Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 120255   Estimate Number: 0009 , Final     Spec Year: 2009
Primary JP: 29085(04)   Residency: GARVER, LLC. (04011)     Contract No: 810261
Date Created: 10/29/2013   Contractor FEI: 731161549     Account No: 404400

Project Number(s): SSP-237E(001)SS
Contract Description: GRADE, DRAIN, AND SURFACE US-81: FROM 2.6 MILES SOUTH OF THE SH-33 JUNCTION EXTEND NORTH. PROJECT LENGTH = 0.177 MILES.
Primary County: KINGFISHER              
Name of Road: US-81              
Prime Contractor: TOM HUDSON PAVING, INC.           Time Charged: 104.00
    7400 W. UNIVERSITY           Time Allowed: 116.00
    GUTHRIE , OK   73044           Percent Time: 89.66 %

  Paid To Date: $559,084.11 Payable This Statement: $3,487.98

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.                                
TOM HUDSON PAVING, 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:    10/29/2013
Contract ID: 120255   Estimate Number: 0009     Contract No: 810261
Residency: GARVER, LLC. (04011)   Estimate Type: Final     Account No: 404400

Project Number(s): SSP-237E(001)SS
Primary Job Piece No: 29085(04)
Contract Description: GRADE, DRAIN, AND SURFACE US-81: FROM 2.6 MILES SOUTH OF THE SH-33 JUNCTION EXTEND NORTH. PROJECT LENGTH = 0.177 MILES.
Primary County: KINGFISHER              
Name of Road: US-81              
Prime Contractor: TOM HUDSON PAVING, INC.              
    7400 W. UNIVERSITY              
    GUTHRIE , OK   73044              
Surety Company: WESTFIELD INSURANCE COMPANY              

Date Let: 07/19/2012 NTP Effective Date: 12/03/2012 Pay Period: 05/01/2013  TO  08/26/2013
Date Awarded: 08/06/2012 Date Work Began: 12/10/2012 Original Contract Time: 90
Date Contract Executed: 08/16/2012 Date Time Stopped: 04/12/2013 Current Time Charged: 104.00
Date NTP Issued: 08/21/2012 Completion Date: 04/12/2013 Current Time Allowed: 116.00
General Liability Expires: 09/01/2014 Workman's Comp Expires: 09/01/2014 Percent Time Used: 89.66 %
Specification Year: 2009        

Bid Amount: $536,881.85 Total to Date Prev to Date This Estimate
Funds Available (Bid + Positive C/O): $567,375.30 Participating: $0.00 $0.00 $0.00
Percent Complete: 98.54 % Non Participating: $563,814.52 $567,733.11 $-3,918.59
Unearned Balance: $8,291.19 Total Earnings: $563,814.52 $567,733.11 $-3,918.59
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $563,814.52 $567,733.11 $-3,918.59
Other Adjustments: $-4,730.41 $-12,136.98 $7,406.57
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $559,084.11 $555,596.13 $3,487.98

Estimate Adjustment Detail

Contract ID: 120255   Estimate Number: 0009     Primary JP: 29085(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Separator Fabric and Raise Manhole Approved 01/31/2013 12.0 $19,392.72
002 Weather days Approved 04/17/2013 14.0 $0.00
003 Add Removal of Traffic Stripe Approved 04/25/2013 0.0 $610.00
004 Aggregate Base Gradation Deduction Approved 06/25/2013 0.0 $-3,560.81
005 Final Quantity Change Order Approved 08/16/2013 0.0 $578.21
006 Air Content Deduct, Quantity Adjust for Asphalt and Agg Base Approved 10/15/2013 0.0 $9,912.52


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 --1.0 $500.00 $-500.00
System Application of Liquidated Damages 0008 -1.0 $500.00 $500.00
Subtotals For Liquidated Damages $0.00


