Oklahoma Department of Transportation
Final Estimate Affidavit

Contract ID: 120305   Estimate Number: 0016 , Final     Spec Year: 2009
Primary JP: 27594(04)   Residency: PERRY (04100)     Contract No: 810211
Date Created: 01/23/2014   Contractor FEI: 420805868     Account No: 404400

Project Number(s): SBR-136B(217)SB
Contract Description: BRIDGE REHABILITATION US-60: OVER US-60B SOUTHWEST OF PONCA CITY. PROJECT LENGTH = 0.070 MILES.
Primary County: KAY              
Name of Road: US-60              
Prime Contractor: A. M. COHRON & SON, INC.           Time Charged: 107.00
    62180 GREAT RIVER ROAD           Time Allowed: 111.00
    ATLANTIC , IA   50022           Percent Time: 96.40 %

  Paid To Date: $849,667.66 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.                                
A. M. COHRON & SON, 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: 120305   Estimate Number: 0016     Contract No: 810211
Residency: PERRY (04100)   Estimate Type: Final     Account No: 404400

Project Number(s): SBR-136B(217)SB
Primary Job Piece No: 27594(04)
Contract Description: BRIDGE REHABILITATION US-60: OVER US-60B SOUTHWEST OF PONCA CITY. PROJECT LENGTH = 0.070 MILES.
Primary County: KAY              
Name of Road: US-60              
Prime Contractor: A. M. COHRON & SON, INC.              
    62180 GREAT RIVER ROAD              
    ATLANTIC , IA   50022              
Surety Company: UNITED FIRE & CASUALTY CO.              

Date Let: 07/19/2012 NTP Effective Date: 12/03/2012 Pay Period: 12/12/2013  TO  01/23/2014
Date Awarded: 08/06/2012 Date Work Began: 10/22/2012 Original Contract Time: 90
Date Contract Executed: 08/21/2012 Date Time Stopped: 07/12/2013 Current Time Charged: 107.00
Date NTP Issued: 08/24/2012 Completion Date: 07/12/2013 Current Time Allowed: 111.00
General Liability Expires: 07/01/2014 Workman's Comp Expires: 07/01/2014 Percent Time Used: 96.40 %
Specification Year: 2009        

Bid Amount: $768,838.37 Total to Date Prev to Date This Estimate
Funds Available (Bid + Positive C/O): $854,289.68 Participating: $0.00 $0.00 $0.00
Percent Complete: 99.46 % Non Participating: $849,667.66 $849,667.66 $0.00
Unearned Balance: $4,622.02 Total Earnings: $849,667.66 $849,667.66 $0.00
Stockpiled Materials: $0.00 $0.00 $0.00
Gross Earnings: $849,667.66 $849,667.66 $0.00
Other Adjustments: $0.00 $0.00 $0.00
Liq Dam/Disincentive: $0.00 $0.00 $0.00
TOTAL: $849,667.66 $849,667.66 $0.00

Estimate Adjustment Detail

Contract ID: 120305   Estimate Number: 0016     Primary JP: 27594(04)



CHANGE ORDER HISTORY
Change Order Nbr. Change Order Description Status Approval Date Contract Time Adjustment Total Change Order Amount
001 ADD PAINTING, COLLECT.OF WASTE, 14 DAYS, CL.C CONC., CURBING Approved 11/02/2012 14.0 $35,150.08
002 ADD ASPHALT REMOVAL, CONCRETE SHOULDERS, CLSM, AND 7 DAYS Approved 03/05/2013 7.0 $48,036.17
003 TRANSFER 2012 ASPHALT SPEC ON TYPE S4 TO THIS PROJECT Approved 01/29/2013 0.0 $0.00
004 ADD JOINT SEALING, MOVE ASPHALT BINDER & S4 DEDUCTION Approved 06/04/2013 0.0 $2,265.06
005 APPLY SMOOTHNESS DEDUCTION TO NEW CONCRETE BRIDGE Approved 09/11/2013 0.0 $-1,201.34
006 FINAL QUANTITY CHANGE ORDER Approved 01/21/2014 0.0 $-3,420.71


