HomeMy WebLinkAboutHLP2013-121171 - I;z 1'
mt4 13-OW
MEMORANDUM CITY OF GRAPEVINE, TEXAS
TO: BRUNO RUMBELOW, CITY MANAGER
DAN HAMBRICK, RISK MANAGER
FROM: SCOTT WILLIAMS, DEVELOPMENT SERVICES
DIRECTOR/ BUILDING OFFICIAL
SUBJECT: HELICOPTER LIFT REQUEST
DATE: APRIL 3, 2013
Attached is a request for a helicopter lifts are scheduled for Wednesday, April 10,
2013 at 7:00 A.M. & a Rain Date of April 11, 2013 at 7:00 A.M. for 3000
Grapevine Mills Parkway #418, if it meets your approval, please sign below:
Bruno Rumbelow, City Manager
Dan Hambrick, Risk Manager
OACCook\HehcopterMemorandum
HOLD HARMLESS AND INDEMNITY AGREEMENT
PROJECT ADDRESS: Grapevine Mills Mall, 3000 Grapevine Mills Pkwy, Grapevine. Tx. 76051
Crocs Suite 418
NATURE OF OPERATION: air lifting air conditioning units
DATE OF OPERATION: 4-10-2013 with 4 -11 -2013 as weather date
1, Linda Norman . the undersigned, representing 5-State Helicopters, Inc., binding my heirs, executors,
administrators., administrators, estate and assigns, do hereby agree to completely and wholly release,
indemnify the hold harmless the city of Grapevine, its officers, agents. Independent contractors, and
employees from any and all claims, damages, Harm personal injury, including death, property damage,
lawsuits and judgments, including court costs, expenses and reasonable attorney's lices, and all other
expenses resulting from any and all activities conducted within the city of Grapevine,Texas.
It is the understanding f all parties that this release, indemnity, and bold
9 harmless agreement shall
apply whether or not the claims, damages, liarra, personal iqjury, including deaths, property damage,
lawsuits, judgments, court costs, attorney's fees and any other expenses arise from the
negligence of whatever nature, omissions, willful and intentional acts of this individual, company or
company's officers, agents, employees, independent contractors, other representatives, invitee,
licensee, or guests.
I the undersigned individual and/or company or company's officer certifies. warrants and represents that
the individual whose signature appears below is duly authorized to execute this agreement on behalf of
the firms, corporation partnership or other entity who will operate within the city of Grapevine, Texas.
In witness whereof, this agreement has been executed this 3 day and (month.) j�� 2013.
COMPANY: 5-STATE HELICOPTERS, INC.
BY: LINDA NORMAN (printed) L I AICI 14 NO:tYid Al
'11TLE: OWNER (signature)
tIN � A "11,
I
STATE OF TEXAS COUNTY OF ROC `W LL
Caledonim
Insurance Group, Inc.
Cerfificate of Insurance
Certificate Number.
This is to certify that the polic)lics) of insurance as described below have been issued to the Insured for whom this Certificate is executed and Ware in force at this
time. This Certificate is issued for information only and confers no rights upon the holder. This Certificate neither affirmatively nor negatively amends, extends or
alters the coverage afforded by such policy(ics) or binder(s) stated herein. This certificate cancels and supersedes all previously issued certificates.
Certificate Holder: City of Grapevine
PO Box 95104
Grape-vine, TX
Named Insured: 5 - State Helicopters, Inc,
285 Blackland Road
Royse City, TX 75189-4746
Polity T)pe: Aircraft Hull & Liability and Aviation General Liability Policy
Policy Period: February 01, 2013 to February 01, 2014 both days at 12:01 am Local Standard Time at the address of the Named
Insured shown above.
Insurer(s): Company
Aircraft Covered: Sikorsky S58T, N4XY; Sikorsky s58'r, N6131.
Coverages & Limits
Aircraft Liability
Combined Single Limit Bodily Injury, including Personal Injury and
Property Damage Liability(Excluding Passenger Liability)
Cargo Legal Liability
Cargo Legal Liability including Slung Loads
Coverage Limit
S10,00(000 each occurrence.
Coverage Limit
5500,000 each occurrence, subject to a deductible of $1,000 each claim.
Certificate Provisions
Additional Insured
With respect to Aircraft Liability, it is understood and agreed the Certificate Holder(s) shall be included as Additional Insured(s) hereunder solely
Kith respect to the operations of the Named Insured. It is specifically agreed the inclusion of rijoie than one Insured hereunder shall not operate to
increase the Limits of Liability and is limited to those coverages provided by these policies.
