Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 120295   Estimate Number: 0010 , Final     Spec Year: 2009
Primary JP: 22090(04)   Residency: ADA (03100)     Contract No: 810385
Date Created: 01/23/2014   Contractor FEI: 731427175     Account No: 436300

Project Number(s): BRO-163D(337)CI
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD (EW-134): OVER TRIBUTARY TO SALT CREEK, 0.2 MILES WEST OF US-177. PROJECT LENGTH = 0.126 MILES.
Primary County: POTTAWATOMIE              
Name of Road: COUNTY ROAD              
Prime Contractor: K & R BUILDERS, INC.           Time Charged: 90.00
    P.O. BOX 656           Time Allowed: 90.00
    WHEATLAND , OK   73097           Percent Time: 100.00 %

  Paid To Date: $673,886.79 Payable This Statement: $4,261.84

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:    01/23/2014
Contract ID: 120295   Estimate Number: 0010     Contract No: 810385
Residency: ADA (03100)   Estimate Type: Final     Account No: 436300

Project Number(s): BRO-163D(337)CI
Primary Job Piece No: 22090(04)
Contract Description: BRIDGE AND APPROACHES COUNTY ROAD (EW-134): OVER TRIBUTARY TO SALT CREEK, 0.2 MILES WEST OF US-177. PROJECT LENGTH = 0.126 MILES.
Primary County: POTTAWATOMIE              
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: 08/16/2012 NTP Effective Date: 02/18/2013 Pay Period: 04/16/2013  TO  12/31/2013
Date Awarded: 09/10/2012 Date Work Began: 11/30/2012 Original Contract Time: 90
Date Contract Executed: 09/27/2012 Date Time Stopped: 05/31/2013 Current Time Charged: 90.00
Date NTP Issued: 10/02/2012 Completion Date: 05/31/2013 Current Time Allowed: 90.00
General Liability Expires: 05/01/2014 Workman's Comp Expires: 07/01/2014 Percent Time Used: 100.00 %
Specification Year: 2009        

Bid Amount: $673,401.24 Total to Date Prev to Date This Estimate
Funds Available (Bid + Positive C/O): $676,569.94 Participating: $673,886.79 $669,624.95 $4,261.84
Percent Complete: 99.60 % Non Participating: $0.00 $0.00 $0.00
Unearned Balance: $2,683.15 Total Earnings: $673,886.79 $669,624.95 $4,261.84
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $673,886.79 $669,624.95 $4,261.84
Other Adjustments: $0.00 $0.00 $0.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $673,886.79 $669,624.95 $4,261.84

Estimate Adjustment Detail

Contract ID: 120295   Estimate Number: 0010     Primary JP: 22090(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 Revising pay items, Adding Time to Contract Approved 09/30/2013 0.0 $3,168.70
002 Finalizing Contract Item Qtys Approved 12/13/2013 0.0 $-2,683.14


