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Home My WebLink AboutHLP2012-3203MEMORANDUM 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: September 6, 2012 Attached is a request for a helicopter lifts are scheduled for Monday, September 10, 2012 at 7:00 A.M. and Tuesday, September 11, 2012 at 7:00 A.M. for 601 Westport Pkwy., if it meets your approval, please sign below: 2� Bruno Rumbelow, City Manager Dan Hambrick, Risk Manager OACCook\ IelicopterMemorandum September 6, 2012 The attached attached mem Manager has Services. application is for a Helicopter Lift Request. Please sign the o_ and forward packet to the City Manager's Office. Once City signed please forward back to Connie Cook, Development a• — Dan Hambrick, Risk Manager... j (' Bruno Rumbelow, City Manager Thank you, & r\;4 Cook Connie Cook Development Services (817) 410 -3158 09/07/2012 14:10 9726361300 ESep. '!. 10113 1:09P%-126361300 PAGE 4 S -STATE HELICOPTERS, INC. Congested Area Plan JOB SM: Geman Deli 601 'Westport Pkwy-Suite 0100 Grapevine, Texas 76051 DATE. OF JOB.- 9-10-2012/ 9- 11.2012 TIME: appmximately 7:00 gna 5 STATE HEL1 rHUt UZIU/ 5 STATE HELI No. 7209 P. 2- 86!10 TMRE ARE POWER :LINES AND LIGHT POLES IN THE AREA BUT, THEY WILL NOT CAUSE A SAFETY HAZARD TO THE LIFT. TODAY'S DATE, 9--6 -2012 r PLAIN PRF„PARED BY : LimLda�rn�e►n SHOULD A WEATIMR, NIECHAN'ICAL OR MATERI,AI. DELAY BE EXPERIENCED THIS CAP IS APPROVED FOR TEE DATE AND TIME LISIED ABOVE PLUS 10 DAYS. FAA., Dallas, Texas APPROVED BY. FAA STAMP- THIS COMPANY CONIPLIES WITH THE "CODE OF EMM- OF THE HMCOPTER ASSOCIATION OF AID MRI;C:A. 09/06/2012 14:18 9726361300 5 STATE HELI PAGE 02/11 HOLD HARMLESS AND INDEMNITY AGREEMENT PROJECT ADDRESS: (pp 6 Wer,5T'Pv rr ('%'LPev%A -�C' , 7X NATURE OF OPERATION: Air Lifting Air Conditioning Units DATE OF OPERATION:.. 4.10 -:x I, 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, indeminify 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 fees, and all other expenses resulting from any and all activities conducted within the city of Grapevine, Texas. It is the understanding of all parties that this release, indemnity, and hold harmless agreement shall apply whether or .not the claims, damages, harm, personal injury, including deaths, property damage, lawsuits, judgrnents, 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 kh day and (month) ,2012. COMPANY: 5 -STATE HELICOPTERS,C. BY: LINDA NORMAN (printed) TITLE. OWNER (signature) STATE OF �p_y�_ COUNTY OF This instrument was acknowledged before me on this the 4d"/A' _Day o�OX 2 NOTARY PUBLIC IN AND FOR THE STATE OF My commissio expires — p signature , r 'MD&M.VAtOif GA1ry 01 20131 09/06/2012 14:18 9726361300 5 STATE HELI PAGE 03/11 C . =.Mail drleur kw- Certificate of Insurance Certifiaee Numbs: 2735?FXVST -1 Ilia is to coftity that the policy(ies) of inturacc as described