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Home My WebLink AboutHLP2013-2423�)LP�0T3 a1�3 MEMORANDUM 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: JULY 8, 2013 Attached is a request for a helicopter lifts are scheduled for Friday, July 12, 2013 at 6:30 A.M., 3000 Grapevine Mills Parkway #510, if it meets your approval, please sign below: Bruno Rumbelow, City Manager Dan Hambrick, Risk Manager O ACCook \HelicopterM emorandum HOLD HARMLESS AND INDEMNITY AGREEMENT PROJECT ADDRESS: Grapevine Mills Mall 3000 Grapevine Mills Pk,Ny, Grapevine, Tx 76051 (footlocker) 1- 5 i c NATURE OF OPERATION: Helicopter air lifting equipment DATE OF OPERATION: 7 -12 -2013 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. 1 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 th day and (month) JJ w_201J. COMPANY: 5 -STATE HELICOPTERS, INC. , BY: LINDA NORMAN (printed) TITLE: OWNER (signature) 1 STATE OF�'� COUNTY OFF�c;�l;r This instrument was acknowledged before me on this the Day of 201 NOTARY PUBLIC IN AND FOR THE STATE OF,, My commission expires w 1 signature LINDA MAE VAUGHT MV -c6mmisslon E%Pku May 6. 2017 .,�n d AEA' Caledonian insurance Graup,►nc. Certificate of Insurance • Certificate Number. This is to certify that the policy(ies) of insurance as described belove have been issued to the Insured for whore this Certificate is executed and is;are in force at this time. This Certificate is issued for infoanation only and confers no rights upon the holder. This Certificate ncitlwc affirmatively nor negatively amends, extends or alters the coverage afforded by such policy(ics) or hinder(s) stated herein. This ecrtiticate cancels and supersedes all previously issued ecrtilicates. Certificate Holder: City of Grapevine PO Box 95104 Grapevine, TX Named Insured: 5 - State Helicopters, Inc. 285 Blackland Road Royse City, TX 75189 -4746 Police Type: Aircraft Hull & Liability and Aviation General Liability Policy Policy Period: February 01, 2013 to February 01, 2014 both days at 12:01am Local Standard Time nt the address of the Named Insured shown above. Insurer(s): Company Policy- NO(S), StarNet Insurance Company through Berkley Aviation, LLC Aircraft Covered: Sikorsky sm, N4XY; Sikorsky S58T, X6BL Coverages & Limits Aircraft Liability Coverage limit Combined Single Limit Bodily Injury, including Personal Injury and 510,000,000 each occurwncc, Property Damage Liability(Excluding Passenger Liability) Cargo Legal Liability Coverage limit Cargo Legal Liability including Slung Loads 5500,(N)0 each occurrence, subject to a deductible of $ 1,000 each claim. Certificate Provisions Additional insured With respect to ,Aircraft Liability, it is understood and agreed the Certificate Holder(s) shall be included as Additional Insureds) hereunder solely with 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 limited to those coverages provided by these policies. Certificate Date: 1/2512013 • 0 Authorized Representative 3023 80th Avenue S.1;.. Suite 300 Mailing .Address: P.O. Box 60, Mercer Island, Washington 98010- 00()1) Phone: (206) 232 -9870 - Fan- (206) 232 -9515 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 Congested