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Home My WebLink AboutHLP2021-3635October 18, 2021 The attached application is for a Helicopter Lift Request. Please sion the attached memo and forward packet to the City Manager's Office. Once City Manager has signed please return to Connie Cook, Development Services. Location: 3000 Grapevine Mills Pkwy #532, October 25, 2021 at 7:45 a.m., with a rain date of November 5, 2021 at 7:45 a.m. Melanie Hill, Risk Manager Bruno Rumbelow, City Manager Thank you, Connie Cook Development Services (817) 410-3158 Permit will not be issued until FAA Approval has been received. 0 \CCOOK\Instruct ons\Hebcopterinfo\CoverLetter flLQA)-3(-65 MEMORANDUM TO: FROM: SUBJECT: DATE: CITY OF GRAPEVINE, TEXAS BRUNO RUMBELOW, CITY MANAGER MELANIE HILL, RISK MANAGER DON DIXSON, BUILDING OFFICIAL HELICOPTER LIFT REQUEST OCTOBER 18, 2021 Attached is a request for a helicopter lift scheduled for October 25, 2021 at 7:45 a.m. for 3000 Grapevine Mills Pkwy #532 with a rain date of November 5, 2021 at 7:45 a.m. if it meets your approval, please sign below: City Manager Risk Manager , Building Official , FAA Approval 0.1000OKMWr,ctl onsTelwcpterinfoWEMO City of Grapevine P O. Box 95104 Grapevine, TX 76099 (817) 410-3165 Voice (817) 410-3012 Fax CONTRACTOR 5 State Helicopter's 285 Blackland Rd. Fate, TX 75189 (972)636-4009 Phone OWNER Grapevine Mills Mall Lip HELICOPTER LIFT PERMIT Issue Date: October 22, 2021 PROJECT DESCRIPTION: Helicopter Lift - October 25, 2021 with Rain date of November 5, 2021 @ 7:45 a.m. "Adicli - [RTU] PROJECT# (817)410.3010 WWW.mygov.us HLP-21-3635 Inspections Permits LOCATION TENANT LEGAL 3000 Grapevine Mills Pkwy. Adidas Grapevine Mills Addition Elk 1 Suite # 532 Lot 1r3 Grapevine, TX 76051 *41307097* IIM61:HIiIII **APPLICANT NAME '*APPLICANT PHONE NUMBER APPROVAL CITY MANAGER APPROVAL DEVELOPMENT SERVICES APPROVAL RISK MANAGEMENT County DATE & TIME OF HELICOPTER LIFT RAIN DATE FOR HELICOPTER LIFT IZoning Susan Bitros 9726364009 YES YES YES Tarrant 2021-10-25 07:45 pm 2021-11-05 07:45 pm CC - Community Commercial MYGOV US City of Grapevine] HELICOPTER LIFT PERMIT I HLP-21-3635 I Printed 10/22/21 at 247 p in Page 1 of 1 MECHANICAL PERMIT {VALUE) Issue Date: October 19, 2021 PROJECT DESCRIPTION: Remove and replace 3 HVAC systems to include Roof Top Units "Adidas" PROJECT# (817)410-3010 WWW.mygov.tls MECH-21-3630 Inspections Permits City of Grapevine LOCATION TENANT LEGAL P.O. Box 95104 3000 Grapevine Mills Pkwy. Adidas Grapevine Mills Addition Blk 1 Grapevine,TX 76099 Suite #532 Lot 1r3 (817) 410-3165 Voice Grapevine, TX 76051 `41307097• (817)410-3012 Fax CONTRACTOR Merit Services (MECH) State ID # TACLA27622C 204 N. Mayhill Rd, Denton, TX 76208 (972)245-2848 Phone (972)242-4898 Fax ( chad@meritsvc.com OWNER Grapevine Mills Mall Lp 225 W Washington St Indianapolis, IN 46204-6120 ph, (317) 636-1600 AVAILABLE INSPECTIONS o Mechanical Duct (required) � Mechanical Rough (required) k Mechanical Final (required) INFORMATION Is Dud Work Being Installed? Square Footage VALUATION FEES Mechanical Permit Fee (Vafuej YES 10821_ 