below have been issued to the insured for whore this Certificate is executed and W6 my in ferao•a this tine. This Cartiti`icate is issued for iafon mtion only and coofcrs uo rights upon the holder. This Certificate neither afftMA*ely nor negatively arttaods, extends or alters the ooverttpjc afforded by ouch policy(ies) or binder(s) stated hernia. This certi&ste c mcals end supenades all previously issued act0 ieotm Certificate Holder: City of Grapevine PO Box 95104 Grapevine, TX Named Insured: 5 - State Helicopters, Inc. 28$ Blackland Aoad Royse City, TX 751894746 Policy Type: Aircraft Hull & i..iability and Aviation General Liability Policy Policy Period: February 01,;2012 to February 01, 2013 both days at 12:01 am Local Standard Time at the address of the Nmned lnau W shown above. Insurer(s),. Company Policy No. % Participation StarNet Insureatce Company through Berkley Aviation, LLC BA120200017/BA12020001 100% 8 Aircraft Covered: Sikorsky S58T, N XY; Sikorsky S58T, J CONarI Aircraft Liability Combined Single Limit Bodily Injury, including Personal Injusy and Property Damage Liability(PxeludiAg Pameager Liability) Cargo Legall Usblity Cargo Legal liability including Stung loads V6BL rgsts dt Limib Coverage Limit $10,000,000 each occurrence. Coverage Limit S500,000 each occurrence, subject to a deductible of $ 1,000 each claim Certificate Providons AdditioaW Insured With respect to Aircraft Liability, it Is understood and agreed the Certificate Holder(s) aball be included as Additional Insureds) berauader solely will► respect to the operations oftbe Named Insured It is specifically agreed the inclusion of more than one Insured betettudcr shall not operate to increase the Limits of Liability and is limited to those coverages provided by these policies. CartifkateDate: if3012012 Audwrized Representative 3023 80th Avenue S.E., Suite 300 Ma7iag Adders P.0. Box 60. Macer Island Waht'apou 980404060 Pbeoe: (206) 23,2 -9870 - Fax: (2o6) 232 -31515 09/06/2012 14:18 9726361300 5 STATE HELI PAGE 04/11 FIVE 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. LDUL599B PROCEDURES REQUEST PER 8900.1 CHG. 89 Congested Area Plan DATE: 9-6 -2012 5- STATE HELICOPTERS, INC. 285 BLACKLAND ROAD ROYSE CITY, TEXAS 75189 972 - 6364009 800- 543 -8442 972 - 636 -1300 FAX CONTRACTOR.: Metro Mechanical 504 Beltlive # 102 Mesquite, Texas 75149 Permit # 12 -2945 JOB SITE. German Deli Suite #100 601 Westport Pkwy Grapevine, Texas 76051 HEIG14T OF BUILDING: 25 FEET TOTAL OF LIFTS: 5 rtu up l rtu up 2600 Ibs and I curb up DATE OF LIFTS: 9 -10 -2012 /9 -11 -2012 APPROXIMATELY: 7 :00 am IF A PROBLEM OR SAFETY HAZARD EXISTS THE GROUND PERSONS WITH RADIOS WILL NOTIFY THE PILOT TO MOVE THE HELICOPTER TO A SAFE AREA. N6BL OR N4XY SIKORSKY S -58T STANDARD CATEGORY PILOT: BRADFORD S. LADUE COMM. CERT. 2760587 PILOT: SCOTT BRADFORD LADUE COMM. CERT 3250744 