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Home My WebLink AboutHLP2012-3002MEMORANDUM 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: August 22, 2012 Attached is a request for a helicopter lifts are scheduled for Sunday, August 26, 2012 at 8:00 A.M., Sunday, September 9, 2012 at 8:00 A.M., and Sunday September 23, 2012 at 8:00 A.M., for 1001 Nolen Drive, if it meets your approval, please sign below: Bruno Rumbelow, City Manager Dan Hambrick, Risk Manager O: \CCook\Heli eopterMemorandum 08/21/2012 11:26 9726361300 5 STATE IELI PAGE 02/10 HOLD HARMLESS AND INDEMNITY AGREEMENT PROJECT ADDRESS:1001 Nolen Dr., Grapevine, Texas 76051 NATURE OF OPERATION: Air lifting air conditioning units DATE OF OPERATION: 8 -26 -12 9 -09 -12 ad 9 -23 -2012 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, 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 fees, and all other expenses resulting from any and all activities conducted within the city of Grapevinc, 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 ir;jury, 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? ,day and (month) l r 2012. COMPANY: 5 -STATE HELICOPTERS, INC. BY: LINDA NORMAN (printed) TITLE: OWNER (signature) STATE OF 2a6.j COUNTY OF This instrument was acknowledged before me on this the _ Day of 2012 NOTARY" PUBLIC IN AND FOR THE STATE OF , My commission expires signature — ��ar`r LINDA M. VAUQH'r My sY o pires M tg 08/21/2012 11:26 9726361300 5 STATE HELI PAGE 03/10 1". tale!" ,-- Carr flan Insu rInc. Certificate of >laaarrtnce Certificate Number: This is to ecrtify,thst the policy(its) of insumeeo as descrihod below have been issued to the Insured for whom this Cereifieete is executed and Ware in fotewat this time, This Certificate is issued for information only and con&n no rights upon the holder. This Cettificato neither affirmatively nor negatively amends, extend$ or alters cite coverage afforded by such policy(its) or binder(s) stated hettein. This certificate cancels and supersedes all previously issued aettifieatm, Cerlt4eate Holder: City of Grapevine PO Box 95104 Grapevine, TX Napped insured: 5 - State Helicopters, Inc. 285 9lackland Road Royse City, TX 751894746 Policy Type: Aircraft Hull & Liability 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 Named Insured sbown above. Insurer(s). Company Policy No. % Participation StarNet Insurance Company through Berkley Aviation, LLC Aircraft Covered: Sikorsky S58T,1N4XX; Sikorsky S58T, NOL Coverages & Limits Aircraft Liability Combined Single Limit Bodily Injury, including Personal Injury and Property Damage Liability(Excluding Passenger Liability) Cargo UV( Liability Cargo Legal Liability including Stung Loads Coverage Limit S 10,000,000 each occurrence. Coverage Limit $500,000 each occurrence, subject to a deductible of $1,000 each claim. Cerdfleate Provisioas A,delitlonal Insured With respect to Aircraft Liability, it is understood and agreed the Certificate Holders) shall be included as Additional Insured(s) bereuv&r solely with respect to the operations of the N..med Insured. It is specifically agreed the inclusion of more than one Insured hereutader shall not operate