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
NMDOT Indemnification and Hold Harmless Agreement Summary
This is an Indemnification and Hold Harmless Agreement form utilized by the New Mexico Department of Transportation (NMDOT) to manage liability for activities and events conducted on state highways. The agreement requires entities organizing activities on NMDOT roadways to assume responsibility for defending and indemnifying NMDOT against claims arising from personal injury, property damage, or third-party claims resulting from the specified activity. The form is designed to be completed with details regarding the organizing entity, authorized representative, activity description, date of activity, specific route segments and mileposts affected, and the designated location where the activity will occur.
The agreement mandates that the sponsoring entity obtain comprehensive liability insurance coverage in the amount of one million dollars ($1,000,000.00) per occurrence, with NMDOT named as an additional insured. The sponsoring entity must provide NMDOT with a certificate of insurance in a form acceptable to NMDOT prior to the event. Failure to timely submit the certificate of insurance constitutes grounds for NMDOT to cancel approval of the state highway closure and associated roadway work permit. The agreement requires notarization and is executed by the authorized agent representing the entity, with certification by a notary public including the notary's 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 .