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
29085(04) 0006 AGGREGATE BASE TYPE A * SUBSTANDARD ITEM 0007 -43.34 $82.16 $-3,560.81
29085(04) 0006 AGGREGATE BASE TYPE A * SUBSTANDARD ITEM 0009 43.34 $82.16 $3,560.81
29085(04) 0011 SUPERPAVE, TYPE S3(PG 76-28 OK) * HMA Deduction as per Sec. 411 0003 -5.92 $88.09 $-521.49
29085(04) 0011 SUPERPAVE, TYPE S3(PG 76-28 OK) Asphalt Binder Adjustment 0003 264.17 $-1.04 $-275.99
29085(04) 0011 SUPERPAVE, TYPE S3(PG 76-28 OK) * HMA Deduction as per Sec. 411 0009 5.21 $88.09 $458.95
29085(04) 0012 SUPERPAVE, TYPE S3(PG 64-22 OK) Asphalt Binder Adjustment 0003 358.48 $-1.04 $-374.52
29085(04) 0013 SUPERPAVE, TYPE S4(PG 76-28 OK) Asphalt Binder Adjustment 0004 245.64 $-1.19 $-293.29
29085(04) 0014 SUPERPAVE, TYPE S4(PG 64-22 OK) Asphalt Binder Adjustment 0005 351.84 $-1.19 $-420.10
29085(04) 0014 SUPERPAVE, TYPE S4(PG 64-22 OK) * HMA Deduction as per Sec. 411 0005 -72.13 $92.76 $-6,690.78
29085(04) 0014 SUPERPAVE, TYPE S4(PG 64-22 OK) * HMA Deduction as per Sec. 411 0009 51.41 $92.76 $4,768.79
29085(04) 0018 P.C. CONCRETE FOR PAVEMENT * PCCP Deduction as per Sec. 414 0009 -12.90 $107.13 $-1,381.98
Subtotals For Line Item Adjustments $-4,730.41
* = 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: 120255   Estimate Number: 0009     Primary JP: 29085(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:    SSP-237E(001)SS Project:    29085(04) Category:    0100/ROADWAY
0001 CLEARING AND GRUBBING 201(A) 0102 LSUM 1.000 1.000   1.000 $8,342.33 $0.00 $8,342.33
0002 EARTHWORK 202(H) 0185 LSUM 1.000 1.000   1.000 $30,480.47 $0.00 $30,480.48
0003 TEMPORARY SILT FENCE 221(C) 2801 LF 750.000 668.000   668.000 $4.00 $0.00 $2,672.00
0004 TEMPORARY SILT DIKE 221(F) 0100 LF 28.000 0.000   0.000 $15.18 $0.00 $0.00
0005 SOLID SLAB SODDING 230(A) 2806 SY 4,670.000 6,173.610   6,173.610 $1.79 $0.00 $11,050.76
0006 AGGREGATE BASE TYPE A 303(A) 2100 CY 786.000 867.200 0.210 867.200 $82.16 $17.25 $71,249.15
0007 SEPARATOR FABRIC 325 5271 SY 1,000.000 5,386.230   5,386.230 $1.74 $0.00 $9,372.04
0008 TRAFFIC BOUND SURFACE COURSE TYPE E 402(E) 0225 TON 211.000 425.350 -0.420 425.350 $44.55 $-18.71 $18,949.34
0009 TACK COAT 407(B) 0250 GAL 332.000 224.920   224.920 $5.00 $0.00 $1,124.60
0010 PRIME COAT 408 5774 GAL 900.000 0.000   0.000 $8.00 $0.00 $0.00
0011 SUPERPAVE, TYPE S3(PG 76-28 OK) 411(B) 5935 TON 320.000 264.170 0.000 264.170 $88.09 $0.00 $23,270.74
0012 SUPERPAVE, TYPE S3(PG 64-22 OK) 411(B) 5945 TON 392.000 358.480   358.480 $77.14 $0.00 $27,653.15
0013 SUPERPAVE, TYPE S4(PG 76-28 OK) 411(C) 5950 TON 212.000 245.640   245.640 $101.74 $0.00 $24,991.41
0014 SUPERPAVE, TYPE S4(PG 64-22 OK) 411(C) 5960 TON 340.000 351.840 0.000 351.840 $92.76 $0.00 $32,636.68
0015 COLD MILLING PAVEMENT 412 5267 SY 910.000 762.400   762.400 $4.08 $0.00 $3,110.59
0016 P.C.CONCRETE PAVEMENT(PLACEMENT) 414(A) 0210 SY 615.000 619.880   619.880 $24.49 $0.00 $15,180.86
0017 DOWEL JOINTED P.C. CONCRETE PAVEMENT(PLACEMENT ) 414(B) 5725 SY 2,115.000 2,151.420   2,151.420 $30.07 $0.00 $64,693.19
0018 P.C. CONCRETE FOR PAVEMENT 414(G) 5275 CY 682.000 692.820 0.000 692.820 $107.13 $0.00 $74,221.82
0019 CLASS AA CONCRETE 509(A) 0319 CY 8.000 9.460   9.460 $989.79 $0.00 $9,363.41
0020 REINFORCING STEEL 511(A) 0332 LB 990.000 985.500   985.500 $2.33 $0.00 $2,296.22