Area Plan DATE: 7 -8 -2013 5 -STATE HELICOPTERS, INC. 285 BLACKLAND ROAD ROYSE CITY, TEXAS 75189 972 - 636 -4009 800 -543 -8442 972- 636 -1300 FAX CONTRACTOR: EMS Ac & Heating 802 Gemini Ave Duncanville, Texas 75137 JOB SITE: Grapevine Mills Mall 3000 Grapevine Mills Pkwy Grapevine, Tx 76051 Footlocker Suite 510 HEIGHT OF BUILDING: 25 FEET TOTAL OF LIFTS: I rtu up and down 2899 lbs DATE OF LIFTS: 7 -12 -2013 APPROXIMATELY 6:30 am 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 -58T STANDARD CATEGORY PILOT: BRADFORD S. LADUE COMM. CERT. 2760587 PILOT: SCOTT BRADFORD LADUE COMM. CERT 3250744 LENGTH OF THE CABLES WILL BE 75 FT. CONTACTED: City of Grapevine Mr. Scott Williams (Connie) 817- 410 -3158 Police and Fire: Supervisor Karen Ballard 817 -410 -8127 DFW: Mall Manager: Cooper Black 972 - 724 -4910 SIGNATURE OF RSPONSIBLE COMPANY OFFICIAL 4,LLb t*t 1'r,� 5 -STATE HELICOPTERS, INC. 285 BLACKLAND ROAD ROYSE CITY, TEXAS 75189 972 -636 -4009 800 -LIFT -442 FAX 972 - 636 -1300 FAA CERTIFICATE 4 LDUL -599B DATE: 7 -8 -2013 CONGESTED AREA PLAN - EXTERNAL LOAD LIFT TO: FAA OFFICE: Dallas, Texas TELEPHONE: 972 -582 -1800 Fax 972 -582 -1872 JOB SITE Grapevine Mill Mall (Footlocker Suite 510) 3000 Grapevine Mill Pkwy Grapevine, Tx 76051 SCHEDULED DATE AND TIME OF OPERATION: 7 -12 -2013 approximately 6:30 am CONTRACTOR: EMS Ac & Heating 802 Gemini Ave Duncanville, Tx 75137 CONTACT PERSON: David 972 - 296 -1939 Ems.hvacwahoo.com AIRCRAFT: S -58T N -613L OR N4XY STANDARD CATEGORY PILOT: BRADFORD S. LADUE COMM CERT. 4 2760587 SCOTT BRADFORD LADUE COMM. CERT. 93250744 LOADS: NUMBER TYPE WEIGHTS I rtu up and I rtu down 2899 Ibs CARRYING HAZARDOUS MATERIAL: NO DESCRIPTION: CONTACTS: City of Grapevine, Texas Mr. Scott Williams (connie) 817 -410 -3158 Police and Fire: Supervisor: Karen Ballard 817 -410 -8127 Mall Manager: Cooper Black 972 - 7244910 DFW: SIGNATURE OF RESPON I LE MPANY OFFICIAL NARRATIVE OF PLAN OF OPERATIONS: 5 -STATE HELICOPTERS, INC. Congested Area Plan Job Site Grapevine :Mills Mall (Footlocker) Suite 510 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 DATE OF JOB: 7 -12 -2013 END OF JOB: 7 -12 -2013 ENCLOSED ON SKETCH ATTACHED TO THIS REQUEST FLIGHT PATH FROM THE STAGING AREA WHERE THE EQUIPMENT IS LIFTED TO THE AREA WHERE THE EQUIPMENT 1S PLACED ON THE BUILDING WILL BE CLEARED OF UNAUTHORIZED PERSONS. THE ESTIMATE OF HOW MANY FLOORS OF THE BUILDING WILL BE PENETRATED IF T14E LOAD IS RELEASED AT THE MAXIMUM HEIGHT WHEN LIFTED ABOVE THE ROOF IS NONE. FOR SAFETY REASONS THE AREA OF 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 MALL. THE SECTION OF THE MALL BEING LIFTING 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 NORTH WEST SIDE OF THE MALL 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 SUPERINTENDENT OF THE JOB SITE WILL CLOSE THE OPERATIONAL AREA SO NO UNAUTHORIZED PERSONS WILL BE ALLOWED INTO THE PARKING LOT DURING THE LIFT". 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 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. 