NMDOT_Indemnification_and_Hold_Harmless_Agreement.pdf
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- Attached to
- Carbon Coal Road, McKinley County Industrial Park Waterline - US Department of Commerce (EDA) 08-79-05634
- Solicitation number
- ITB-2609
- Issued by
- Quay County, New Mexico
About this file
This is an Indemnification and Hold Harmless Agreement issued by the New Mexico Department of Transportation (NMDOT) that establishes liability and insurance requirements for entities conducting activities on state highways. The agreement requires the sponsoring entity to defend, protect, indemnify, and hold harmless NMDOT from all personal injury, property damage, or third-party claims arising from approved activities conducted on specified state highway segments. The agreement is executed by an authorized representative of the entity and must be notarized. The document includes blank fields for the entity name, authorized signatory, activity description, date of activity, specific mileposts, and affected routes.
The agreement mandates that the sponsoring entity obtain comprehensive liability insurance with a minimum coverage amount of one million dollars ($1,000,000.00) per occurrence, with NMDOT named as an additional insured on the policy. The entity must provide NMDOT with a certificate of insurance in a form approved by NMDOT prior to the event. Failure to submit the required certificate of insurance in a timely manner constitutes grounds for NMDOT to cancel its approval for any state highway closures associated with the roadway work permit. This agreement is standard for activities affecting state transportation infrastructure and represents a critical prerequisite for obtaining authorization to conduct work on New Mexico highways.
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Text version
NEW MEXICO DEPARTMENT OF TRANSPORTATION (NMDOT)
INDEMNIFICATION AND HOLD HARMLESS AGREEMENT
_____________________________________________________acting through its authorized agent, (entity) _____________________________________________________agrees to defend, protect, indemnify (person authorized to sign on behalf of entity) and hold harmless the New Mexico Department of Transportation (NMDOT) from all personal injury or property damage suffered by the _____________________________________, its members and (entity) participants, the NMDOT, or by third parties resulting from the________________________________ (activity) to be held on ______________________________ at or from milepost(s) _________________________ (date of activity) (mileposts) following route(s) ___________________________. Additionally the above agrees to obtain liability (route) insurance covering the event in the policy amount of one million dollars ($1,000,000.00) per occurrence, which names the NMDOT as an additional insured. Sponsor shall provide NMDOT with a certificate of insurance in a form satisfactory to NMDOT as evidence of the insurance coverage prior to the event.
Failure to timely provide a certificate of insurance shall be grounds for cancellation of NMDOT’s approval of the closing of a state highway for the roadway work permit.
Authorized Agent Signature__________________________________
SUBSCRIBED AND SWORN to before me this______________ day of ______________, 20___________
Notary Public Signature_______________________________________
My Commission Expires_______________________________________
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