NMDOT_Indemnification_and_Hold_Harmless_Agreement.pdf
PDF 100 KB Posted
- Solicitation number
- ITB-2604
- Issued by
- Quay County, New Mexico
About this file
This document is an Indemnification and Hold Harmless Agreement from the New Mexico Department of Transportation (NMDOT). The form is designed to protect NMDOT from personal injury or property damage during an unspecified activity occurring on a state highway. The entity using the highway must obtain liability insurance coverage of $1,000,000 per occurrence, with NMDOT named as an additional insured. The agreement requires the entity to provide a certificate of insurance prior to the event, with failure to do so potentially resulting in cancellation of the roadway work permit.
The document outlines specific insurance and liability requirements for entities seeking to conduct activities on New Mexico state highways. The key financial requirement is a $1,000,000 liability insurance policy that must be submitted to NMDOT in a form deemed satisfactory by the department. The agreement must be signed by an authorized agent of the entity, notarized, and includes provisions for defending and holding NMDOT harmless from any damages or injuries that might occur during the specified activity.
View the file
Other files
Show all 12
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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 .