C) 0538 TON 477.000 469.830   469.830 $23.25 $0.00 $10,923.55
0019 18" CORR. GALV. STEEL PIPE 613(B) 0689 LF 44.000 44.000   44.000 $12.41 $0.00 $546.04
0020 18" GALV. STEEL CULVERT END SECTION ROUND 613(P) 0760 EA 2.000 2.000   2.000 $110.16 $0.00 $220.32
0021 REMOVAL OF ASPHALT PAVEMENT 619(B) 4728 SY 3,018.000 2,994.440   2,994.440 $3.33 $0.00 $9,971.49
0022 BEAM GUARDRAIL W-BEAM SINGLE 623(A) 0932 LF 412.500 412.500   412.500 $17.97 $0.00 $7,412.63
0023 GUARDRAIL END TREATMENT (GET) 623(G) 8571 EA 4.000 4.000   4.000 $2,300.00 $0.00 $9,200.00
0024 MAILBOX INSTALLATION-SINGLE 629(A) 4958 EA 1.000 1.000   1.000 $81.17 $0.00 $81.17
0025 MAILBOX 629(C) 4960 EA 1.000 1.000   1.000 $28.99 $0.00 $28.99
0026 REMOVAL OF MAILBOX INSTALLATION 629(D) 4961 EA 1.000 1.000   1.000 $17.39 $0.00 $17.39
0027 SHEET ALUMINUM SIGNS 850(A) 8110 SF 22.180 22.180   22.180 $31.31 $0.00 $694.46
0028 2 1/4" SQUARE TUBE POST 851(C) 8327 LF 36.000 36.000   36.000 $10.44 $0.00 $375.84
0029 TRAFFIC STRIPE(PAINT)(4" WIDE) 854(A) 8800 LF 5,522.000 5,280.000   5,280.000 $0.29 $0.00 $1,531.20
0030 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $3,043.76 $0.00 $3,043.76
Subtotals For Category     0100/ROADWAY    $0.00 $508,377.30
Fed/State Project Number:    BRF-121C(122)CI Project:    25901(04) Category:    0200/BRIDGE
0031 REMOVAL OF EXISTING BRIDGE STRUCTURE 619(D) 1397 LSUM 1.000 1.000   1.000 $10,500.00 $0.00 $10,500.00
Subtotals For Category     0200/BRIDGE    $0.00 $10,500.00
Fed/State Project Number:    BRF-121C(122)CI Project:    25901(04) Category:    0600/STAKING
0032 CONSTRUCTION STAKING LEVEL II 642(B) 0096 LSUM 1.000 1.000   1.000 $7,826.82 $0.00 $7,826.83
Subtotals For Category     0600/STAKING    $0.00 $7,826.83
Fed/State Project Number:    BRF-121C(122)CI Project:    25901(04) Category:    0640/CONSTRUCTION
0033 SWPPP DOCUMENTATION AND MANAGEMENT 220 2800 LSUM 1.000 1.000   1.000 $1,500.00 $0.00 $1,500.00
0034 FIELD OFFICE 640(A) 1398 EA 1.000 1.000   1.000 $6,377.41 $0.00 $6,377.41
0035 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $20,000.00 $0.00 $20,000.00
Subtotals For Category     0640/CONSTRUCTION    $0.00 $27,877.41
Subtotals For Project BRF-121C(122)CI /25901(04) $0.00 $554,581.54