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
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
27594(04) 0002 SUPERPAVE, TYPE S4(PG 70-28 OK) Asphalt Binder Adjustment 0012 60.00 $-1.19 $-71.64
27594(04) 0002 SUPERPAVE, TYPE S4(PG 70-28 OK) * Material Discrepancy Adjustments 0012 0.00 $0.00 $-2,975.40
27594(04) 0002 SUPERPAVE, TYPE S4(PG 70-28 OK) * Asphalt Binder Adjustment 0014 0.00 $0.00 $71.64
27594(04) 0002 SUPERPAVE, TYPE S4(PG 70-28 OK) * Material Discrepancy Adjustments 0014 0.00 $0.00 $2,975.40
Subtotals For Line Item Adjustments $0.00
* = 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: 120305   Estimate Number: 0016     Primary JP: 27594(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:    SBR-136B(217)SB Project:    27594(04) Category:    0100/ROADWAY
0001 AGGREGATE BASE TYPE A 303(A) 2100 CY 20.000 78.910   78.910 $65.00 $0.00 $5,129.15
0002 SUPERPAVE, TYPE S4(PG 70-28 OK) 411(C) 5955 TON 58.280 60.000   60.000 $750.00 $0.00 $45,000.00
0003 COLD MILLING PAVEMENT 412 5267 SY 477.000 340.350   340.350 $25.00 $0.00 $8,508.75
0004 REMOVAL OF GUARDRAIL 619(B) 4780 LF 587.500 584.500   584.500 $3.50 $0.00 $2,045.75
0005 BEAM GUARDRAIL W-BEAM SINGLE 623(A) 0932 LF 475.000 525.000   525.000 $15.50 $0.00 $8,137.50
0006 GUARDRAIL END TREATMENT (GET) 623(G) 8571 EA 2.000 2.000   2.000 $2,125.00 $0.00 $4,250.00
0007 GUARDRAIL BRIDGE CONNECTION-TYPE A 623(I) 8675 EA 6.000 6.000   6.000 $1,600.00 $0.00 $9,600.00
8000 CLASS C CONCRETE 509(D) 0325 CY 0.000 5.470   5.470 $551.35 $0.00 $3,015.89
8001 (PL)GUARDRAIL CURBING 623 0100 EA 0.000 2.000   2.000 $730.24 $0.00 $1,460.48
8004 FULL DEPTH P.C.C. PATCH(PLACEMENT ONLY) 414(E) 0225 SY 0.000 458.240   458.240 $43.96 $0.00 $20,144.23
8005 P.C. CONCRETE FOR PAVEMENT 414(G) 5275 CY 0.000 103.150   103.150 $114.53 $0.00 $11,813.77
8006 REMOVAL OF ASPHALT PAVEMENT 619(B) 4728 SY 0.000 458.240   458.240 $27.17 $0.00 $12,450.39
8011 ASPHALT BINDER PRICE ADJUSTMENT 109 1150 LSUM 0.000 -1.000   -1.000 $71.64 $0.00 $-71.64
8012 ADJUSTMENT FOR NON-CONFORMING MATERIALS 105 2100 LSUM 0.000 -1.000   -1.000 $2,975.40 $0.00 $-2,975.40
Subtotals For Category     0100/ROADWAY    $0.00 $128,508.87
Fed/State Project Number:    SBR-136B(217)SB Project:    27594(04) Category:    0200/BRIDGE 'A'
0008 APPROACH SLAB 504(A) 1304 SY 180.600 180.600   180.600 $195.33 $0.00 $35,276.60
0009 SAW-CUT GROOVING 504(B) 1305 SY 1,142.800 1,142.800   1,142.800 $5.81 $0.00 $6,639.67
0010 SEALED EXPANSION JOINT 504(C) 6250 LF 80.000 80.000   80.000 $278.30 $0.00 $22,264.00
0011 42" F-SHAPED PARAPET 504(E) 6190 LF 549.300 549.300   549.300 $82.50 $0.00 $45,317.25
0012 RAPID CURE JOINT SEALANT 504(G) 6390 LF 80.000 80.000   80.000 $7.34 $0.00 $587.20
0013 STRUCTURAL STEEL 506(A) 1322 LB 500.000 0.000   0.000 $4.74 $0.00 $0.00
0014 CLASS AA CONCRETE 509(A) 1326 CY 333.600 333.600   333.600 $686.46 $0.00 $229,003.06
0015 MECHANICAL SPLICES 511 6306 EA 800.000 800.000   800.000 $14.53 $0.00 $11,624.00
0016 REINFORCING STEEL 511(A) 1332 LB 7,598.000 7,598.000   7,598.000 $1.02 $0.00 $7,749.96
0017 EPOXY COATED REINFORCING STEEL 511(B) 6010 LB 103,921.000 103,921.000   103,921.000 $1.00 $0.00 $103,921.00
0018 WATER REPELLENT (VISUALLY INSPECTED) 515(A) 6013 SY 556.800 542.510   542.510 $5.51 $0.00 $2,989.23
0019 PREPARATION OF CRACKS, ABOVE WATER 520(A) 6058 LF 70.000 15.080   15.080 $37.61 $0.00 $567.16
