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Home My WebLink AboutHLP2016-0681February 18, 2016 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. Melanie Hill, Risk Manager Bruno Rumbelow, City Manager Thank you, Connie Cook Development Services (817) 410 -3158 Permit will not be issued until FAAApproval has been received. MEMORANDUM CITY OF GRAPEVINE TEXAS TO: BRUNO RUMBELOW, CITY MANAGER MELANIE HILL, RISK MANAGER FROM: SCOTT WILLIAMS, DEVELOPMENT SERVICES DIRECTOR/ BUILDING OFFICIAL SUBJECT: HELICOPTER LIFT REQUEST DATE: FEBRUARY 18. 2016 Attached is a request for a helicopter lift are scheduled for February 24, 2016 at 7:00 A.M., with a rain date of February 25, 2016 at 7:00 A.M. for 3000 Grapevine Mills Parkway #613, if it meets your approval, please sign below: Bruno Rumbelow, City Manager Melanie Hill, Risk Manager 0ACCook\He1icopterMMemomndum NATURE OF OPERATION: Air Lifting Air conditioning units DATE OF OPERATION: 2 -24 -2016 with back up of 2 -25 -2016 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 day and (month) 2016 COMPANY: 5 -STATE HELICOPTERS, C. BY: LINDA NORMAN (printed) n TITLE: OWNER (signature) ` STATE OF _ > - COUNTY OF J This instrument was acknowledged before me on this the Day of 2016 NOTARY PUBLIC IN AND FOR THE STATE OF My commission expiresG . i7 signature LINDA MAE VAUGHT My Commission Expires May 6. 2017 Certificate of Insurance Certificate No. 60274 Rev. Daze: Jan 15, 2016 This is to certify that the policy(im) of insurance as described below have been issued to the Insured for whom this Certificate is executed and Ware in force at this time. This Certificate is issued for information only and confers no rights upon the holder. This Certificate neither afrinmatively nor negatively amends, extends or roar McGriff, Seibels & Williams, Inc. Certificate of Insurance Certificate No. Rev. Date: Jan 15, 2016 • This is to cenify that the policy(ics) of insurance as described below have been issued to the Insured for whom this Certificate is executed and is/are in force at this time. This Certificate is issued for information only and confers no rights upon the holder. This Certificate neither affirmatively nor negatively amends, extends or alters the coverage afforded by such policy(ies) or binder(g) stated herein. This certificate cancels and supersedes all previously issued certificates. Certificate Holder: City of Grapevine PO Box 95104 Grapevine, TX 76051 Named Insured: 5 - State Helicopters, Inc, and California Helicopter Airways, Inc. 285 Blackland Road Roysc City, TX 75189.4746 Policy Type: Aircraft Hull & Liability and Aviation General Liability Policy Policy Period: February 01, 2016 to February 01, 2017 both days at 12:01 am Local Standard Time at the address of the Named Insured shown above Insurer(s): Company Aircraft Covered: Sikorsky S58T, N4XY; Sikorsky S58T, N6BL v Aircraft Liability Coverage Limit Combined Single Limit Bodily Injury, including Personal Injury and S10,000,000 each occurrence as respects Sikorsky S -58BT and Sikorsky Property Damage Liability(Excluding Passenger Liability) S-58ET type aircraft. Cargo Legal Liability Coverage Limit Cargo Legal Liability including Slung Loads S500,000 each occurrence, subject to a deductible of SI,000 each claim. Certificate Provisions Additional Insured It is agreed that the Certificate Holder is included as an Additional Insured under the Aircrdft Liability Coverages, but only to the extent of liability vicariously imposed upon the Certificate Holder solely as ilia result of an actor omission of the Named Insured or its employees in connection with the Named Insurd(s Aircraft operations, subject to all policy terms, conditions and exclusions. Auth 'zed Repr ntative • V 3023 801h Avenue S.E., Suite 300 Mailing Address: P.O. Box 60, Mercer Island, Washington 98040.0060 Certificate No: Page I of I Phone: (206) 232.9870 - Fax: (206) 232 -9515 60274 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: 2. 11.2016 5 -STATE HELICOPTERS, INC. If a problem or safety hazard exists 285 Blackland Rd. Royse City, Texas 75189 972- 636 -4009 800 -543 -8442 972 -636 -1300 FAX CONTRACTOR: Quality 1 Energy Systems 10870 Plano Rd Suite A Dallas, Texas 75238 Mohammad Gharbieh, MSME JOB SITE: Grapevine Mills Mall Round One S,; �- � i 3 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 HEIGHT OF BUILDING: 40 Ft. TOTAL OF LIFTS: 22 rtu "s 2600 lbs and down in weight DATE OF LIFTS: 2-21-2016 with back up date of 2-�S - 2016 Time; approx. 