NMDOT_Indemnification_and_Hold_Harmless_Agreement.pdf
PDF 100 KB Posted
- Attached to
- Whole Block Reconstruction - Ciniza Drive, Gallup NM State and local contract opportunity
- Solicitation number
- ITB-2701
- 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) for activities conducted on state highways. The agreement requires the sponsoring entity to defend, protect, indemnify, and hold harmless NMDOT from all personal injury or property damage suffered by participants, NMDOT members, or third parties resulting from approved activities on designated state routes and mileposts. The document serves as a contractual requirement for entities seeking approval to close state highways for roadway work permits or special events, establishing clear liability responsibilities prior to activity commencement.
The agreement mandates that the sponsoring entity obtain liability insurance with a minimum coverage of one million dollars ($1,000,000.00) per occurrence and designate NMDOT as an additional insured on the policy. The sponsor must provide NMDOT with a certificate of insurance in a form satisfactory to the department prior to the scheduled event or activity. Failure to timely submit the certificate of insurance prior to the event constitutes grounds for NMDOT to cancel its approval of the state highway closure for the roadway work permit. The document requires notarization and signatures from both the authorized agent representing the sponsoring entity and a notary public, with specified fields for the date of execution and notary commission expiration.
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Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| Whole_Block_Reconstruction_-_Ciniza_Drive,_Gallup_NM_(Addendum_#1_Revision).pdf | ||
| Whole_Block_Reconstruction_-_Ciniza_Drive,_Gallup_NM.pdf | ||
| Plans:_Whole_Block,_Ciniza_Drive_ITB-2701-stamped.pdf | ||
| Engineer_Estimate_Whole_Block_Ciniza.pdf | ||
| Wage_Rates_MC-26-2209-A.pdf | ||
| EPA_Form_3510-9.pdf | ||
| NMDOT_A-066TrafficControlRoadwayWorkPermit.pdf | ||
| EPA_Form_3510-13.pdf | ||
| Gallup_Municipal_ROW-Public_Easement_Work_Permit.pdf | ||
| Statement_of_Intent_To_Pay_Prevailing_Wages.pdf | ||
| Affidavit_of_Wages_Paid.pdf | ||
| Gallup_Sample_Contract.pdf |
Show all 12
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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 .