Certificate Date: 1125/2013
MR
Authorized Representative
3023 801h Avenue S.•., Suite 300
Mailing Address: P.O. Box 60, Mercer Island, Washington 98040-0060
Phone: (206) 232-9870 - ;Fax: (206) 232-9515
5- STATE HELICOPTERS INC.
-AERIAL CRANE SERVICE"
285 BLACKLAND ROAD ROYSE CITY, TEXAS 75189
972-636-4009 800-543-8442
FAX 972-636-1300
FAA CERT. LDUL59911
PROCEDURES REQUEST PF'R 8900.1 C11G. 89
Congested Area Plan
DATE: 4-3-2013
5-STATE HELICOPTERS, INC.
285 BLACKLAND ROAD
ROYSE ary, TEXAS 75189
972-636-4009
800 - 543 -8442
972-636-1300 FAX
CONTRACTOR:
Express Service Heating and Air
P.O. Box 1012
Rockwall, Texas 75087
JOB SITE:
Grapevine Mills Mail
Croes Suite 418
3000 Grapevine Mills Pkwy
Grapevinc,'I'exas 76051
HEIGHT OF BUILDING: 25 FEET
TOTAL OF LIFTS: I rtit up I rtu do
2400 lbs
DATEOFLIFTS: 4-10-2013
weather date: 4-11-2013
APPROXIMATELY: 7:00 atri
IF A PROBLEM OR SAFETY HAZARD
EXISTS THE (-.►R.OLJNI) PERSONS WITH
RADIOS WILL NOTIFY THE PILO] I TO
MOVE THEE I-IELICOPTERTO A SAFE
AREA.
N6BL OR N4X.Y
SIKORSKY S-58-F
STANDARD CATEGORY
PILOT: BRADFORD S. LADUTE
COMM. CERT. 2760587
PILOT: SCOTT BRADFORD LADUE
COMM. CERT 3250744
LENGTH OF THE CABLES
WILL BE 75 FT.
CONTACTED: City of Grapevine: Mr. Scott Williams (connie) 817-410-3158
Police and Fire Dispatch: 817-410 -8127 !3214 Karen Ballard
DFW Airport:
SIGNATURE OF RESPO L PANY OFFICIAL
5-STATE HELICOPTERS, INC.
285 BLACKLAND ROAD
ROYSE CITY, TEXAS 75189
972-636-4009
800-LIFT-442
FAX 9721-636-1300
FAA CERTIFICATE # LDUL-599B
DATE: 4-3-2013
CONGESTED AREA PLAN-EXT[,,RNAI, LOAD LIFT
TO: FAA OFFICE: Dallas, Texas
Telephone: 972-582-1800 Fax 972-582-1872
JOB SITE: Grapevine Mills Mail
Cross Suite 418
3000 Grapevine Mills Pkwy
Grapevine, Texas 76051
SCHEDULED DATE AND TIME OF OPERATION: 4-10-2013 with rain date of 4-11-2013) 7:00 am
CONTRACTOR: Express Service Heating& Air
P.O. Box 1012
Rockwall, Texas 75087
CONTACT PERSON: Jeff
Telephone: 972-771-7807 Fax 972-771-1551
AIRCRAFT: S-58T N-6BLORN4XY STANDARD CATEGORY
PILOT: BRADFORD S. LADUE COMM CER'l-. #2760587
SCOTT BRADFORD LADUE CONIM. CERT. #3250744
LOADS: NUMBER TYPE WEIGHTS
I rtu tip and I rtu down 2400 lbs
CARRYING HAZARDOUS MATERIAL: NO
DESCRIPTION:
CONTACTS: City of Grapevine: MR. Scott Williams (connic) 817-410-3158
Fire and Police Dispatch: Karen Ballard 817-410-8127
DFW Airport:
SIGNATURE OF RESPQ IBLL,' COMPANY iO�l-'Fl-�-C-IA�L
NARRATIVE OF PLAN OF OPERATIONS:
5-STATE HELICOPTERS, INC.
Congested Area Plan
Job Site: Grapevine Mills Mall: Crocs: Suite 418
3000 Grapevine. Mill Pkwy
Grapevine, Texas 76051
DATFOFJOB: 4-10-2013 with rain date of4-I 1-2013
END OF JOB: 4-10-2013 with rain date of 4 -11 -2013
ENCLOSED ON SKETCH ATTACI IEO TO THIS REQUEST
FLIGHT PATH FROM THE STAGING AREA WHERE THE EQUIPMENT IS LIFTED TO THE AREA
WHERE THE EQUIPMENT IS PLACED ON THE BUILDING WILL BE CLEARED OF
UNAUTHORIZED PERSONS. THE ESTIMATE OF HOW MANY FLOORS OF THE BUILDING WILL
BE PENETRA'FED IF THE LOAD IS RELEASE[) AT THE MAXIMUM HEIGI-IT WI-IEN LIFTED
ABOVE THE ROOF IS NONE. FOR SAFETY REASONS THE AREA OFTI-IE BUILDING BEING
LIFTED OVER WILL BE VACANT.
