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Home My WebLink AboutHLP2012-1280MEMORANDUM 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 13, 2012 Attached is a request for a helicopter lift scheduled for Tuesday, April 17, 2012, at 7:00 A.M., at 3000 Grapevine Mills Parkway #529 if it meets your approval, please sign below: 4--11 � Bruno Rumbelow, City Manager DanC.blambrick, Risk Manager O: \CCook \HelicopterM emorandum 04/13/2012 15:00 9726361300 eAp r, 13. 20127 2; 41 PM9726361300 PAGB 4 54WATH HEUC PTERS, INC CONTTNUBD>>> ]OH SITE: CItA.PEVINE MILLS MALL 3004 GRAPEVDIE UM LS PKWY GRAPRVIfIB, TEAS 76051 DATE: 4- 17.2012 TIME= 4-17 -2012 5 STATE HELI PAGE 02/02 5 STATE Ha-i No. 5849 P. 1= 05/08 5 -3TA7E MICOP'TM GROUNDSMAN AND ROOF PERSON HAS RADIO'S AND WILL BE TA,i,KWU W1'I'II Ti's PILOT AT ALL TIMES DUWXCr T'H8 J WT1NQ MOCW. al' FOR ANY REASON TMRE SHOULD BE A SAFETY FACTOR ARISF TWy WILL IM1 MIATELY ALHRT TILE PIIAT. THE PII.'r WILL MOVE TM MCOP'1'BR TO A SAFE AREA UN1'II. TH RISK HAS HESN CORRECTED. IF nWRE ARE POWER I,IWS AND LdOHT PALES IN THE AREA, TrrIEY WILL NQT CAUSE A $AMY IWARD TO TO LIFT, HAzARD MATMAL CARRIED: NO TODAY'S DATE: 4 -22 -2012 1� g mp SHOM A. WFATIBR WCHA1NICAL OR MATERIAL DELAY BE EXPERIENCED THIS CAP IS APPROVED FOR M DATE AND MZ LISTED ABOVE PLUS 10 DAYS. FAA: DALLAS, TEXAS APPROVED BY; % =�� —/' p m THIS COMPANY COMPLIES WITjK THE "CORE OF ETHICS; OF TW HELICOPTER ASSOCIATION IN ERNA71ONAL OF AMERICA. 04112/2012 17:64 9726361300 5 STATE HELI PAGE 02/10 HOLD HARMLESS AND INDEMNITY AGREEMENT PROJECT .ADDRESS: 3000 Grapevine Mill Pkwy, Grapevine, Texas 76051 NATURE OF OPERATION: air lifting air conditioning units DATE OF OPERATION: 4 -17 -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 airy axrd 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, 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 offtcexs, agents, employees, independent contractors, other representatives, invitee, licensee, or guests. I the undersigned individual and/or company or company's officer certifies, ,varrauts 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 12th day and (month) April 2012. COMPANY: 5- STATE. HELICOPTERS, INC. BY: LINDA NORMAN (printed) Lind No aarr TITLE: OWNER (signature) CA-.1 STATE OF D COUNTY OF R r? I1 This instrument was acknowledged before me on this the i_,2_17ay of 46L-% 2012 NOTARY PUBLIC IN AND FOR THE STATE OF "2-5 My commission expires S- -! - ;ta r �3 signature',,6�i � LINDA M. VAUGH-i' MY commission Ires May 01, 2013 ['4112/2012 17:04 9726361300 5 STATE HELI PAGE 03110 ' nian Incur ` . p,Inc. Certificate of Insurance Certificate Nvmber: This is to certify that the poIicy(im) of insurapce as described below bave been issued to the Insured for whom this Certificate is executed and islate iii foece,at this time. This Certificate i$ issued for iofoimation only and confers no tights upon the holder. This Certificate neither affirmatively nor negatively amends, extends or alters the coverage afforded by such policy(ies) of binders) stated herein. Tbis certificate cancels and supersedes all previously issued