Fillable Printable Trailer Parking and Storage Agreement - North Dakota

Trailer Parking and Storage Agreement - North Dakota

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Trailer Parking and Storage Agreement

Questions about this form? Please call 701-231-5771

PARK-Trailer- Rev 12/2014

Return this completed form to:

Parking Office

1801 15th Ave N

Fargo ND 58102

[email protected]

Phone: (701) 231-5771

Fax: (701) 231-7980

Parking Office Use Only

Date Received/Initials: ___________________

____ Approved: Permit number ______________________

____ Not Approved

Authorized By: ___________________________ Date:___________

Insurance/Indemnification:

Sponsor agrees to assume all risk of and liability for and hereby defends, indemnifies, and holds harmless the state of North Dakota

and its agencies, officers, and employees (State), from and against any and all claims based on the vicarious liability of the State or its

agents, but not against claims based on the State's contributory negligence, comparative and/or contributory negligence or fault, sole

negligence, or intentional misconduct. Sponsor shall also secure and keep in force during the entire term of the event noted herein,

from an insurance company, government self-insurance pool or government self-retention fund authorized to do business in North

Dakota, commercial general liability insurance covering any and all claims of any nature arising out of this agreement, naming the state

of North Dakota and its agencies, officers, and employees (State) as additional insured's, and furnish a certificate of insurance showing

the endorsement naming the State as additional insured's. The limits of liability required of the liability insurance coverage area at least

$250,000 per person and at least $1,000,000 per occurrence. The endorsement to the policy will provide that the policy may not be

canceled without 10 days' written notice to the State, shall contain a “Waiver of Subrogation” waiving any right of recovery the

insurance company may have against the State and provide that any attorney who represents the State under this policy must first

qualify as and be appointed by the North Dakota Attorney General as a Special Assistant Attorney General as required by N.D.C.C.

Section 54-12-08. Sponsor will deliver said certificate of insurance and endorsement to the University at least 10 days prior to the

event.

Authorized Signature Date

Name:

ID or #:

Contact Name:

Contact Phone: Contact Email:

Total Length (including tongue):

Department/Organization and Contact Information:

Trailer Information:

License Plate: (if applicable)

Trailer VIN: (if applicable)

Insurance Company Name:

Distinguishing Features (logos, names, etc.):

Fee and Funding:

Amount:

Account:

Fund: Dept #:

Covered

Flatbed

Stakebed Other

Insurance Policy Number:

Style:

West Building - either inside or outside the fenced area: $75.00 annually

FA Lot - West Side - Parking space required: $185.00 annually per parking space required