ESTIMATED LENGTH OF CABLE IN FEET .APPROXIMATELY 75 FEET
EMERGENCY LANDING AREA: UNLESS OTHERWISE NOTED ON THE PLOT PLAN. THE
HELICOPTER LANDING AREA AND PICK UP SITE WILL BE EMERGENCY LANDING AREAS,
ADDITIONAL INFORMATION: THIS IS A EXSISTING MALL. THE SECTION OF THE MALL BEING
LIFTED OVER WILL BE VACANT DURING THE LIFT. NO UNAUTHORIZED PERSONS WILL BE
ALLOWED INTO THE OPERATIONAL AREA OF JOB SITE DURING THE: LIFTING OFTI IF'
EQUIPMENT TO THE ROOF. THE PARKING LOT ON THE NORTI-IWEST SIDE OF `I'[ 11, MALL
WILL BE USED FOR LANDING, STAGING. AND EMERGENCY AREA. HELICOPTER LANDING
AREA WILL BE SECURED BEFORE THE HELICOPTER ARRIVES AND WILL REMAIN SECURED
UNTIL THE HELICOPTER HAS LEFT THE AREA. CONTRACTOR AND SUPERINTENDENT OF
THE JOB SITE WILL CLOSE TI IE OPERATIONAL AREA SO NO UNAUTHORIZED PERSONS WILL
BE ALLOWED INTO THE PARKING LOT DURING THE LIFT. THE PATH BETWEEN THE
STAGING AREA AND WHERE THE UNITS WILL BE PLACED ON THE ROOF WILL BE CLEAR. NO
UNAUTHORIZED PERSONS WILL. BE ALLOWED IN 'THE LIFTING AREA. SAFETY BRIEFINGS
THAT ARE GIVEN BY 5-STATE HELICOPTERS GROUND CREW WILL 11F, GIVEN BEFORE THE
LIFTING :BEGINS. THE OPERATIONAL AREA WILL BE SURVEYED BY 5-STATE HELICOPTERS
GROUND PERSONAL FOR ANY SAFETY HAZARDS BEFORE THE LIFTING OF TI IF EQUIPMENT
BEGINS. IF ANY SAFETY HAZARDS EXIST THE CONTRACTOR WILL BE REQUIRED TO
ELIMINATE THE HAZARD BEFORE THE LIFTING OF THE EQUIPMENT BEGINS. 5-STATF,
HELICOPTERS GROUNDSMAN AND R0017 PERSON, I IAS RADIO'S AND WILL BE TALKING
WITHTHE PILOT' AT ALL "TIMES DURINGTHF.' LIFTING PROCESS. IF FOR ANY REASON THERE
SHOULD BE A SAFETY FACTOR ARISE THE'Y WILL IMMEDIATELY ALERT Tf I.EPILOT. ']'HE
PILOT WILL MOVE TIME HELICOPTER TO A SAFE AREA UNIT THE RISK HAS BEEN
CORRECTED.
LIFTING AREA COULD BE ANYWHERE INSIDE T11E OPERATIONAL AREA DUE TO
CONTRACTOR AND OR St.)PERIN'1'1-,Nl)l N'I'MOVIN(i'THE 1:,"Qtl"IIPMEN'I' BEFORE '1'14L-
HELICOPTER ARRIVES. FLIGHT PATH WILL BE WITHIN OPEMTIONAL AREA.
SIGNATURE OI-'RESPONSIBI- E(',OMPAN'Y' 01-1 °1CIAL
PAGE 4
5-STATE HELICOPTERS, INC.
Congested Area Plan
JOB SITE: Grapevine Mills Mall Crow Suite 418
3000 Grapevine Mills Pk,,N,,v
Grapevine, Texas 76051
DATE OF JOB: 4-10-2013 with weather date of 4-11-2013
TIME: approximately 7:00 am
THERE ARE POWER LINES AND LIGHT POLES IN TI AREA BIJT, THEY WILL NOT
CAUSE A SAI`E'rY HAZARD TO THE LIFT.
TODAY'S DATE: 4-3-2013
PLAN PREPARED BY: Linda Nomian
SHOULD A WEATHER, MECHANICAL OR MATERIAL DELAY BFFIXPERIENCED THIS
CAP IS APPROVED FOR TI-1E DATE AND TIME LISTED ABOVE PLUS 10 DAYS.