135000 TOTAL = $ 1,002.00 $ 1,002.00 PAYMENTS TOTAL = $ 1,002.00 Merit Services (MECH) (Chad Volluz) ($1,002.00) Cc on 101192021 NOTICES ALL work must be done in compliance with the 2006 INTERNATIONAL MECHANICAL CODE. PLAN SUBMITTAL. WHEN PLANS ARE REQUIRED BY CODES, ORDINANCES, OR AS DETERMINED BY THE BUILDING OFFICIAL, THREE (3) SETS OF PLANS SHALL BE SUBMITTED IN HARD COPY FORMAT. ENGINEER SEALED PLANS AND CALCULATIONS SHALL BE SUBMITTED AS REQUIRED BY CODES, ORDINANCES OR WHERE OTHERWISE REQUIRED BY STATE LAW. READ AND SIGN I HEREBY CERTIFY THAT THE FOREGOING IS CORRECT TO THE BEST OF MY KNOWLEDGE AND ALL WORK WILL BE PERFORMED ACCORDING TO THE DOCUMENTS APPROVED BY THE BUILDING DEPARTMENT AND IN COMPLIANCE WITH THE CITY OF GRAPEVINE CODES REGULATING CONSTRUCTION. IT IS UNDERSTOOD THAT THE ISSUANCE OF THIS PERMIT DOES NOT GRANT OR AUTHORIZE ANY VIOLATION OF ANY CODE OR ORDINANCE OF THE CITY OF GRAPEVINE. I FURTHER CERTIFY THAT ALL WORK THAT IS REQUIRED TO COMPLY WITH ANY FEDERAL, STATE, AND I OR LOCAL LAW REGARDING ENERGY CONSERVATION WILL BE PERFORMED IN ACCORDANCE WITH THOSE LAWS, AND THAT VERIFICATION OF ENERGY CODE COMPLIANCE SHALL BE SUBMITTED TO THE CITY UPON REQUEST. Signature Date MYGOV.US City of Grapevine I MECHANICAL PERMIT IVALUE) I MECH-21-3630 I Printed 10/19/21 at 11:39 a.m. Page 1 of 2 HOLD HARMLESS AND INDEMNITY AGREEMENT PROJECT ADDRESS: Grapevine Mills Mall - Adidas #617 3000 Grapevine Mills Pkwy Grapevine, TX 76051 NATURE OF OPERATION: Helicopter external lift operation of Roof Top Units to building roof. DATE OF OPERATION October 25, 2021with rain date opovermber 5, 2021with a 10 day grace period for each date mentioned. I, Shawn Harris, the undersigned, representing 5-State Helicopters, Inc., binding my heirs, executors, 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, 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 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 18th day of October 2021 COMPANY: 5-STATE HELICOPTERS, I BY: Shawn Harris (printed) Sha n H TITLE: OWNER (signature) _ STATE OF TEXAS COUNTYOF Rockwall This instrument was acknowledged before me on this the 18th day of October 2021 NOTARY PUBLIC IN AND FOR THE STATE OF TEXAS My commission ex es 08-26-2024 Yip/, . SUSAN BITROS Signature Notary Public. State of Texas a:-1�; Comm. Expires 08.26-2024 'nnua` Notary ID 132643898 i Arthur J. Gallagher Risk Management Services, Inc Aerospace US Suite 1500, Chicago, IL 60606 sarah_allen@ajg.mm February 17, 2021 To: City of Grapevine 200 S. Main St. Grapevine, TX 76051 Certificate Of Insurance 4G-- ➢ Gallagher Insurance I Risk Management I Consulting This is to certify that the insurance brokers of Arthur J. Gallagher Risk Management Services, Inc have placed Insurance for 100% with Starr Indemnity & Liability Company, Policy Number SASICOM60184921-01, on behalf of the Named Insured covering their operations against the following risks and up to the limits stated whilst operating Worldwide or as defined in the policy Named Insured: 5-State Helicopters, Inc.; California Helicopter Airways, Inc dba Centerpointe