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Home My WebLink AboutHLP2012-0239MEMORANDUM CITY OF GRAPEVINE, TEXAS TO: BRUNO RUMBELOW, CITY MANAGER DAN HAMBRICK, RISK MANAGER FROM: SCOTT WILLIAMS, DEVELOPMEN ERVICES DIRECTOR / BUILDING OFFICIAL SUBJECT: HELICOPTER LIFT REQUEST DATE: February 23, 2012 Attached is a request for a helicopter lift scheduled for Tuesday, January 31, 2012, at 7:15 A.M. with a rain date of February 1, 2012, at 7:15 A.M., at 3000 Grapevine Mills Parkway #205 if it meets your approval, please sign below: Bruno Rumbelow, City Manager e Vj - Dan Hambrick, Risk O ACCook\HelicopterMemorandum nager �r � Tj4e FAX CITY OF GRAPEVINE P.O. BOX 95104 200 S. MAIN STREET GRAPEVINE, TX 76099 (817) 410 -31659 FAX (817) 410 -3012 TO: Linda Norman (Five State Helicopter) FROM: Scott Williams FAX #: 1- 972 - 636 -1300 SUBJECT: Approval of Helicopter Lift DATE: January 26, 2012 Pages: 2 sheet. COMMENTS: Your request for a helicopter lift scheduled for Tuesday, January 31, 2012 at 7:15 A.M. with a rain date of February 1, 2012 at 7:15 A.M., at 3000 Grapevine Mills Pkwy #209, has been approved. E- MAILED NOTICE TO LINDA ON 1/26/2012 OACCook\lelicopter Fax 01/24/2012 08:43 9726361300 5 STATE HELI PAGE 03/03 HOLD HARMLESS AND INDEMNITY" AGREEMENT PROJECT ADDRESS: NATURE OF OPERATION: DATE OF OPERATION: 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 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 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 13 day and (month) „ X2012. COMPANY: 5 -STATE HELICOPTERS, INC. BY: LINDA NORMAN (printed) L, h urn► M. VAWHr TITLE: OWNER (signature) My ° mmosi°" N'� MAY01, 2018 STATE OF/— COUNTY OF�.�!/ This instrument was acknowledged before me on this the .2 .3 Day of^ 2012 NOTARY PUBLIC IN AND FOR THE STATE OF 'T ,e* K My commission expires AA !4 01 2.013 signature �D /,�� 01/23/2012 16:27 9726361300 5 STATE HELI CERTIFICATE'OF INSURANCE Issued an behalf of Insurers by Willis Global Aviation 801 South Figueroa Street Los Angeles, CA 90017 Telephone: '(213) 607 -6300 Facsimile: (213) 607 -6301 This is t0 Certify To: City of Grapevine PO Box 95104 Grapevine, TX PAGE 02/16 (Sometimes referred to herein as the Cdtificate Fioider(s)) Named Insured: 5 -State Helicopters, Inc. Named Insured's Address: 285 Blackland Road, Royse City, 7X75189.4746 insurance Coverage: Aircraft Liability and General Aviation Liability Insurance Policy Period: February 1, 2011 to February 1, 2012 on both dates at 12,01 A.M. Local Standard Time at the address of the Named Insured. Geographies Limits: U.S.A. (excluding Alaska), Canada, Mexico and ft Caribbean. Limas of Liability: Aircraft LiaW* insurance: Combined Single Limit Bodily Injury and Property Damage including Personal Injury and Property Damage (excluding Passenger Liability) US$10,000,000 each occurrence Cargo Legal Liability Including Slung Cargo: USS250,000 each occurrence subject to a deductible of $2,500 each claim. Equipment Usured: Sikorsky 858T, Registration WXY Sikorsky S58T, Registtaation N6BL SECURITY (the' Insurers`1 As respects Aircraft iJabiLdy oral