certificates. Certificate Holder: City of Grapevine PO Box 95104 Grapevine, TX Named insured- 5 - State Helicopters, Inc. 285 Blaekland Road Royse City, TX 75189 -4746 Policy Type-, Aircraft Hull &-- Liability and Aviation General Liability policy Policy Period; February 01, 2012 to February 01, 2013 both days at 12:01 ant Local Standard Time at the address of the Named Insured shown above- Insurer(s)! Company Policy No. % Participation StarNet Insurance Company through Berkley Aviation, LLC Aircraft Covered: Sikorsky S58T, N4XY; Sikorsky S58T, N6BL Coverages & Limits Aircraft Liability Coverage Limit Combined Single Limit Bodily ,iAju y, including Personal Injury and $10,000,000 each occurrence. Property Damage Tiability(Excluding Passenger Liability) Cargo Legal Liability Coverage Limit Cargo Legal Liability including Stung Toads $500,000 each occurrence, subject to a deductible of $1,000 each claim. Certificate )Prpvisious Additional Insured With wspect to Aircraft Liability, it is understood and agreed the Certificate ) Tolder(s) shall be included as Additional Insureds) hereunder solely . with respect to the operations of the Named Insured. It is specifically agreed the inclusiozr of more 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: 1/30/2012 Authorized Representative 3023 Wtb'Avenue S.E,, Suite 300 Mailing Address: P.0_ Box 60, Mercer island, Washington 98040-0060 Phone: (206) 232 -9870 - Fax: (206) 232-9S15 04/12,'2912 17:04 9726361300 5 STATE HELI PAGE 94/10 5- STATE HELICOPTERS INC. "AERIAL CRANE SERVICE' 285 BLACKLAND ROAD ROYSE CITY, TEXAS 75189 972 - 6364009 800 - 543 -8442 FAX 972 -636 -1300 FAA CERT. LDUL5998 PROCEDURES REQUEST PER 8900.1 CHG. 89 5 -STATE HELICOPTERS, INC. 285 BLACKLAND ROAD ROYSE CITY, TEXAS 75189 972-636 -4009 800 - 543 -8442 972 -636 -1300 FAX CONTRACTOR: Mazzuca Contracting 10907 Cruilford Rd. 4A Annapolis Junction, Maryland 20701 LOCATION: Grapevine Mills Mall Under Armour R2/529 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 HEIGHT OF BUILDING: 25 FEET TOTAL OF LIFTS 3 rte's 1000 lbs & down CARRYING HAZARDOT TS MATERIAL YES NO DESCRIPTION: DATE OF LIFTS: 4 -17 -2012 TIME: approximately 7:00 wn CONTACTED: DATE: 4 -12 -12 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 -59T STANDARD CATEGORY PILOT: BRADFORD S. LADUE COMM. CERT. 2760587 PILOT: SCOTT B- LADUE COMM, CERT 3250744 LENGTH OF THE CABLES WILL BE 75 FT. City of Grapevine, Texas Mr, Scott Williams 817 - 410 -3158 Police and Fire Dispatch: 8X7- 410 -8127 Karen Ballard. DFW Mr. Paul Donaldson 972 - 615 -2805 Metter and map faxed to the control tower at DFW 0�` SIGNATURE OF RESPONSIBLE COMPANY OFFICIAL ' 0 N5 04/1212012 17:04 9726361300 5 STATE HELI PAGE 05/10 DATE: 4 -12 -2012 5- STATE HELICOPTERS, INC. 285 BLACKLAND ROAD ROYSE CITY, TEXAS 75189 972 - 636 -4009 800 -LIFT -442 FAX 972 - 636 -1300 FAA CERTIFICATE #LDUL599B CONGESTED AREA PLAN - EXTERNAL LOAD LIFT TO: FAA OFFICE: Dallas, Texas TELEPHONE: 972 - 582 -1800 Fax 972 - 5821872 JOB SITE Grapevine Mills Mall UnderArmour R2/529 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 SCHEDULED DATE AND TIME OF OPERATIONS: 4 -17 -2012 approximately 7:00 am CONTRACTOR: Mazzuca Contracting 10907 Guilford Rd_ Suite A Awlapolls Junction, Maryland 20701 CONTACT PERSON: Rob "TELEPHONE. 