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 is an Indemnification and Hold Harmless Agreement form from the New Mexico Department of Transportation (NMDOT) designed to protect the department from liability arising from activities conducted on state highways. The agreement requires the sponsoring entity to defend and indemnify NMDOT, its members, and participants from all personal injury or property damage claims resulting from a specified activity at designated mileposts along identified routes. The form requires completion of activity details including the entity name, authorized representative, activity description, date, location mileposts, and route information. The agreement must be executed with notarization by an authorized agent of the sponsoring entity before the activity may proceed.
The agreement mandates that the sponsoring entity obtain comprehensive general liability insurance with a minimum coverage of one million dollars ($1,000,000.00) per occurrence, naming NMDOT as an additional insured party. The sponsor must provide NMDOT with a certificate of insurance in a form acceptable to the department prior to the event. Failure to provide timely proof of insurance coverage serves as grounds for cancellation of NMDOT's approval for highway closure associated with any roadway work permit. The form is a standardized template used by NMDOT for events and activities requiring use of state highway rights-of-way, establishing clear risk allocation and insurance requirements as preconditions for activity authorization.
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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 .