NMDOT_Indemnification_and_Hold_Harmless_Agreement.pdf
PDF 100 KB Posted
- Solicitation number
- ITB-2614
- Issued by
- San Juan County, New Mexico
About this file
This is an Indemnification and Hold Harmless Agreement from the New Mexico Department of Transportation (NMDOT) that establishes liability and insurance requirements for entities conducting activities on state highways. The agreement requires the contracting entity to defend, protect, indemnify, and hold harmless NMDOT from all personal injury or property damage claims arising from the specified activity. The document is a template form that must be completed with details including the entity name, authorized signatory, the specific activity being conducted, the date and location of the activity (identified by route and milepost), and the responsible individual or organization. The agreement is executed through notarization and requires the authorized agent's signature along with a notary public's authentication.
The agreement mandates that the sponsoring entity obtain comprehensive liability insurance with a minimum coverage of one million dollars ($1,000,000.00) per occurrence, with NMDOT named as an additional insured on the policy. The sponsor must provide NMDOT with a certificate of insurance in a form approved by NMDOT prior to the event or activity. Non-compliance with the insurance requirement, specifically the failure to provide a timely certificate of insurance, constitutes grounds for NMDOT to cancel its approval for any roadway work permit or closure of a state highway associated with the project.
View the file
Other files
Show all 29
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 .