Aviation t,,eneral Liability Insurance: Insuw Policy Number participmall Houston Casualty Company Certificate No. 5- StWe_2011 Ce010 �-� Page 1 of 2 100% Willis 01/23/2012 16:27 9726361300 5 STATE IELI PAGE 03/16 t—*,\. Subject always to the scope of the policies noted above and the Insuring agrements, del'INHons, terms, conditions, limitations, exclusions, deductibles warranties and endorsements remaining paramount: Solely as respects: (I) the Covefage(s) noted above; (ii) the Contracts) (and then only to the extent of the Named Insured's obligation to provide Insurance under the terms of the Contract(s)); and (it) the operations of the Named Insured: the following prov4on(s) apply(ies); Soldy as respects Airorafi Liati ty Coverage(s): City of Grapevine are Included as Additional Insureds (collectively, the "Additional Insureds ", Individually an 'Additional insured') as respects liability arising out of the Named Insured's performance or non - performance of Its obligations under the Contract. This Certificate of Insurance is issued ae a summary of the Insurances under the policies noted above and confers no rights upon the Cartifleade Holder(s) as regards those Insurances other than those provided by the policies. The undersigned has been euthofted by the above Insurers to Issue this oeri ficate on their behalf and is not an Insurer and has no Ilabliity of eny sort under the above policies as an Insurer as a rasull of this certlflcatlon, Date of issue: January 31, 2011 AUTHORIZED REPRESENTATIVE: Willis Global Aviation Certificate No. 5-t te_2011_Cerl#10 Page 2 of 2 Willis 01/23/2012 16:27 9726361300 5 STATE HELI PAGE 04/18 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 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: ABLE SHEET METAL 6400 Greenvalley Circle Aubrey, Texas 76227 LOCATION: Grapevine Mills Mall (coach 209A) 3000 Grapevine Mills Pkwy Grapevine, Texas HEIGHT OF BUILDING: 25 FEET TOTAL OF LIFTS 3 rte's off and 2 rtu's up 2700 lbs and down CARRYING HAZARDOUS MATERIAL YES NO _x_ DESCRIPTION: DATE OF LIFTS: 1 -31 -2012 with rain date of 2 -1 -2012 TIME: approximately 7:15 azn DATE: 1 -23 -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. N68L OR N4XY SIKORSKY 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: Karen Ballard 817- 410 -8127 DFW Airport D� �J c.�►r�. SIGNATURE OF RESPONSIBLE CO Y OFFICIAL 01/23/2012 16:27 9726361300 5 STATE FELI DATE: 1- 23 -20I2 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 -582 -1872 fax JOB SITE Grapevine Mills Mall (Coact #209A) 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 SCHEDULED DATE AND TIME OF OPERATIONS. 