NMDOT_Indemnification_and_Hold_Harmless_Agreement.pdf
PDF 100 KB Posted
- Solicitation number
- ITB-2611
- 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) for activities conducted on state highways. The agreement requires entities conducting activities on NMDOT roadways to defend, protect, indemnify, and hold harmless the NMDOT from all personal injury, property damage, and third-party claims resulting from the specified activity. The form accommodates the entity name, authorized representative, activity description, date, location (including route and milepost information), and notarization requirements. The agreement establishes liability insurance requirements, project timelines, and conditions for roadway work permits.
The agreement mandates that the sponsor obtain liability insurance covering the event with a policy amount of one million dollars ($1,000,000.00) per occurrence, naming NMDOT as an additional insured. The sponsor must provide NMDOT with a certificate of insurance in a form acceptable to NMDOT prior to the event. Failure to timely provide the certificate of insurance serves as grounds for cancellation of NMDOT's approval of the state highway closure for the roadway work permit. The document requires notarization by an authorized notary public with commission expiration information documented on the agreement.
View the file
Other files
Show all 14
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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 .