Aerospace and Aviation Resources Holdings LLC at 285 Blackland Road, Royse City, TX 75189-4746 Policy Period: February 15, 2021 to February 15, 2022 both days at 00 01 Local Standard Time at the address of the Named Insured Coverages: Combined Single Limit Bodily Injury, including Personal Injury and Property Damage Liability$5,000,000 each occurrence as respects to Sikorsky S-513T and BK 117 B2 type airacraft. Cargo Legal Liability including Slung Loads $1,000,000 each occurrence, subjectto a deductible of $2,500 each occurrence Physical Damage As per Insured Values below subject to deductibles of: 5 % Of Insured Value Not In Motion and 5% of Insured Value In Motion. Aircraft AndlOr Eauiomerl 1 One (1) Sikorsky S-5BT, Registration Number N4XY, Serial Number 58700 2. One (1) Sikorsky S-513T, Registration Number N6BL, Serial Number 581567 3. One (1) BK 117 62, Registration Number N170MC, Serial Number 7217 Contracts: Soecial Provisions Subject always to the scope of the referenced policies and all the policies' declarations, insuring agreements, terms, conditions, limitations, exclusions, deductibles, warranties and endorsements thereof remaining paramount' Solely as respects' (i) The Coverage(s) noted above; (ii) the Contract(s) (and then only to the extent of the Named Insured's obligation to provide insurance under the terms of the Contract(s)), and (iii) the operations of the Named Insured; the policies are endorsed to include the following provisions(s): City of Grapevine is included as an Additional Insured ("the Additional Insured") as their respective rights and interests may appear, warranted no operational interest; however, no party shall be included as an Additional Insured as respects its legal liability as manufacturer, repairer or servicing agent of the Aircraft and/or Engines In the event of cancellation or material changes of the policies by insurers which would adversely affect the interests of the Certificate Holder(s), Insurers agree to provide 60 days (ten (10) days in the event of cancellation for non-payment of premiums) prior written notice to the Certificate Holder(s). This is to certify that policies of insurance listed above have been issued to the Insured named above and are in force at this time. Notwithstanding any requirement, term or condition of any contracts or other documents with respect to which the certificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all terms, exclusions and conditions of such policies. Authorized Representative 5z'TATE AELICOPTEAS WALR4NESEAVICES CAP# 102521 DATE: October 18, 2021 TO:FAAOFFICE North Texas FSDO REFERENCE$CONGESTE4/CONTINGENCY -SAFETY PLAN DATE/TIME OF JOB JOBSITE INFORMATION CONTRACTOR INFORMATION DATE: October 25, 2021 ADDRESS: Merit Services TIME FRAME: 7:45AM-9:OOAM Grapevine Mills Mall - Adidas 204 N. Mayhill Rd. 3000 Grapvine Mills Pkwy Ste 617 Denton, TX 76208 Grapevine, TX 76051 JOBSITECONTACT: Alan Bishop CONTACT: Alan Bishop PHONE NUMBER: 940-735-3805 PHONE NUMBER: 940-735-3805 ** SHOULD A WEATHER, MECHANICAL OR MATERIAL DELAY BE EXPERIENCED, THIS PLAN IS APPROVED FOR ABOVE