0020 EPOXY RESIN, ABOVE WATER 520(C) 6060 GAL 3.000 0.500   0.500 $107.08 $0.00 $53.54
0021 PNEUMATICALLY PLACED MORTAR 521(A) 6210 SY 5.000 6.630   6.630 $921.00 $0.00 $6,106.23
0022 (SP)CORROSION INHIBITOR(SURFACE APPLIED) 535 6130 SY 83.700 85.750   85.750 $53.50 $0.00 $4,587.63
0023 (PL)REPAIR BRIDGE ITEM (TYPE A) 540 4515 EA 383.000 80.000   80.000 $78.50 $0.00 $6,280.00
0024 (PL)REPAIR BRIDGE ITEM (TYPE B) 540 4525 EA 1.000 1.000   1.000 $6,460.25 $0.00 $6,460.25
0025 REMOVAL OF BRIDGE ITEMS 619(B) 2500 LSUM 1.000 1.000   1.000 $85,000.00 $0.00 $85,000.00
8002 PAINTING EXISTING STRUCTURES 512(A) 1323 LSUM 0.000 1.000   1.000 $26,763.00 $0.00 $26,763.00
8003 COLLECTION AND HANDLING OF WASTE 512(B) 6303 LSUM 0.000 1.000   1.000 $4,721.20 $0.00 $4,721.20
8009 CLSM BACKFILL 501(G) 6309 CY 0.000 4.000   4.000 $388.42 $0.00 $1,553.68
8010 CONCRETE JOINT SEALING 415 6300 LF 0.000 274.500   274.500 $5.40 $0.00 $1,482.30
8013 PAVEMENT/BRIDGE SMOOTHNESS ADJUSTMENT 430 5010 LSUM 0.000 1.000   1.000 $-1,201.34 $0.00 $-1,201.34
Subtotals For Category     0200/BRIDGE 'A'    $0.00 $607,745.62
Fed/State Project Number:    SBR-136B(217)SB Project:    27594(04) Category:    0300/TRAFFIC
0026 TRAFFIC STRIPE(MULTI-POLYMER)(4" WIDE) 856(A) 8530 LF 865.000 2,887.000   2,887.000 $1.10 $0.00 $3,175.70
0027 TRAFFIC STRIPE(MULTI-POLY)(12" WIDE) 856(A) 8548 LF 270.000 303.000   303.000 $4.50 $0.00 $1,363.50
0028 (PL)TRUCK MOUNTED ATTENUATOR 876(A) 8482 SD 180.000 246.000   246.000 $20.00 $0.00 $4,920.00
0029 DELIVER PORTABLE LONGITUDINAL BARRIER 877(B) 8484 LF 690.000 474.000   474.000 $26.50 $0.00 $12,561.00
0030 RELOCATION OF PORTABLE LONGITUDINAL BARRIER 877(C) 8486 LF 690.000 474.000   474.000 $5.74 $0.00 $2,720.76
0031 ARROW DISPLAY(TYPE C) 880(A) 8812 SD 180.000 296.000   296.000 $5.50 $0.00 $1,628.00
0032 CONSTRUCTION SIGNS 0 TO 6.25 SF 880(B) 8818 SD 1,980.000 1,680.000   1,680.000 $0.15 $0.00 $252.00
0033 CONSTRUCTION SIGNS 6.26 SF TO 15.99 SF 880(B) 8821 SD 2,160.000 3,521.000   3,521.000 $0.15 $0.00 $528.15
0034 CONSTRUCTION SIGNS 16.0 SF TO 32.99 SF 880(B) 8824 SD 2,340.000 3,680.000   3,680.000 $0.15 $0.00 $552.00
0035 CONSTRUCTION BARRICADES(TYPE III) 880(C) 8842 SD 675.000 1,134.000   1,134.000 $3.50 $0.00 $3,969.00
0036 WING BARRICADES 880(C) 8848 SD 360.000 1,104.000   1,104.000 $0.31 $0.00 $342.24
0037 WARNING LIGHTS(TYPE A) 880(E) 8860 SD 720.000 4,634.000   4,634.000 $2.14 $0.00 $9,916.76
0038 DRUMS 880(F) 8878 SD 4,230.000 14,452.000   14,452.000 $1.53 $0.00 $22,111.56
0039 PORT.CHANGEABLE MESSAGE SIGN 882(A) 8306 SD 208.000 290.000   290.000 $10.71 $0.00 $3,105.90
8007 TRAFFIC STRIPE(PAINT)(4" WIDE) 854(A) 8800 LF 0.000 1,500.000   1,500.000 $0.22 $0.00 $330.00
8008 PAVEMENT MRKNG.REMOVAL(TRAF.STRP) 857(F) 8006 LF 0.000 2,498.000   2,498.000 $0.55 $0.00 $1,373.90
Subtotals For Category     0300/TRAFFIC    $0.00 $68,850.47
Fed/State Project Number:    SBR-136B(217)SB Project:    27594(04) Category:    0600/STAKING
0040 CONSTRUCTION STAKING LEVEL I 642(A) 0095 LSUM 1.000 1.000   1.000 $6,062.00 $0.00 $6,062.00
Subtotals For Category     0600/STAKING    $0.00 $6,062.00
Fed/State Project Number:    SBR-136B(217)SB Project:    27594(04) Category:    0640/CONSTRUCTION
0041 MOBILIZATION 641 1552 LSUM 1.000 1.000   1.000 $38,500.69 $0.00 $38,500.70
Subtotals For Category     0640/CONSTRUCTION    $0.00 $38,500.70
Subtotals For Project SBR-136B(217)SB /27594(04) $0.00 $849,667.66