1 -31 -2012 with rain date of 2 -1 -2012 CONTRACTOR: Able Sheet Metal 6400 Greenvalley Circle Aubrey, Texas 76227 CONTACT PERSON: Mike Bishop 940 -594 -1840 TELEPHONE: 940 - 566 -6406 fax 940 -566 -6419 AIRCRAFT: S -58T N -6BL OR N4XY STANDARD CATEGORY PILOT: BRADFORD S. LADUE COMM CERT. # 2760587 SCOTT B. LADUE COMM. CERT. #3250744 LOADS: NUMBER TYPE WEIGHTS 3 rtu's off 2700 lbs and 2 rtu's up at 2400 lbs CARRYING HAZARDOUS MATERIAL: YES — NO X DESCRIPTION: CONTACTS: City of Grapevine, Texas Mir. Scott Williams 817 - 410.3158 Police and Fire: Karen Ballard 817 - 410 -8127 171;W: Mr, Donaldson 972 - 615 -2805 COORDINATION WITH AIR TRAFFIC CONTROL: TO BE CONTACTED BY THE PILOT PAGE 05/16 �f SIG ATURE O RESP SIBLE COMPANY OFFICIAL 01/23/2012 16:27 9726361300 5 STATE HELI PAGE 06/18 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: 1 -31 -2012 with rain date of 2-1 -2012 END OF JOB: 1 -31 -2012 with rain date of 2 -1 -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 SECTION OF THE MALL 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 OF THE EQUIPMENT TO THE ROOF. THE PARKING LOT ON THE SOUTH 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 MALL SECURITY 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 MALL SECURITY CONTRACTOR BY 5 -STATE HELICOPTERS, INC. THE PATH BETWEEN THE STAGING AREA AND WHERE THE UNITS WILL BE PLACED ON TIME 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 LIF'T'ING 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. SIGNATURE OF RESPONSIBLE COMPANY OFFICIAL 01/23/2012 16:27 9726361300 5 STATE HELI PAGE 07/16 PAGE 4 5 -STATE HELICOPTERS, INC CONTINUED >>> JOB SITE: GRAPEVINE MILLS MALL 3000 GRAPEVINE MILLS PKWY GRAPEVINE, TEXAS 76051 DATE: 1 -31 -2012 WITH RAIN DATE OF 2 -1 -2012 TIME: APPROXIMATELY 7:15 AM 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 THEM ARE POWER LINES AND LIGHT POLES IN THE AREA, THEY WILL NOT CAUSE A SAFETY HAZARD TO THE LIFT. HAZARD MATERIAL CARRIED: NO TODAY'S DATE: 1 -23 -2012 C PLAN PREPARED BY: LINDA N ORMAN 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 INTERNATIONAL OF AMERICA. 01/23/2012 16:27 9726361300 5 STATE HELI PAGE 08/18 I .. I ATIO 5 -STATE HELICOPTERS, INC. Mag 13.00 Mon Jan 23 10:45 2012 Scale 1:62,500 (at center) 1 Miles 2 km — Local Road — Trail C-0 Intarstatell.1mited Access ' Major Cormector State Route Exit Railroad Point of Interast Small Town Airfield �ark/Roservation elwf Service Airport Locale Cemetery County Boundary Water North Lake 01/23/2012 16:27 972636130B ,... . p � Cp ~ �n ` AU/ } pw � x 5 STATE HELI RIF ss REMOVE PAGE l0/l8 = � " . � ! �z^ | r" ! ^ | ' / | 01/23/2012 16:27 9726361300 5 STATE HELI 2012 -01-23 12:06 FAA 99725821862 » S- STATE INUADOl M1NC. "ABSI.A►X.CRAISM=u 21S DIAM AND ROAR ROYOR C ,, M(AS ?3189 q!' 436. w M-343-ow PAXST"M-130 FAA COLT.LDLL PRl3t;8 URIS Mww PER 89003 cum 89 225 BLACXIAM ROAD A�tr3,Y.gP. t:l'1Y,'T11 M 95189 9l�FV 00 �5 -8442 X172436.1300 FAX CONTMCML- ABLE SHM R4U',f.AI. Ail., W, Too M27 � ' II : Grnpevbw milts mall (oowh 209A) 3000 ©n"Vinow"i nwy omvmfl e, TOM 'd'C rAL OP UM 3 on's off ad 2 tw's up 2700 Ik and dogs CAMYR40 HAZAMOUS MA'l RIAL DEC O� DATE Of UM: 1-31-2012 wA rain ddo of 2.1,2012 Tim: approximaWy 7.15 sm PAGE 12/16 9726361300 F 1/7 DAM 1- 2W12 IIP��ytp�y�C1�.1 N OR Sl�,�'��tp' UAM" KOi►Z'iMitt;Ll1XwMTG A L4M A1» Ni131.OA�lKlrwY S'A1 7' CAVOMY PORT .. BLAUP= & LADUS COW CERT. 276OW P.Q.0r. 20= B. LADEM CO NN. CIRT 32501 LROMOTTUSCAMM WILL $B75IT. CM4TACTRD. ChYOfC$ap *Yl^ TOM M. 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