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Home My WebLink AboutHLP2012-0555MEMORANDUM 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: February 20, 2012 Attached is a request for a helicopter lift scheduled for Friday, February 24, 2012, at 7:00 A.M., at 3000 Grapevine Mills Parkway #529 if it meets your approval, please sign below: Bruno Rumbelow, City Manager O: \CCook\HelicopterMemorandum 0212112012 13:04 9726361300 5 STATE HELI PAGE 02102 ®Feb. 21. 20121 5:56ANb726361 -300 5 STATE HELI No, 5199 P. 1_ 05/09 PAGE 5 -STATE BELICOPTkRS, INC coN1'N(Jm > >> JOB SITE: Grapevine MMs Malt 3000 Grapevine Mills PYW Gopuviw, Texas 76051 DATE: 2-24-2012 TIME: 7:00 am 5 -STATE REUCOFTEW QR.0M0$MAX AND ROOF PERSON HAS RADIO'S AND VEU, )5E TALX1NG WITH THE PILOT AT ALL TIMES DURINCr TIC LWTIN(3 PROCESS. W VOR ANY XBASON IMM SHOUW EE .A, S,AWr X FAC Ca AM9 TAY WILL lmm�DIATELY A,MT Tim mm THE PILOT WPJ- MOVE THE HELMOP7RX TO A, SAFE AREA UM TBE RJSK HAS BEEN CORMCTM. IF THERE ARE POWER LMS AND LIGHT POLES IN THE ApEA. , TBEY WILL NOT CAUSE A &AFETY HAZARD TO THE L)1-7. WARD MATERIAL CARRIED: NO TODAY'S A.A.TR: 2 -20 -2012 Koh OR 09 SHOULD A WFAT R, N ECRANIGAL alt MAMkL4 1 D)�L.,Ay BE ExpERIENCED THIS CAp IS APPROVED FOR THE DATE AND TIME LISTED A13OVE PLUS 10 I]AYS. TIAA, Dallas, Tors ,APPROVED BY THIS COMPANY COMPL.IF S WITH TM "CODE OF ETHICS; OV THE HBLICOPTM ASSOCIATION ItMNATIONAL OF A IUCA. 02/2012012 11:51 9726361300 5 STATE HELI PAGE 02/11 C t2� fan Insur This is to certify that the golicy(ies) of jasurance as described tithe, This Certificate is issued for mformatim only and coo alters the coverage afforded by such policy(iea) orhimder(a) i Certificate Holder; City of Gra eviae PO Box 95104 Grapevine, TX :ate of Insurance Nurmber have been issued to the Insured for whom this Certificate is executed and is /are in foreeeat this rights upon the holder, This Certificate neither, affirmatively nor negatively amends, extends or erein. This cerHcatc cancels and supersedes all previously issued certificates, Named Insured: 5 - State Helicopters, Inc � 285 Blackland Road Royse City.TX 75189 -4 6 Policy Type: Aircraft bull & Liability hd ,4'viation General Liability Policy Policy Period: February 01, 2012 to ]Feb ary{01, 2013 both days at 12:0 jam T wal Standard Time at the address ofthe Named Insured shown above_ lhsurer(6): Company Policy No. % Participation StarNm Insurance Com tbrougb Berkley Aviation, LLC 100% I AircJral t Covered: Sikorsky S58T, N'4Xx; S orsky S58T, N613L I r C4vefages & Limits ,Aircraft )Viability i Coverage Limit Combined Single Limit Bodily Injury, including Perso Injury and $10,000,000 each occurrence. P.ropezty Damage Liability(Excluding Passenger Liabil t) i i Cargo Legal Liability Coverage Limit Cargo Legal Liability including Stung Loads $500,000 each occutr"ea, subject to a dcdnctible of $1,000 each claim. Certif] Cate provisions Additional Insured With respect to Aircraft Liability, it is understood and rocd the Certificate Holder(s) shall be included es Additional JRsumd(s) hereunder solely wifh respect to the operations of the Named Insured. It is specifically agreed the inclusion of more than one Insured hereunder shall not operate to increase the Limits of Liability and is Iimited to tho8c't erages provided by these policies. I i I Certificate Date: 1/3012012 .Authorized Representative I i i i 302,3 Both Avenue $.P, 5nite 300 Mailing Address I.O. Box 60, Mercer Island, Washington 98040 -0060 PbI Pg: (206) 232 -9870 - Fax: (206) 232 -9515 