NMDOT_Indemnification_and_Hold_Harmless_Agreement.pdf
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- Solicitation number
- ITB-2614
- Issued by
- San Juan County, New Mexico
About this file
This is an Indemnification and Hold Harmless Agreement form issued by the New Mexico Department of Transportation (NMDOT) that establishes liability and insurance requirements for entities conducting activities on state highways in New Mexico. The agreement requires the sponsoring entity to defend, protect, indemnify, and hold harmless NMDOT from all personal injury or property damage claims arising from specified activities conducted on state roadways. The form is designed to be completed with details regarding the activity type, date, location (including specific mileposts and routes), and the authorized representative executing the agreement. The document must be notarized and signed by the entity's authorized agent before the activity may proceed.
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 entity must provide NMDOT with a certificate of insurance in a form acceptable to NMDOT prior to commencement of the activity. Failure to provide timely proof of adequate insurance coverage constitutes grounds for NMDOT to cancel its approval of any state highway closure related to the activity. This agreement is referenced in the City of Gallup's New Sunshine Substation Transmission Line Construction solicitation (ITB-2614), requiring all contractors to execute this indemnification agreement and maintain the specified minimum liability coverage as a condition of contract performance.
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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 .