LENGTH OF THE CABLES WILL BE 75 FT, CONTACTED: City of Grapevine: Mr. Scott Willams 817 -410 -3158 Police and Fire Dispatch: Karen Ballard 817 -410 -3260 DFW Airspace Mr. Mike Porter 972 -615 -2833 C� SIGNATURE OF RESPONSIBLE COMPANY OFFICIAL 09/06/2012 14:16 9726361300 5 STATE FELI PAGE 05/11 S -STATE HELICOPTERS, INC. 285 BLACKLAND ROAD ROYSE CITY, TEXAS 75189 972 - 6364009 800 -LIFT -442 FAX 972 - 636 -1300 FAA CERTIFICATE # LDUL -5998 DATE: 9 -6 -2012 CONGESTED AREA PLAN - EXTERNAL LOAD LIFT TO: FAA OFFICE: Dallas, Texas TELEPHONE 972 -582 -1800 Fax 972 -582 -1872 JOB SITE German Deli Suite # 100 601 Westprot Pkwy Grapevine, Texas 76051 SCHEDULED DATE AND TIME OF OPERATION: 9 -10 -2012 with back up date of 9 -11 -2012 CONTRACTOR. Metro Mechanical 504 Beltline #102 Mesquite, Texas 75149 CONTACT PERSON: Sam Cramer Telephone: 972 - 289 -8681 Fax: 972-289-2666 AIRCRAFT: S -58T N -6BL OR N4XY STANDARD CATEGORY PILOT: BRADFORD S. LADUE COMM CERT. # 2760587 SCOTT BRADFORD LADUE COMM. CERT. #3250744 LOADS: NUMBER TYPE WEIGHTS 5 rtu's up and 1 rtu down 2600 lbs 1 curb up CARRYING HAZARDOUS MATERIAL: NO DESCRIPTION: CONTACTS: City of Grapevine, Texas Mr_ Scott Williams 817 -410 -8127 Police and Fire Dispatch- Karen Ballard 817 -410 -3260 DFW Airspace Mr. Mike Porter 817 -615 -2833 �e� 0 ou'or—' SIGNATURE OF RESPONSIBLE COMPANY OFFICIAL 09/06/2012 14:18 9726361300 5 STATE HELI PAGE 06/11 NARRATIVE OF PLAN OF OPERATIONS: 5 -STATE HELICOPTERS, INC. Congested Area. Plan Job Site: German Deli Suite #100 601 Westprot Pkwy Grapevine, Texas 76051 DATE OF JOB: 9-10-2012/9-11-2012 END OF JOB: 9 -10 -2012 /9-11-2012 ENCLOSED ON SKETCH ATTACHED 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 PENETRATED IF THE LOAD IS RELEASED AT THE MAXIMUM HEIGHT WHEN LIFTED ABOVE THE ROOF IS NONE. FOR SAFETY REASONS THE AREA OF THE 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 BUILDING. THE BUILDING WILL BE VACANT DURING THE LIFT. NO UNAUTHORIZED PERSONS WILL BE ALLOWED INTO THE OPERATIONAL AREA OF JOB SITE DURING THE LIFTING OF THE EQUIPMENT TO THE ROOF, THE PARKING LOT ON THE WEST SIDE OF THE BUILDING 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 THE 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 BE 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 THE EQUIPMENT BEGINS. IF ANY SAFETY HAZARDS EXIST THE CONTRACTOR WILL BE REQUIRED TO ELIMINATE THE HAZARD BEFORE THE LIFTING OF THE EQUIPMENT BEGINS. 5 -STATE HELICOPTERS GROUNDSMAN AND ROOF PERSON HAS RADIO'S AND WILL BE TALKING WITH THE PILOT AT ALL TIMES DURING THE LIFTING PROCESS. IF FOR ANY REASON THERE SHOULD BE A SAFETY FACTOR ARISE THEY WILL IMMEDIATELY ALERT THE PILOT, THE PILOT WILL MOVE THE HELICOPTER TO A SAFE AREA UNIT THE RISK HAS BEEN CORRECTED. LIFTING AREA COULD BE ANYWHERE INSIDE TIME OPERATIONAL AREA DUE TO CONTRACTOR AND OR SUPERINTENDENT MOVING THE EQUIPMENT