NMDOT_Indemnification_and_Hold_Harmless_Agreement.pdf
PDF 100 KB Posted
- Solicitation number
- ITB-2612
- Issued by
- San Juan 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 the NMDOT from all personal injury or property damage claims arising from the specified activity. The agreement applies to activities occurring at designated mileposts along specified routes and requires the entity to provide notice of the activity date and location to NMDOT for approval of any highway closures related to roadway work permits.
The sponsoring entity must obtain and maintain liability insurance with a minimum policy amount of one million dollars ($1,000,000.00) per occurrence that names NMDOT as an additional insured. A certificate of insurance in a form satisfactory to NMDOT must be provided prior to the event, with timely submission being a prerequisite to NMDOT's approval of any state highway closure for the roadway work permit. The agreement requires the authorized agent of the entity to sign the document, which must then be notarized with the notary public providing their signature and commission expiration date.
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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_______________________________________
File details come from the government source that posted it. Updated .