[Pin Code][hhhhhhj]This is a S A M P L E only. You should consult your attorney for specific
language to meet your specific needs. Additionally, you should refer to your general
liability policy for any specific requirements
Insured’s Name and Address
INDEMINIFICATION, HOLD HARMLESS AND INSURANCE AGREEMENT
A. INDEMNIFICATION AND HOLD HARMLESS
To the extent permitted by law,
agrees to defend, indemnify and hold harmless ______________________ (“General Contractor”)
and______________________________________________________(“Owner”), (if any)
its/their officers, directors, agents and employees from and against any and all claims, suits, liens,
judgments, damages, losses and expenses including reasonable legal fees and costs arising in
whole or in part and in any manner from acts, omissions, breach or default of Subcontractor, in
connection with performance of any work by Subcontractor, its officers, directors, agents,
employees and subcontractors.
• Subcontractor hereby agrees that it will obtain and keep in force an insurance
policy/policies to cover its liability hereunder in the minimum amounts of $1,000,000 per
occurrence (or another appropriate agreed upon amount) and will defend and hold
harmless _______________________ (General Contractor) and owner for personal
injury, bodily injury and property damage.
• Said liability policies shall name _________________ (General Contractor) and owner
as additional insured’s and shall be primary to any other insurance policies.
• Subcontractor will obtain and keep in force Workers Compensation insurance including
Employees Liability to the full statutory limits.
• Subcontractor shall furnish to ____________________(General Contractor) Certificates
of Insurance evidencing that the aforesaid insurance coverage is in full force.