LISTED DATE PLUS 14 CALENDAR DAYS. ** AIRCRAFT INFORMATION: N66L SIKORSKYS-58T PI�SPOIjTC TE N4XY SIKORSKYS-58T t Jr1U Ei � N9VY SIKORSKY S-58T TRANSPORT CATEGORY) N170MC MESSERSCHMITT TRANSPORT CATEGORY PILOT INFORMATION: ROBERT SMITH COMMERCIAL CERTIFICATE # 3493515 SHAWN HARRIS ATP # 2727633 ANDREW DALE COMMERCIAL CERTIFICATE # 3168484 PREPARED BY: Susan Bltros (/\l /u1A.rE .3a;l 44- APPROVED BY: OPERATING CERTIFICATE #LDUL599B 285 BLACKLAND ROAD FATE, TEXAS 75189 (972) 636-4009 Digitally signed by ROBERT B ROBERTB WILLIAMS W I L LI A M S Date: 2021.10.22 12:22:57 -05'00' NTX FSDO SW19 ��TA E HELICOPTERS 11AtlNNE SEAVIRS LOAD DESCRIPTION HAZMAT: YES XX(DOT-SP 16606 & DOT-SP 20490) NO XXROOFTOP UNITS MATERIALS EQUIPMENT OTHER: NUMBER OF TOTAL LIFTS (RANGE) 1 - 10 WEIGHT RANGE 1,000 - 3,500 PERCENTAGE OF LIFT ABILITY OF AIRCRAFT 83% LOAD AERODYNAMIC: YES NO Xx LENGTH OF ATTACHING GEAR (FROM HOOK TO BOTTOM OF LOAD) BUILDING OCCUPIED DURING LIFT: YES NO XX * IF YES, ESTIMATED LOAD PENETRATION OF FLOORS AREA CONSIDERED CONGESTED: YESXXNO OPERATING CERTIFICATE # LDUL599B 285 BLACKLAND ROAD FATE, TEXAS 75189 (972) 636-4009 m by ROBERT B ROBERT B WILLIAMS WILLIAMS 122140zo5ooz NTX FSDO SW19 t UWPTERS i� CONGESTED COMMERCIAL AREA CONGESTED RESIDENTIAL AREA __XK CONGESTED AREA PROBABILITY/POSSIBILITY This is congested area operations. Items are located in staging area(s) on either transportable vehicles or ground surface. Item(s) to be placed on building/structure roof top(s) or designated areas. Direct flight path(s) from staging area(s) to placement area(s) will occur unless otherwise notated on provided maps. Lift(s) amount(s), description(s), order and placement could be altered by contractor personnel, however, pick up site and drop site shall not be outside the parameter of this request. Helicopter landing area(s) will be secured at all times (prior, during and departure). Flight path(s) during lift operations inside the designated operational area(s) will remain clear of unauthorized personnel, equipment, obstacles at all times. Flight path(s) will remain within operational area(s) at all times. The operational area(s) has been surveyed for hazard(s) and mitigated to the lowest risk level acceptable to, or able to obtain, by both 5 State Helicopters, Inc. and contractor(s). Should a unforeseen, or additional hazard(s) surface, lifting will immediately halt till the hazard(s) have been rectified or mitigated. Primary means of communication via radio will be maintained constantly during the operation. Secondary means of communication via hand signals will be immediately incorporated should radio communications fail. Appropriate ATC communications will be maintained by pilot in all possible and/or feasible situations. Narrative: Due to the job -site being a mall in a commercial and residential area we classify this to be a potential congested area. However, all entrances will be blocked and controlled by security personnel so that no unauthorized persons shall enter or cross the operational area. The building will be vacant inside the operational area during operations. Operations will be performed before mall business hours (11:OOAM-8:o0PM). 