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 UNIT THE RISK HAS BEEN CORRECTED. LIFTING AREA COULD BE ANYWHERE INSIDE THE OPERATIONAL AREA DUE TO CONTRACTOR AND OR SUPERINTENDENT MOVING THE EQUIPMENT BEFORE THE HELICOPTER ARRIVES. FLIGHT PATH WILL BE WITHIN OPERATIONAL AREA. SIGNATURE OF RESPONSIBLE COMPANY OFFICIAL 4: `�'V3726361300 PAGE a 5-STATE HELICOPTERS, INC. Congested Area Pfau. JOB SITE: GRAPEVINE MILLS MALL a000 C;FMEVYNE MILLS PKWY GRAPEVINE, TXAS 76051 DATE OF 3013: 7 -12 -2013 TARE: APPROXMIATELY 6 :30 AM 1 0 5 ^•� r � s STATE Ki l 04/07 TBERE ARE POWER LINES AND LIGHT POLES IN THE AREA BUT, THEY WILL NOT CAUSE A SAFETY HAZARD TO THE L&7. TODAY'S DATE: 7 -8 -2013 111LIClouil..'jux I I IN 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 TIUS COMPANY COMPLIES WITH THE "CODE OF ETMCS: OF THE HELICOPTER ASSOCIATION OF AMERICA T S_" X& - .InNtS .sxFS :J; C - t2t 5 -STATE HELICOPTERS, INC. i —; --1 4.Flewer M�6.und= P, 'n- o+ ill ry ESTb� h� a � P + � z I„ � otk Pint ? +. \z�a +2+ ^� f i 4\\'alnut Gro;c Pall GRAPEVINE MILLS MALL � z' I _ M, U} 3000 6R-NPEVINE. MILLS PKWY ?�' 44 88 GRAPEVINE. TX 76051 ,120 57.N85' t 1497°02.553' y� DATE OF LIFT: ? -12 -2013 wfll �' 4 S SN1TY MVL> t TI1vIE: APPROXIMATELY 6:30 A 14 lgU P++aii z s �TTTnilylills \ E 1 ' I r r LU �� - R r. CQ r 0 � I Fz' Sand) Lake 444' .I a ,rove Valk 1 k e u U14, J,it4 -� 25 cn ' ^�9 �Coppell��, HELICOPTER WILL NOT : r - Silver L i I - B E 5 F.r r S,ouhlake , "� CQapELL�tp !�` MORE THAN 125 :1130VE x\44 ALL 382 --' f— r II l I bvtBe� i W 25 FT. MALI. WHEN .AIR � ��J r z ! Far LIFT INtt EQUIPMENT TO , THE 'I -',�` i 2s ROOF. N I ;f 161 \ yy'ok ? {I \ '4`- 0 440E lit > n Ilasrl "t rnrth Mtern 1f PILOT WILL BE lfv 441 -i� Gribbfe � ..1 360 z � i Fq�R CONTACT YAL LN CYA L • N` +r WITH DFti (Y) N fRO Jp Meg 12.00 Mon Jul 08 14:35 2013 Scale 1-125.000 (at center) 2 Miles 2 km Local Road Airfield Trail Geographic Feature C== Interstate/Limited Access Park/Reservation Major Connector Sched Service Airport State Route Locale Exit Cemetery Railroad County Boundary Small Town Water Trinilr R rer ri ! 114 Highland ACINSRD zI 12'� -'RK+i t • � ,) � Catitit�rn' Cstl�+it� RD a� 4E/ 1114^1 �A A7's I t,r t71 r'rt-� , &C L i ' RDG t4FRITAGAN �� 5-STATE HELICOPTERS, INC. X > ii 1 COPPE ME PAf OALTONS J, 7 ♦Rockled, Park 61rapevim: Recteational Park GRAPEVINE MILLS MALL a. 0 3000 GRAPEVINE MILLS PKWY - U GRAPEVINE, TX 76051 121 W SANDY LAKE RD I z Z �Rl �(;,Ko T DATE OF LIFT: 7 -12 -2013 \4'97- 02,55..' --Cc — 0 IC 1 C N 6:30 A. 01% TIME: APPROXIMATELY M At TJ I W�;OD LN NORTHPOINT �7-7,GREI 2 0 1 LL M RD CnEEKV IN LU S1 II > eel > I RD 26 icoppoll vv F 8Ass PRO 121 BUS G RD ry E LY SilVer Lake Park 3 ♦ C z OuTH 0 Ui 0 Z:p A Him. h GATEWAY Oe 2 4z .2 m TURK C TTON RD rRITZ IL RRD. .... .. — III COTTONWOOD RD 26 E WA..�,r, COPPELL RO v - E T14L L -*.T-.'- TEXAS xOR1 F-1 Mk rlD �T—mw Atlas 1-11, MH 00 1, hic Rd. 01:2001 L 01 ST ATISMAN Mag 14.00 Mon Jul 08 14:32 2013 Local Road Small Town Scale 1:31,250 (at center) Trail Parlt.'Reservation -- 2000 Feet D Interstatell-imited Access County Boundary 1000 meters Major Connector Water State Route Riveritanal Exit Railroad Point of Interest Nof2ry fil I ( e;, Vii- � �.�. F r °t.< �` �'•� �. v - i :'!'. 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