0021 INLET (SMD-TYPE 2) 611(G) 6002 EA 1.000 1.000   1.000 $2,313.25 $0.00 $2,313.25
0022 18" R.C.PIPE CLASS III 613(A) 0491 LF 158.000 153.000   153.000 $51.12 $0.00 $7,821.36
0023 REMOVAL OF STRUCTURES & OBSTRUCTIONS 619(A) 0920 LSUM 1.000 1.000   1.000 $10,358.44 $0.00 $10,358.44
0024 REMOVAL OF ASPHALT PAVEMENT 619(B) 4728 SY 455.000 1,187.180   1,187.180 $6.47 $0.00 $7,681.05
8004 AGGREGATE BASE TYPE A 303(A) 2100 CY 0.000 43.340 43.340 43.340 $-82.16 $-3,560.81 $-3,560.81
8005 CLASS AA CONCRETE 509(A) 0319 CY 0.000 2.000 2.000 2.000 $-178.16 $-356.32 $-356.32
Subtotals For Category     0100/ROADWAY    $-3,918.59 $454,915.74
Fed/State Project Number:    SSP-237E(001)SS Project:    29085(04) Category:    0300/TRAFFIC TEMPORARY
0025 ARROW DISPLAY(TYPE C) 880(A) 8812 SD 90.000 120.000   120.000 $4.20 $0.00 $504.00
0026 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000   1.000 $5,250.00 $0.00 $5,250.00
Subtotals For Category     0300/TRAFFIC TEMPORARY    $0.00 $5,754.00
Fed/State Project Number:    SSP-237E(001)SS Project:    29085(04) Category:    0301/TRAFFIC PERMANENT
0027 SHEET ALUMINUM SIGNS 850(A) 8110 SF 137.000 136.820   136.820 $20.48 $0.00 $2,802.07
0028 2" SQUARE TUBE POST 851(C) 8324 LF 130.000 130.000   130.000 $5.25 $0.00 $682.50
0029 TRAFFIC STRIPE(MULTI-POLYMER)(4" WIDE) 856(A) 8530 LF 3,210.000 3,406.000   3,406.000 $0.81 $0.00 $2,758.86
0030 TRAFFIC STRIPE(MULTI-POLY.)(24" WIDE) 856(A) 8555 LF 30.000 22.000   22.000 $5.15 $0.00 $113.30
0031 TRAFFIC STRIPE(MULTI-POLY.)(SYMBOLS) 856(B) 8870 EA 6.000 6.000   6.000 $362.25 $0.00 $2,173.50
8003 PAVEMENT MRKNG.REMOVAL(TRAF.STRP) 857(F) 8006 LF 0.000 608.000   608.000 $1.00 $0.00 $608.00
Subtotals For Category     0301/TRAFFIC PERMANENT    $0.00 $9,138.23
Fed/State Project Number:    SSP-237E(001)SS Project:    29085(04) Category:    0600/STAKING
0032 CONSTRUCTION STAKING LEVEL II 642(B) 0096 LSUM 1.000 1.000   1.000 $6,458.67 $0.00 $6,458.68
Subtotals For Category     0600/STAKING    $0.00 $6,458.68
Fed/State Project Number:    SSP-237E(001)SS Project:    29085(04) Category:    0640/CONSTRUCTION
0033 SWPPP DOCUMENTATION AND MANAGEMENT 220 2800 LSUM 1.000 1.000   1.000 $4,021.39 $0.00 $4,021.39
0034 MOBILIZATION 641 1552 LSUM 1.000 1.000   1.000 $50,377.92 $0.00 $50,377.92
0035 (SP)CONTRACTORS QUALITY CONTROL 643 0087 LSUM 1.000 1.000   1.000 $8,949.15 $0.00 $8,949.15
Subtotals For Category     0640/CONSTRUCTION    $0.00 $63,348.46
Fed/State Project Number:    SSP-237E(001)SS Project:    29085(04) Category:    0900/ROADWAY NON-PARTICIPATING
0036 EARTHWORK 202(H) 0185 LSUM 1.000 1.000   1.000 $13,988.87 $0.00 $13,988.88
0037 TEMPORARY SILT FENCE 221(C) 2801 LF 500.000 365.000   365.000 $3.10 $0.00 $1,131.50
0038 SOLID SLAB SODDING 230(A) 2806 SY 460.000 2,136.000   2,136.000 $1.79 $0.00 $3,823.44
0039 REMOVAL OF CURB 619(B) 4791 LF 60.000 59.000   59.000 $9.93 $0.00 $585.87
8000 MANHOLES ADJUST TO GRADE 612(A) 0641 EA 0.000 1.000   1.000 $2,564.78 $0.00 $2,564.78
8001 REPLACEMENT OF MANHOLE FRAME & COVER 611(C) 4215 EA 0.000 1.000   1.000 $1,304.94 $0.00 $1,304.94
8002 CLSM BACKFILL 501(G) 6315 CY 0.000 8.000   8.000 $100.00 $0.00 $800.00
Subtotals For Category     0900/ROADWAY NON-PARTICIPATING    $0.00 $24,199.41
Subtotals For Project SSP-237E(001)SS /29085(04) $-3,918.59 $563,814.52