to increase the Limits of Liability and is limited to those✓ coverages provided by these politics. Certifieate Date: 150/2012 Authorized Representative 3023 80th Avenue S.g, Suite 300 Meiling Address$ P.O. Box 60, Mercer Island, Washington 98040,0460 Phone: (206) 232 -9870 • Fax: (206) 232 -9515 08/21/2012 11:26 9726361300 5 STATE HELI PAGE 04/10 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. LDUL599B PROCEDURES REQUEST PER $900.1 CHG. 89 5 -STATE HELICOPTERS, INC. 285 BLACKLAND ROAD ROYSE CITY, TEXAS 75189 972- 636 -4009 800 -543 -8442 972 -636 -1300 FAX CONTRACTOR: 24 Hour LTD 8911 Doctors Row Dallas, Texas 75247 LOCATION: Henry Schien 1001 Nolen Dr. Grapevine, Texas 76051 HEIGHT OF BUILDING: 25 FEET TOTAL OF LIFT'S 26 10 rtu's up and down 3775 Ibs and down 6 curbs 375 lbs CARRYING HAZARDOUS MATERIAL, YES NO X DESCRIPTION: — DATE OF LIFTS: 8 -26 -2012, 9 -09 -2012, and 9 -23 -2012 TIME: approximately 8:00 am DATE: 8 -21 -2012 IF A PROBLEM OR SAFETY HAZARD EXISTS THE GROUND PERSONS WITH RADIOS WILL NOTIFY THE PILOT TO MOVE THE HELICOPTER TO A SAFE AREA. N6BL OR N4XY SIKORSK,Y S -58T STANDARD CATEGORY PILOT: BRADFORD S. LADUE COMM. CERT. 2760587 PILOT: SCOTT B. LADUE COMM. CERT 3250744 LENGTH OF THE CABLES WILL BE 75 FT. CONTACTED: City of Grapevine, Texas Mr. Scott Williams 817 - 410 -3158 Police and Fire: Supervisor. Karen Ballard 817-410 -8127 DFW Airspace: Mr. Mike D. Porter 972 -615 -2833 Letter and Map faxed to the control tower at Dfw SIGNATURE OF RESPONSIBLE COMPANY OFFICIAL 08/21/2012 11:26 9726361300 5 STATE FELI PAGE 05/10 DATE: 9-21-2012 5 -STATE HELICOPTERS, INC. 285 BLACKLAND ROAD ROYSE CITY, TEXAS 75189 972 - 636 -,4009 800 -LIFT -442 FAX 972 - 636.1300 FAA CERTIFICATE #LDUL5998 CONGESTED AREA PLAN - EXTERNAL LOAD LIFT TO: FAA OFFICE: Dallas, Texas TELEPHONE: 972 - 582 -1800 FAX 972 - 582 -1872 JO$ SITE Henry Schlen 1001 Nolen Dr. Grapevine, Texas 76051 SCHEDULED DATE AND TIME OF OPERATIONS: 8 -26 -2012, 9- 09 -12, 9 -23 -12 CONTRACTOR: 24 Hour Ltd 8911 Dectors Row Dallas, Texas 75247 CONTACT PERSON: Gary TELEPHONE: 214- 630 -3000 Fax 214 -638 -8378 AIRCRAFT: S -58T N -6131, OR N4XY STANDARD CATEGORY PILOT: BRADFORD S. LADUE COMM CERT. # 2760587 SCOTT B. LADUE COMM. CERT. #3250744 LOADS: NUMBER TYPE WEIGHTS Each trip: 10 rtu'S up and down: 3775 lbs and down 6 curbs 375 lbs CARRYING HAZARDOUS MATERIAL: YES _ NO DESCRIPTION: CONTAC7S: City of Grapevine, Texas Mr. Scott Williams 817- 410 -3158 Police and Fire: Karen Ballard 817- 410.8127 Dfw Airspace: Mr. Mike Porter 972 - 615 -2833 Letter and map faxed to the control tower at DFW COORDINATION WITH AIR TRAFFIC CONTROL: SIGNATURE OF RESPONSIBLE TO BE CONTACTED BY THE PILOT COMPANY OFFICIAL 08/21/2012 11:26 9726361300 5 STATE HELI PAGE 06/10 PAGE NARRATIVE OF PLAN OF OPERATIONS: 5 -STATE HELICOPTERS, INC. JOB SITE: Henry Schien 1001 Nolen, Dr. Grapevine, Texas 76051 DATE OF JOB: 8.26 -12, 9 -09 -12 and 9 -23 -12 END OF JOB: 8- 26 -12, 9 -09 -12 and 9 -23 -12 ENCLOSED ON SKETCH ATTACHED TO THIS REQUEST FLIGHT PATH FROM TIM 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 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 EAST 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 OF THE JOB SITE WILL BE ULTIMATELY RESPONSIBLE FOR THE OPERATIONAL AREA SO NO UNAUTHORIZED PERSONS WILL BE ALLOWED INTO THE PARKING LOT DURING THE LIFT . THE RESPONSIBILITY HAS BEEN CONVEYED TO THE - CONTRACTOR BY 5 -STATE HELICOPTERS, INC. 