02/20/2012 11:51 9726361300 5 STATE HELI PAGE 03111 HOLD HA.RMLE S SAND INDEMNITY AGREEMENT PROJECT ADDRESS: NATURE OF OPERATION: DATE OF OPERATION: 1, Linda Norman, the undersigned, representing 5-State Helicopters, Inc., binding my heirs, executors, administrators, adminis Mgrs, estate and assigns, do hereby agree to completely and wholly release, indemnify the hold 4xkWess the city of Grapevine, its officers, agents, Independent contractors, anq employees from any and all claims, damages, Hann personal injury, including death, pi °f'pe. damage, lawsuits and judgments, including court costs, expenses and reasonable attorney's Pees, and all other expenses resulting from any and all activities conducted within the city �f Grapevine, Texas, It is the understanding of all partie� t this release, indemnity, and hold harmless agreement shall apply whether or not the claim, damages, harm, personal injury, including deaths, property damage, lawsuits, judgments, couri �Ots, attorney's fees and any other expenses arise from the negligence of whatever nature, om ssions, willful and intentional acts of this individual, company or company's officers, agents, enip oye:.es, independent contractors, other representatives, invitee, licensee, or guests. I the undersigned individual and/o o 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, cp. oration partnership or other entity who will operate within the city of Grapevine, Texas. I j In witness whereof, this agreement as been executed this A o day and (month) r e Ja , 2012, COMPANY: 5-STATE HELIC TERS, INC. BY: LINDA NORMAN (printed ]UNDAUVAUGHT TITLE: OWNER sx at mmission Expires ( I) May 01, 2013 STATE OF, COUNT OE, This instrument was acknowledge be£oz-e rare on this the., - Day o 2012 NOTARY PUBLIC IN AND FOR STATE OF My commission expires _ signature 02/20/2012 11:51 9726361300 285 5 -STATE HELICOPTERS, INC. 285 BLACKLAND ROAD ROYSE CITY, TEXAS 75189 972 - 636 -4009 800 -543 -8442 972 -636 -1300 FAX CONTRACTOR: Sherrell A/C 103 West Broad St. Forney, Texas 75126 LOCATION: Grapevine Mills Mall 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 HEIGHT OF BUILDING: 25 FEET TOTAL OF LIFTS 1 rta off 2500 lbs CARRYING HAZARDOUS MA' YES NO�x` DESCRIPTION: DATE OF LIFTS: 2 -24 -2012 TIME: approximately 7:00 am CONTACTED: City of Grapevine, Tee Police and Fire: Karen DEW airport he control tower at DFW { c RESPONSIBLE COMP,A.I�TY OFFICIAL i 1 02120/2012 11:51 9726361300 5 STATE HELI PACE 05111 DATE: 1 -20 -2012 TO: FAA OFFICE: Dallas, Texas JOB SITE Grapevine Mills N 3000 Grapevine � Grapevine, Texas SCHEDULED DATE AND TIME OF C CONTRACTOR: SherreIl A/C 103 West Broad St. Forney, Texas 75126 CONTACT PERSON: Larry 214 - TELEPHONE: 972 - 216 -19 AIRCRAFT: S-58T N -613L OR PILOT: BRADFORD S. LAI SCOTT B. LADUE 1,OADS: NUMBER 1 Ttu off 2500 lbs i .ATE MLICOPTERS, aNC. ;5 BLACKLAND ROAD . NSF CITY, TEXAS 75189 972- 636 -4009 Sao -LIFT -442 FAX 972- 636 -1300 CERTIFICATE #LDUL599B :> AREA PLAN - EXTERNAL LOAD LIFT 972 -582 -1800 972 -582 -1872 FAX Parkway i1 TIONS: 2 -24 -2012 approximately 7:00 am 972 -258 -1081 fax STANDARD CATEQQRY AIM CERT. ## 2760587 CERT. #3250744 TYPE WEIGHTS CARRYING HAZARDOUS MATERIAL: IS NO X DESCRIPTION: CONTACTS: City of Grapevine, Teas' Mr. Scott Williams 817 -410 -8127 Police and Fire: Ka 'Ballard 817- 410 -8127 DFW Letter and Map faxed to the control tower at']'FW 1ATUA COOIZDINA.TION WITH AIR TRAFFI CONTROL: SIG RESPONS113LE TO BE CONTACTED BY THE PILOT COMPANY OFFICIAL 02x'20/2012 11:51 9726361300 5 STATE HELI