285 BLACKLAND ROAD FATE, TEXAS 75189 (972) 636-4009 WWW SCTATF rnnn Digitally signed by ROBERT B ROBERTB WILLIAMS W I LLIAM 5 Date: 2021.10.22 12:21:09-05'00' NTX FSDO SW19 fiTATE 285 BLACKLAND ROAD FATE, TEXAS 75189 HELICOPTERS AIA CAANENERVLFS (972) 636-4009 office@Sstate.com www.5state.com Notification of Grapevine City Officials 5 State Helicopters has contacted the following city officials about the lift to be performed on October 25, 2021: 3000 Grapevine Mills Pkwy #617 Grapevine, TX 76051 City Manager: Connie Cook 817-410-7600 Your message has been delivered to the following recipients: 'Connie Cook' ( Subject: 5 State Helicopter Lift of HVAC Equipment October 25, 2021 in Grapevine, TX at approximately 7:45 AM - 9:00 AM, Police: Mike Hamlin 817-410-3225 Your message has been delivered to the following recipients: ' Subject: 5 State Helicopter Lift of HVAC Equipment 25 October 2021 in Grapevine, Texas at approximately 7:45AM-9:OOAM. Fire: Darrell Brown 817-410-4400 Your message has been delivered to the following recipients: ' Subject: 5 State Helicopter Lift of HVAC Equipment 25 October 2021 in Grapevine, Texas at approximately 7:45AM-9:OOAM. ATC: Dallas Fort Worth Intl. Airport 972-615-2650 Your message has been delivered to the following recipients: ' Subject: 5 State Helicopters lift operations 4 miles North of DFW on October 25, 2021. Best Regards, 61t � 5 State Helicopters ROBERT B ROBERTB WILLIAMS WILLIAMS Date 2021 NTX FSDO SW19 000 r .vi .Mil - + it 000 Grapevine Mills Mall #617 _ r � 4 � t 'rapevine, TX 76051 \ A I late of Lift: } Ve 0/25/2021 :45AM 320 57' 53.9"N +� )70 02' 40.4"W 1r RIlk Iperanonal Area � � � t • St R � - * #.44 light Path andmg Area ❑ Fm U"�N ��.Vh �► ` l tagingarea merger, Area /� Q locked Areas 1 III . ONJ ^ 1� fit le fill ,. `�` ^ / �(SR{RT B DigfillY signed j Ilk. i �� BERTB WILLIAM tk row-` ^' �� t4��`5:zsozi 4;. �• ' RS \ z-oroor, .� ► h N F `SW1§f% *. .' N P 000 Grapevine Mills Mall #617 3rapevine, TX 76051 N late of Lift: r '� 0/25/2021 ime: 9 :45AM - 001 _D' _ •e '' 320 57' 53.9"N 970 02' 40.4"W i ,DO SVI 000 Grapevine Mills Mall #611 )rapevine, TX 76051 late of Lift: 0/25/2021 ime: :45AM Mu T,jr 1 (360) 320 57' 53.9"N 970 02' 40.4"W ALTITUDE BETWEEN SOLANA COMPLEX AND NORTH LAKE SHOULD BE AT OR BELOW 1000 /UI FEET MSL WHEN DFW IS IN NORTH FLOW AND AT OR BELOW 800 FEET MSL WHEN DFW IS IN SOUTH FLOW (Pvt) .�- OR SCOTT & WHITE Q GRAPEVINE 1 7/4 L f GRAPEVINE 6) reek�� WEST TOWER FREQUENCY 134.9 �ti 1 [IN.ToF. \� N — 1: THE ROU FLY THROt rasnl B3 MUSTI NOT BE THE F,(NAL APPROACH 35C, 35l.S1336A, AND 36L (Pv OPE �.■ 44 A�= •% 914 10116 'i` Lake (479) y° (4 I) 509 h l �; JOtiro 635 e BAYLOR IRVING COPPI EAST TOWER f`+R52 FREQUENCY 127.5 `t 114 t tt6.2 Ch tiT4�> NO SVFR DALLAS-FORT WORTH INTL ( Helicopter will not CT - 124.15 126.55 127.5 13 Be more than 125' Above a 40' building ;sld Ms When air lifting Equipment to the 161%oi ign.39�� Roof. DO, W)9 Pilot will contact �� . 1 b Dallas Fort Worth Airport. 