STOCKPILE PAYMENT HISTORY
Project Line Nbr Stockpile Description Adjustment Type Estimate Nbr Adjusted Amount
22090(04) 0017 MOH Str Steel 19320 lb Stockpiled Material Initial Payment 0003 $8,418.00
22090(04) 0017 MOH Str Steel 19320 lb Stockpiled Material Adjustment 0005 $-8,418.00
22090(04) 0018 MOH Str Steel A588 Stockpiled Material Adjustment 0005 $-43,437.19
22090(04) 0018 MOH Str Steel A588 Stockpiled Material Initial Payment 0002 $43,437.19
22090(04) 0021 MOH ReBar Stockpiled Material Adjustment 0006 $-12,254.94
22090(04) 0021 MOH ReBar Stockpiled Material Initial Payment 0003 $12,254.94
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
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: 120295   Estimate Number: 0010     Primary JP: 22090(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-163D(337)CI Project:    22090(04) Category:    0100/ROADWAY
0001 CLEARING AND GRUBBING 201(A) 0102 LSUM 1.000 1.000   1.000 $9,000.00 $0.00 $9,000.00
0002 UNCLASSIFIED EXCAVATION 202(A) 0183 CY 1,116.000 1,116.000   1,116.000 $8.50 $0.00 $9,486.00
0003 UNCLASSIFIED BORROW 202(D) 0184 CY 6,187.000 2,117.080 -74.710 2,117.080 $8.25 $-616.36 $17,465.91
0004 TEMPORARY SILT FENCE 221(C) 2801 LF 350.000 350.000   350.000 $4.00 $0.00 $1,400.00
0005 TEMPORARY SILT DIKE 221(F) 0100 LF 200.000 91.000   91.000 $12.00 $0.00 $1,092.00
0006 SOLID SLAB SODDING 230(A) 2806 SY 8,207.890 8,035.110   8,035.110 $2.40 $0.00 $19,284.26
0007 VEGETATIVE MULCHING 233(A) 2817 AC 1.700 0.000   0.000 $500.00 $0.00 $0.00
0008 TRAFFIC BOUND SURFACE COURSE TYPE E 402(E) 0225 TON 959.150 886.790   886.790 $27.68 $0.00 $24,546.34
0009 CLASS C CONCRETE 509(D) 0325 CY 10.000 0.000   0.000 $250.00 $0.00 $0.00
0010 60" CORR. GALV. STEEL PIPE 613(B) 0696 LF 160.000 160.000   160.000 $200.00 $0.00 $32,000.00
0011 28" X 20" CORR. GALV. STEEL PIPE ARCH 613(B) 4528 LF 78.000 78.000   78.000 $28.00 $0.00 $2,184.00
0012 28" X 20" PREFAB. CULVERT END SECTION, ARCH 613(L) 4516 EA 4.000 4.000   4.000 $315.00 $0.00 $1,260.00
0013 SHEET ALUMINUM SIGNS 850(A) 8110 SF 19.460 19.460   19.460 $28.00 $0.00 $544.88
0014 2 1/4" SQUARE TUBE POST 851(C) 8327 LF 24.000 24.000   24.000 $10.00 $0.00 $240.00
Subtotals For Category     0100/ROADWAY    $-616.36 $118,503.39
Fed/State Project Number:    BRO-163D(337)CI Project:    22090(04) Category:    0200/BRIDGE
0015 SUBSTRUCTURE EXCAVATION COMMON 501(B) 1307 CY 812.800 812.800   812.800 $14.00 $0.00 $11,379.20
0016 UNCLASSIFIED BACKFILL 501(D) 6353 CY 576.800 576.800   576.800 $17.00 $0.00 $9,805.60
0017 STRUCTURAL STEEL 506(A) 1322 LB 36,716.000 37,369.340 653.340 37,369.340 $4.85 $3,168.70 $181,241.30
0018 STRUCTURAL STEEL A588 506(A) 6007 LB 34,628.000 34,628.000   34,628.000 $1.95 $0.00 $67,524.60
0019 CLASS AA CONCRETE 509(A) 1326 CY 34.000 34.000   34.000 $750.00 $0.00 $25,500.00
0020 CLASS A CONCRETE 509(B) 1328 CY 97.660 97.660   97.660 $750.00 $0.00 $73,245.00
0021 REINFORCING STEEL 511(A) 1332 LB 24,860.000 24,860.000   24,860.000 $0.94 $0.00 $23,368.40
0022 PILES, FURNISHED (HP 10X42) 514(A) 6010 LF 1,224.000 1,224.000   1,224.000 $28.00 $0.00 $34,272.00
0023 PILES, DRIVEN (HP 10X42) 514(B) 6292 LF 1,224.000 1,087.980   1,087.980 $12.00 $0.00 $13,055.76
0024 TYPE I-A PLAIN RIPRAP 601(B) 1353 TON 394.000 395.380   395.380 $41.00 $0.00 $16,210.58
0025 TYPE I-A FILTER BLANKET 601(C) 1355 TON 54.000 457.520   457.520 $98.00 $0.00 $44,836.96
0026 REMOVAL OF EXISTING BRIDGE STRUCTURE 619(D) 1397 LSUM 1.000 1.000   1.000 $6,250.00 $0.00 $6,250.00
0027 BEAM GUARDRAIL W-BEAM SINGLE 623(A) 0932 LF 200.000 200.000   200.000 $17.00 $0.00 $3,400.00
0028 GUARDRAIL ANCHOR UNIT (TYPE II) 623(F) 6033 EA 4.000 4.000   4.000 $2,364.00 $0.00 $9,456.00
0029 CONSTRUCTION TRAFFIC CONTROL 880(J) 8905 LSUM 1.000 1.000 0.250 1.000 $2,838.00 $709.50 $2,838.00
Subtotals For Category     0200/BRIDGE    $3,878.20 $522,383.40
Fed/State Project Number:    BRO-163D(337)CI Project:    22090(04) Category:    0600/STAKING
0030 CONSTRUCTION STAKING LEVEL I 642(A) 0095 LSUM 1.000 1.000 0.050 1.000 $5,000.00 $250.00 $5,000.00
Subtotals For Category     0600/STAKING    $250.00 $5,000.00
Fed/State Project Number:    BRO-163D(337)CI Project:    22090(04) Category:    0640/CONSTRUCTION
0031 SWPPP DOCUMENTATION AND MANAGEMENT 220 2800 LSUM 1.000 1.000 0.250 1.000 $3,000.00 $750.00 $3,000.00
0032 MOBILIZATION 641 1399 LSUM 1.000 1.000   1.000 $25,000.00 $0.00 $25,000.00
Subtotals For Category     0640/CONSTRUCTION    $750.00 $28,000.00
Subtotals For Project BRO-163D(337)CI /22090(04) $4,261.84 $673,886.79