PAGE 06/11 i PAGE 3 NARRATIVE OF PLAN OF OPERATIONS: 5 -STATE HELICOPTERS, INC. JOB SITE: Grapevine. Mills Mall 3000 6rupevine Mills Pkwy GrOevibic, 'Texas 76051 i DATE OF JOB:i 2 -24 -2012 END OF JOB: 12 -24 -2012 ENCLOSED ON SKETCH ATT�CHED TO THIS REQUEST ii FL1014T PATH FROM THE STAGING AREA WHERE THE EQUIPMENT IS LIFTED TO THE AREA WHERE THE EQUIPMENT IS PLACED 6N THE BUILDING WILL BE CLEARED OF UNAUTHORIZED PERSONS. THE ESTIMATE OF HOW "NY 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 FI✓ET .APPROXIMATELY 75 FEET i EMERGENCY LANDING AREA: UN L SS 0THERWISE NOTED ON THE PLOT PLAN, THE HELICOPTER LANDING AREA AND zCK UP SITE WILL BE EMERGENCY LANDING AREAS. ADDITIONAL INFORMATION: THIS I§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 AMA OF JOB SITE DURING THE LIFTING OF THE EQUIPMENT TO THE ROOF. THE PARKING LOT ON t.HE NORTH WEST SIDE OF THE BUILDING WILL 13E USED FOR LANDING, STAGING. AND EMERZ ENCY AREA. WITH SECONDARY LANDING STAGING AND EMERGENCY AREA ON THE SOUTHEAST OF THE MALL. 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 PATIO 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 HELICOPT4RS GROUND CREW WILL BE GIVEN BEFORE THE LIFTING BEGINS_ THE JOB SITE AND OPERATIONAL AREA WILL BE SURVEYED BY 5-STATF HELICOPTER'S GROUND PERSONAL FOR ANY SAFETY HAZARDS BE'F'ORE THE LIFTING OF THE EQUIPMENT BEGINS. IF ANY" SAFETY HAZARDS; EXIST THE CONTRACTOR WILL 13E 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 OP1IRA.TIONAL AREA- SIGNATURE OF RESPONSIBLE COMP.A,NY OFFICIAL i 02/20/2012 11:51 9726361300 5 STATE HELI PAGE 07111 PAGE 4 5 -STATE HELICOPTERS, INC CONTINUED >>> JOB SITE: Grapevine Mills Mall 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 DATE: 2 -24 -2012 TIME: 7:00 am 5- STATE- HELICOPTERS GROUNDSMAN AND ROOF PERSON HAS RADIO'S AND WILL BE TAL10NG WITH THE PILOT AT ALL TIMES DUNG 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 X; SAFE AREA UNTIL THE RISK HAS BEEN CORRECTED. IF THERE ARE T'O'WER LINES AND LIGHT POLES IN THE AREA, THEY WILL NOT CAUSE A. SAFETY HAZARD TO THE LIFT. HAZARD MATERIAL CARRIED: !NO. TODAY'S DATE: 2 -20 -2012 PLAN PREPARED BY: LINDA NORMAN � 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. 02120/2012 11:51 9726361300 5 STATE HELI PAGE 08111 T Mag 12.00 Mon Feb 2010:10 2012 Scale 1:125,000 (at center) 2 Miles 2 km Local Road Trail Interstate/1-1rhited Acoes5 Major Oorwoolor State Route Exit Railroad Small Town Airfield Geographic Feature +Park/Reservation Schad Service Airport Locale Cemetery County Boundary Water I 02/201'2012 11:51 9726361300 5-STATE HE Mag 13-00 Mon Feb 20 10:07 2012 Scale 1:62,500 (at center) I Was 2 km 5 STATE HELI PAGE 09/11 LICOPTERS, INC. N'- - Local Road - Trall IntarqtatellrnIted Access Major Conna ctor State POL)ta Exit Railroad Point of Inter: st . . ......... Small Town Airfield +Park/Reservation Schad SoNlco Airport Locale Cemetery County Boundary Water North Lake law 011109 k 02/20/2012 11:51 9726361300 5-STATE HEL Gra pevine Recreational park GkAFEvrNE MILLS MALL' 3000 GRAPEVINE MILLP PKWY GRAPEVINE, TEXAS 76051 . D,11TE OE LIFT, 1-14-1112 TIME, APPROXIMATEL-8 7-00 AM Grapevine Gulf Course RU 26 12E I2001 D. St—t Atlas U8A;0200j/ TInc.,RCI-0112001 Mag 15.00 Mon Feb 20 10;01 2012 Local Road Scale 115,625 (at center) C=== Inter5tatefl-irrited Access 1000 Foot Mejor Connector State Route 500 Meters Exit Point of Interest Park/Roservk1on County Boundary 5 STATE HELI PAGE 10/11 [ INC. 0.2.516, Water RiverfG@W r r� 02/20/2012 11:51 9726361300 5 STATE HELI PAGE 11/11