843 -504 -1162 AIRCRAFT: S -58T N -6BL OR N4XY STANDARD CATEGORY PILOT: BRADFORD S. LADUE COMM CERT. # 2760587 SCOTT B. LADUE COMM. CERT_ 03250744 LOADS: NUMBER TYPE WEIGHTS 3 rtu's 1000 lbs CARRYING HAZARDOUS MATERIAL: YES — NO DESCRIPTION: CONTACTS: Utq of Grapevine, Texas Mr. Scoff Williams 817 -410 -3158 Police and Fire: Karen Ballard 817- 410 -8127 DFW Mr. Paul Donaldson 972 -615 -2805 COORDINATION WITH AIR TRAFFIC CONTROL: SIGNATURE OF RESPONSIBLE TO BE CONTACTED BY THE PILOT COMPANY OFFICIAL 0411212012 17:04 9726361300 5 STATE HELI PAGE 06110 PAGE 3 NARRATIVE OF PLAN OF OPERATIONS: 5 -STATE HELICOPTERS, INC. JOB SITE: Grapevine Mills Mall 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 DATE OF JOB: 4 -17 -2012 END OF JOB: 4 -17 -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 13E PENETRATED IF THIr 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 MALI.., 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 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 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. TM 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 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. LIFTING AREA COULD OF 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. SIGNATURE OF RESPONSIBLE COMPANY OFFICIAL 04/1/2012 17:04 9726361300 5 STATE HELI PAGE 07/10 PAGE 4 5 -STATE HELICOPTERS, INC CONTINUED >?= JOE SITE: GRAPEVINE MILLS MALL 3004 GRAPEVINE MILLS PKWY GRAPEVINE, TEXAS 76051 DATE. 4 -17 -2012 TIME: 4 -17 -2012 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 UNTIL THE RISK HAS BEEN CORRECTED. IF THERE ARE POWER LINES AND LIGHT POLES IN THE AREA, THEY WILL NOT CAUSE A SAFETY .HAZARD TO THE LIFT. HAZARD MATER IAI. CARRIED: NO TODAY'S DATE: 4-12-2012 PLAN PREPARED 13Y. LINDA NORMAN` SHOULD A WEATHER, MECHANICAL OR MATERIAL DELAY BE EXPERIENCED THIS CAP IS APPROVED FOR THE DATE AND TIME LISTED ABOVE PLUS XO DAYS. FAA: DALLAS, TEXAS APPROVED BY: FAA STAMP: THIS COMPANY COMPLIES WITH THE "CODE OF ETHICS: OF THE HELICOPTER ,ASSOCIATION INTERNATIONAL OF AMERICA. -04/1212012 17:04 9726361300 5 STATE HELI PAGE 08110 5-STATE HELICOPTERS, INC. ,E�l i i Mag Apr 2, 1 00 * 162012 ThuA 2 2 —'"^ Local Road Airfield Scale 1:125.000 (at center) — Trail Geographic Feature dtr 2 Miles C==l interstate /Limited Access Park/Reservation Major Connector Sched Service Airport + 2 km State Route Locale —1 Exit Cemetery Railroad County Boundary Small Town . . . ........ Water 04/1212012 17:04 9726361300 5 STATE HELI o 5- 'sS . .. ..... .... .... .. ..... .. ...... TATE HELICOPTERS, INC. Mag 14.00 Thu Apr 12 16:14 2012 Scala 1.-31.250 (@t center) 2000 Feet 1000 Meters - Local Road Small Town - hail Park/Reservatlan � Interstate/Urnited Access County Boundary Major Connector Water State Route River/Canal Exit Railroad Point of Interest PAGE 09/10 WE PA LN: rn E ; 04/12/2012 17:04 9726361300 fey, 4 �ti e ` h. 't s'' QTP 43 5 STATE HELI Im a &- WOW, MA PAGE 10/10 CL- LAI Ri i7 2L