FAA: Dallas, Texas
APPROVED BY:
FAA STAMP:
THIS COMPANY COMPLIES WITH THE "CODE OF I,. ri i ics: OF THE HELICOPTER
ASSOCIATION OF AMERICA.
2 3 6 3 a: V9 7426 3 6 13 0- L F i ITE HELI
PAGE 4
5-STATE'HELICOPTERS, Nc.i
Congested Area Plan
1013 SITE: Goapevilk-, Mills Mall ?Wt-. 418
-3000 Grapevine Mills Pk5,
Oveviat, Texas 716W I
)DATE 2 OFIODM4-1, 1
TIME: apVroxWaTc;l)-Vy-17-!-:;lo arn
L
MU, ARE PQWFR LDIES AND�
TOHT�POLES IN THE AREA BUT, THEY Wes. N-OT,,,
._.'CAUJSE A SAFETY HAZARD TO. I E-LJFJ;'%
TODAY'S DATF: 4-m'-1 -2) 0 13
PLAN PREPARED BY:
SHOULD A WEATHER, ME-ClINNICAL O;ZINLAM-3.-AL DELAY BE EXPERIENCED THIS
CAP IS AMR.011RD F:)R TIE DAT7- AND I' WE LIST)FI) AJ30'VE PLUS 10 DAYS,
FAA: Dallas, Tcus
THIS COMPAN'YCOMI'l . N�v-j,l,t4-'HE",'.,'GO O'ETRICS:0 F HE 'f CO TER
R F F
ASSOCIATION OF AMI
1� 7 04/07
5-STA hHtLICU'-"-PT-hr-' TRZ, S INC.
Bolo jkkJPKNJ Point P., Al
Mag 12,00
Wed Apr 03 09:02 2013
Scale 1:125,000 (at center)
2 Miles
2 krn
- LocalRoad
- Trail
C--= Interstatell-imited Access
Major Connector
State Route
Exit
Railroad
Small Town
G�
E ROYAL UN YAf
iz
41L ParklReservation
--*tSched Service Airport
Locale
+VALN,;T
Cemetery
Hiqhl
County Boundary
�01%7�s ITC,
Water
7y'
4t. iltltC�:I
Airfield
Geographic Feature
41L ParklReservation
--*tSched Service Airport
Locale
Cemetery
County Boundary
Water
INC. 5-SrI"ATE HELICOPTERS, `
,Grapevine Recreational Park "1�
7 "
vRoc letiuc Park m
t W S..&NOY LA KE RD
N32" 58,043'
t---t - - -- Oak FW19 �y ` 02.470,' e SAU
��
i .�
?TTT -1 C1 j
GELIPE l' 11\.L t1tLLS %9 ;1LL
�>
-- T
3000 GRAPEVINE MILLS PKN, � zs " � �l� .-tf
r.
GRAPEVINE, TEXAS' b051 ,,'
IT tiE RO t
DATE OF LIFT: 4-10-2013 wk tl I IELICOPTER WILL NOT BE
°
TIME: APPROkIMA; LLY 7:00 AM 1 � `- -� ti101.ZE " �`� t4?rr
1 i ��� '1 *1IA1N 1`5 1"T. AB�?VE A25
_,
,1 P 1y r
a� : LL_
F.Nd�t.L.. coFartt. RD 121 _ NIALL WlIEN AIR LIFTING o
' 4vwL� -I 382 114 EQL1Pb1Et`7 "1 "O'TLIE ROOF. ,
G I p ine 1?/
y4 1 ./J�,� PILO "r �\ 1I.L ELI= IN_�
�cti _ z �+ `° '� CONTACT
�� y ' , A WITH DFW CONTROL
14 TOWER
�- K�z
a
11.1 `-- rte,,,,... _.-^ -! � i 'i''oicc� � � � �•f � • �«
—r m
_`.�` � to — �.•—} �"
tDal)a, '1't Worth )ntemati . at r
t ' � Leo � i '� t,a�
L
L _
r
Minters' Chapel �. ��,
�, 1D
RJE;GpADF R IN 29TH ) eyv 4,
r -
i2?(
s 1E1
cAROON ro
2001 D4 nrnle Stie�K <ltlas U5l 21G i iIli
Inc.. Re[. tt:'?tn ?1 g
,.t, „ ,. ,
%lag 13.00 —
Wed Apr 03 08:59 2013 Local Road Small Town
Scale 1:62,500 (at center) Trail Airfield t
1 Miles C== InterstatelLirrited Access PaNReservation
2 km
Major Connector Sched Service Airport
State Route Locale
Exit Cemetery
Railroad County Boundary
Point of Interest Water
�� I
X0
hti
cz
it
LIP
'ZJ
71
tlY
.... . .. .
ji
�!: ... ............ ....
............
Un
O�v
Jf
. . ..........