1 ttiv 5CUMERS F,E UTE SE W CR4NESENNCES October 18, 2021 285 BLACKLAND ROAD FATE, TEXAS 75189 (972)636-4009 Connie Cook, City of Grapevine Attention: City Manager Reference: 5 State Helicopters Landing and Operations This letter, with the location, dates, and time of a helicopter external load operation that is being flown by 5 State Helicopters, Inc. is to ensure there are no restrictions or regulations preventing the helicopter from landing within the city limits of Grapevine, Texas. Date / Time of Job: Location: I Contractor: October 25, 2021 Adidas Merit Services 7:45AM - 9:OOAM 3000 Grapevine Mills Pkwy 4617 204 N. MayhiII Rd. Grapevine, TX 76051 1 Denton, TX 76208 Helicopter Type: Sikorsky S58T, Kawasaki BK 117, Sikorsky UH-60 TRANSPORT CATEGORY Call Sign: N4XY (Blue), N6BL (Red), N9VY (Orange), N 170MC (Yellow) or NI 12HC (Green) Pilots: Robert Smith, Andrew Dale or Shawn Harris 5 State Helicopters, Inc. assures the City Grapevine, Texas that it will comply with all State, Federal and local regulations, holds and required permits and is licensed to do the type of work as described in this request. 5 State Helicopters, Inc. agrees to provide a Certificate of Insurance with liability coverage of $5,000,000.00 showing the City of Grapevine as an additional insured. Please feel free to contact 5 State Helicopters with any questions and/or concerns that you may have. Office: 972-636-4009 Please sign and e-mail back SINCERELY, y /APPROVED /DISAPPROVED BY DATE Grapevine Mills Mall — Adidas r I ,; 't r'' 3000 Grapevine Mills Mall #617 � L ^'r' !// �� Grapevine, TX 76051 * �` 1 • / N Date of Lift: 10/25/2021 �r � Time: ��^ rr.�' ! f>7► / - _ 7:45AMh I • �'_ i. t- 320 57' 53.9"N a 2 970 02' 40.4"W •� `;� �I ooer,tmr,ei Area (} w y Flight Path -- land� ing Area ❑ Fin and d/ng r r Staerngarea Emergency Area Blocked Areas v C��%a ;�E• • 1 .��D Ilk r leg IL— ! ^/ Pill,,^ L r c� n, ^*. P } rf g,Pi � ) r � r /� �► Grp le Jill • �� /, Grapevine Mills Mall —Adidas 3000 Grapevine Mills Mall #617 Grapevine, TX 76051 Date of Lift: 10/25/2021 Time: 7:45AM 320 57' 53.9"N 970 02' 40.4"W (ri r.i� 2 f�lr�4iyy� Grapevine Mills Mall — Adidas 3000 Grapevine Mills Mall #617 Grapevine, TX 76051 Date of Lift: 10/25/2021 Time: 7:45AM -v 938 Nn (350)MU T 320 57' 53.9"N 0W97° 02' ALTITUDE BETWEEN SOLANA COMPLEX AND I` H NORTH LAKE SHOULD 6E AT OR BELOW 1000 FEET MSL WHEN DFW IS IN NORTH FLOW AND EX AT OR BELOW 800 FEET MSL WHEN DFW IS IN SOUTH FLOW Pvt O BAYLOR SCOTT & WHITE _ GRAPEVINE 714 L % GRAPEVINE 6, Croek tWEST TOWER FREQUENCY 134.9 N . 1 [uNoRrOW--THE- c,LTi-TP.'TO FLY Th OURSE TO RUNWE MILLS MALL 114 12 000 r-'Zz) NONE. 83 MUSTyNOT BE THE FINALXAPPROACH 35C, SW## 56R, AND 36L N w040110. M*W �%% 914 �� 10 F (� NOrtt1 (479) 2Lake 01, (4 19) I I %Z 509 �Ak 4 �°h'N 635 B ,,, BAYLOR IRVING COPPI T IEAST TOWERf%7 L FREQUENCY 127.5 9 9 j16.2 Ch 6 ; N Y-• NO SVFR Helicopter will not DALLAS-FORT WORTH INTL ( Be more than 125' CT - 124.15 126.55 127.5 13 Above a 40' building ATIS 123.775 When air lifting 606 L 122.95 Equipment to the AOE-----� Roof. 161 Pilot will contact Dallas Fort Worth fERICK- _ _� w &- Airport.