NMDOT_Indemnification_and_Hold_Harmless_Agreement.pdf
PDF 100 KB Posted
- 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
This is an Indemnification and Hold Harmless Agreement issued by the New Mexico Department of Transportation (NMDOT) that establishes liability and insurance requirements for entities conducting activities on state highways. The agreement requires the sponsoring entity to defend, protect, indemnify, and hold harmless NMDOT from all personal injury, property damage, and third-party claims arising from specified activities conducted on state roadways at designated mileposts and routes on a specified date. The sponsoring entity must obtain comprehensive liability insurance with a minimum coverage of one million dollars ($1,000,000.00) per occurrence, naming NMDOT as an additional insured. A certificate of insurance in a form satisfactory to NMDOT must be provided prior to the event; failure to submit timely documentation will result in cancellation of NMDOT's approval for highway closure associated with any roadway work permit.
The agreement requires completion and notarization by an authorized agent representing the entity, with signature and seal from a notary public. The document serves as a prerequisite condition for activities that necessitate temporary closures or work on New Mexico state highways, establishing clear financial responsibility and risk allocation between the sponsoring entity and the state transportation department.
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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_______________________________________
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