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 JOB SITE AND OPERATIONAL AREA WILL BE SURVEYED BY 5 -STATE 1FIELICOPTERS 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. LIFTING AREA COULD BE ANYWHERE INSIDE THE OPERATIONAL AREA DUE TO CONTRACTOR AND OR SUPERINTENDENT MOVING THE EQUIPMENT BEFORE THE HELICOPTER ARRIVES. FLIGHT PATCH WILL BE WITHIN OPERATIONAL AREA. opz SIGNATURE OF RESPONSIBLE COMPANY OFFICIAL 08/22/2012 10:16 9726361300 oh i. 22. 20121 8 : 55AA�726361380 PAGB4 5 -STATE HaXOPTMS, WC CUNTIMXD »> JOIN S1 E: 14cmy saden 1001 Nolen Dr. Grapevine, Texas 76031 DATE: 8- 26-2012, 9-09 -12, 9 -23 -12 Tm. opproxlctcley 8:00 as 5 STATE HELI PAGE 02/02 5 STATE HELi No-7046 P. 1_ eB /08 5 -STATE MEUCOPITAS 4ROUNDSMAN AND [GOOF PERSON HAS RADIO'S AND WILL RE TALKINGI WLTB TIC PWT AT ALL T1ME8 DURING THE LIFTING PROCESS. IF FOIL ANY REASON Titer SHOULD 013 A SAFETY FACTOR ARISE THEY WILL IMMMIAMY ALERT TIM PELO T. TM FILOT Wal MOVE TM IMICCIPTER TO A SAFE AREA UNTIL THE RJ3X HAS BEFN CORRWTPD. IF TN E0 ARE POWER LMS AND LIGKr FOLF-S IN THE AREA, TWY WILL NOT CAUSE A SAFETY HA ZAIW TO TM LIFT'. HAZARD MATERIAL CARRIED: NO TODAY'S DATE: 8- 212012 PLAN PREPARED BY -. 11" kQ.�AM SHOULD A. WEAT*MR. MECHANICAL OR MATFSIAL t7W AY 13E ?3VERIE,NCF,D IMS CAP IS "PROVED FOR THB DATE AM TIME TJSTFD ABOVE PLUS 10 DAYS EACH DATE, FAA: DALLAS, TEXAS APPROVED M. THIS COMPANY COWLIE9 WITH THE -CODE OF ETHICS: OF TTM MIC:OPI'FsR ASSOCIATION WrMATIONAL OF AMMUCA. 08/21/2012 11:26 9726361300 5 STATE FELI PAGE 09/10 F.r 5-STATE HELICOPTERS, ITC. XE i Mag 1100 Man Aug 20 16:32 2012 Scale 1:62,500 (at center) Local Road Small Town Trail Aifflold C=== InterstatelUrnited Accosts ParWRoservation Major Connector Schad Service Airport State Route Private Airport Exit -7— Cemetery Railroad County Boundary • Point of Interest Water WOA Jq 08/21/2012 11:26 9726361300 5 STATE HELI PAGE 10/10 5 -STATE HELICOPTERS, INC. J91 erR IPAh r6A o Clcse4 o 5rAqtjp5 Zo100, /011 08/21/2012 11:26 9726361300 5 STATE MELI 5- ST'AT'E ELICOP. ��i ERS, INC. AWd Ckmm LINDA NORMAN V.P. /M arketi nQ LINDA @SSTATE.COM Fa PAGE 01/10 OFC (972) 636 -4009 MBL (214) 212 -6062 FAX (972) 636 -1300 Sheet ATTENTION cc I w► l; L m s IF YOU DO NOT RECEIVE PAGES INCLUDING THIS PAGE PLEASE CALL THE OFFICE AT 972 - 636 -4009 OFFICE FAX 972 - 636,1300 °ON ENTIALITy NOTxcff • The documents occoropanydng this faasbrtile transmission Contain coryfidehtiad Information. Thr Inforhattoh is Intended on3y fen tha um of tha indlvi"(s) er entity nomid ob"t. If you are not the recipient, yam bra notified that arty dlselosuee, eapydng, distrfbi Pion, of the faking of any a0ioh In rellonce on The contents of thIc nforhwtioe fs not pow-c- cible. If you Nava recetued This Ta In error, place imrndiotedr IlOry us by 7e1cph9ft at the %umber obove to arrange for the return of the origihol docutmos, Thank you, Q