BEFORE THE HELICOPTER ARRIVES. FLIGHT PATH WILL BE WITHIN OPERATIONAL AREA. r V-Z91 c 14.v, 04-- '4 L(& Qt SIGNATURE OF RE PONSIBLE COMPANY OFFICIAL 09/06/2012 14:18 9726361300 5 STATE HELI PAGE 07/11 'PAGE 4 5 -STATE HELICOPTERS, INC. Congested Area Plan JOB SITE: German Deli 601 Westport Pkwy Suite #100 Grapevine, Texas 76051 DATE OF JOB: 9 -10 -2012 / 9 -11 -2012 TIME: approximately 7:00 am T14ERE ARE POWER LINES AND LIGHT POLES IN THE AREA BUT, THEY WILL NOT CAUSE A SAFETY I4AZARD TO THE LIFT. TODAY'S DATE: 9 -6 -2012 PLAN PREPARED BY: Linda Norman r SHOULD A WEATHER, MECHANICAL OR MATERIAL DELAY BE EXPERIENCED THIS CAP IS APPROVED FOR THE DATE AND TIME LISTED ABOVE PLUS 10 DAYS. FAA: Dallas, Texas APPROVED BY: FAA STAMP. THIS COMPANY COMPLIES WITH THE "CODE OF ETHICS: OF THE HELICOPTER ASSOCIATION OF AMERICA. 09/06/2012 14:18 9726361300 5 STATE FELI PAGE 08/11 .7 79 5-STATE HELICOPTERS, INC. C=== 5 km interawttguvileu Access Locale -Toll Hlghvay Major connector State Route Exit Sched Service Airport + Public Airport ♦ SMAII Town County Boundary 09/06/2012 14:18 9726361300 5 STATE HELI PAGE 09/11 5-STATE HELICOPTERS, INC. Soo 3 CAPITOL MUSTANG MUSTANG MUSTANG OR TE GERMAN DELI CR T Im , L: 3� 1G D " SUITE #100 177H VEST hk 601 WESTPORT PKWY TH GRAPEVINE, TEXAS 76051 pRoo .UM1 r J6J%A5T -R�l yo I N32- 54,302-1 13 DATE OF LIFT: 9-10-2012 JW97- 16TH G'T WITH BACK OF DATE OF 9 11-2012 TIME: APPROXIMATELY 7:00 AM K li—ELICOPTER WILL NOT AND HI s BE CR MORE THAN 100 FT. p ABOVE A 25 FT. BUILDING WHEN Ro AIR LIFTING EQUIPMENT TO ZSTH N F! NCH HOLL MEA S PILOT WILL BE IN CONTACT LU ,I , WITH WEST CONTROL if TOWER LADE fjo 3: W 29TH z 'Ile Mag 14.00 Thu SOP 013 10:52 2012 Local Road Cemetery Scale 1:31.260 (at center) Interstate/Limlitad A00eS3 Water 2000 Feet Major Connector Rlvar/Cana) State Route -1000 Meters ---- Rumnno Small Town ( ~---mrfiwu 09/06/2012 14:18 9726361300 5 STATE HELI PAGE 10/11 ------- --- - - --- 5-STATE HELICOPTERS INC. .......... . GERMAN DELI SUITE #100 601 WESTPORT PKWY GRAPEVINE, TEXAS 760� DATE OF LIFT: 9-10-201: WITH BACK Of DATE 01 9-11-2012 TIME: APPROXIMATELY Mag 15.00 Thu Sep 06 10,46 2012 Scale 1:15,625 (at center) 1000 Fs ®t 500 Meters r-- I -- HELICOPTER WILL NO] BE MORE THAN 100 FT, ABOVE A 25 FT. BUILDING WHI - Local Road CZ== Interstatail-Imitad Access Major Connector State Route Exit AlMald Water River/Canal PAGE 11/11 ;Nils I'D 2001 Del —c. Street Atlas USA; 0 2001 GIDT, In, Mag 16.00 Thu Sep 06 09;53 2012 Local Road Scale 1:7.812 (at center) C== Interstate/Limited Access X500 Feet Feel Major Connector L 200 Meters Water River/Canal E � -V 4. OC IQ- dve5 HP OfficeJet K Series K80 Personal Printer /Fax /Copier /Scanner Last Transaction Date Time Z= Identification Sep 6 2 :02pm Received 9726361300 Log for DEVELOPMENT SERVICES 8174103018 Sep 06 2012 2:07pm D r i Pales Result 3:41 11 OK