NMDOT_Indemnification_and_Hold_Harmless_Agreement.pdf
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- Solicitation number
- ITB-2617
- Issued by
- Mckinley County, New Mexico
About this file
This document is an Indemnification and Hold Harmless Agreement template issued by the New Mexico Department of Transportation (NMDOT) for use in activities on state highways. The agreement requires the sponsoring entity to defend and indemnify NMDOT from all personal injury, property damage, and third-party claims arising from activities conducted on specified state routes during designated dates and mileposts. The sponsor must obtain liability insurance with minimum coverage of $1,000,000 per occurrence, naming NMDOT as an additional insured, and provide a certificate of insurance in a form acceptable to NMDOT prior to the event. Failure to provide timely proof of insurance constitutes grounds for cancellation of NMDOT's approval for any state highway closure related to roadway work permits.
The agreement requires execution before a notary public with all signature lines and commission expiration dates documented. The template is designed to be completed with specific details including the sponsoring entity name, authorized representative, activity type, date, location by milepost, and affected route numbers. This instrument serves as a standard risk allocation mechanism protecting NMDOT from liability exposure while establishing the sponsor's responsibility for comprehensive insurance coverage during state highway activities.
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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 .