7:00 am the ground persons /crew with radios will notify the pilot to move the helicopter to a safe area N6BL, N4XY, N6VY SIKORSKY S -58T STANDARD CATEGORY PILOT: Bradford S. Ladue Comm. Cert.. 2760587 PILOT: Scott Bradford Ladue Comm. Cert. 3250744 Length of the cables estimated 75 Ft. CONTACTED: City of Grapevine: Mr. Scott Williams ((Connie) 817 - 410 -3158 Mall: Cooper Black 972- 724 -4900 Police and Fire Dispatch: Supervisor: Karen Ballard 817 -410 -8127 DEW FAA: 972 - 615 -2650 Alan Phillips, Michael Styer, Gio Vanni. Dipierro, Greg Juro, Larry Allen SIGNATURE OF RESPONSIBLE COMPANY O/FFICIAL Linda Norman t 5 -STATE HELICOPTERS, INC. 285 BLACKLAND ROAD ROYSE CITY, TEXAS 75189 972- 636 -4009 800 -LIFT -442 FAX 972 - 636 -1300 FAA CERTIFICATE # LDUL -599B DATE: 2 +2016 CONGESTED AREA PLAN - EXTERNAL LOAD LIFT TO: FAA OFFICE: NORTH TEXAS FSDO 214- 277 -8500 JOB SITE Grapevine Mills Mall (Round One) sa: he (, 1'3 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 SCHEDULED DATE AND TIME OF OPERATION: 2 aq 2016 with back up date of 2 Y, -2016 Approx. 7:00 am CONTRACTOR: Quality 1 Energy Systems 10870 Plano Rd Sutie A Dallas, Texas 75238 CONTACT PERSON: Mohammad Gharbieh.MSME 469 -831 -6315 OFFICE 214- 348 -9588 AIRCRAFT: S -58T N -6BL , N4XY , N6VY STANDARD CATEGORY PILOT: BRADFORD S. LADUE COMM CERT. # 2760587 SCOTT BRADFORD LADUE COMM. CERT. #3250744 LOADS: NUMBER TYPE WEIGHTS 22 RTU'S 2600 LBS and down in weight CARRYING HAZARDOUS MATERIAL: no DESCRIPTION: CONTACTS: City of Grapevine: Mr. Scott Williams ((Connie) 817410 -3158 Mall: Cooper Black 972 - 724 -4900 Police and Fire Dispatch: Supervisor: Karen Ballard 817 -410 -8127 DFW FAA: 972 -615 -2650 Alan Phillips, Michael Styer, Gio Vanni. Dipierro, Greg Juro, Larry Allen SIGNATURE OF RESPONS LE OMP NY OFFICIAL Linda Norman %U a- NARRATIVE OF PLAN OF OPERATIONS: 5 -STATE HELICOPTERS, INC. Congested Area Plan Job Site: Grapevine Mills Mall (Round One) Chu tt L" 3 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 DATE OF JOB: 2 -A�-2016 with backup date of 2-j -2016 END OF JOB: 2-;1 -2016 with back up date of 2- 752016 ENCLOSED ON SKETCH ATTACHED TO THIS REQUEST Flight path from the staging area to where the equipment is placed on the building will be cleared of unauthorized persons. Estimated 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. But 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 tip site will be the emergency landing area. Additional Information: This is a existing Mall. The section of the mall being flown over will be vacant during the lifting of equipment. No unauthorized persons will be allowed into the operational area of the job site during the lifting of the equipment to the roof. The parking lot on the westside 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 superintendent of the job site will close the operation 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 crew will be given before the lifting begins. The operational area will be surveyed by 5 State Helicopters crew 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 equipment begins. 5 State Helicopters crew has radio's and will taking 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. Lifting area could be anywhere inside the operational area due to the contractor and or superintendent moving the equipment before the helicopter arrives. Flight path will be within operational area. SIGNATURE OSPONSIBL OMPANY OFFICIAL Linda Norman m ) PAGE 5 -STATE HELICOPTERS, INC. Congested Area Plan JOB SITE: Grapevine Mills Mall 3000 Grapevine Mills Pkwy Grapeivne, Texas 76051 DATE OF JOB: 2 -a f •2016 with back up date of 2 -;r 2016 TIME: approx. 7:00 am There are power lines and light poles in the area but, will not cause a safety hazard to the lift. TODAY'S DATE: 2- 19-2016 PLAN PREPARED BY: Linda Norman `( 11 k7D&P Should a weather, mechanical or material delay be experienced this CAP is approved for the date and time lifted above plus 10 days. "with this extension 5 State Helicopters, Inc. will re- notify all Contacts listed on CAP FAA: North Texas FSDO APPROVED BY: FAA STAMP: THIS COMPANY COMPLIES WITH THE "CODE OF ETHICS: OF THE HELICOPTER ASSOCIATION OF AMERICA. LU16-Ue-1Y UYW FAA NIX I-SOU 114MUKU >> M050131.1V v III PA(il'. a 501 A IF I il•.I.ICOP I ERA INC. ('ongesled Area Plan WKSIII: (impeune Mills Mail 1111111 lir;,p;.v llle `tills PL1�) • • +'1 lirnpei,ow, Icc11s7601 DAI•I: )i Jltll: _' -af 3UIe kith hurh up dulyul'3•',A'3uI6 11\11k uppros. 7mo ant here are pu"vr lines and light poles in the nrco I+ut. Mll 1110 cuux a sJ1n� Ivvtird 10 the fill. I OUAY'S I)A I L: 2•1.3010 I'1.:1N PREPARED BY ; I.inJu Nurnuln ;, `�•.; 1 � � .' Shuuld u,lenthcr. nwchunicul ur rnutcrinl Jvl:1} he ��pericnccJ this (': \I' is upprwed Hir the dale and tilnc tilled 1111MU plus It) dad%. **%\ilh this extension i Mme I Ielicoplcrs. Inv, \till rc•nolil'� till ('onlucts listed till ('AI' I AA: North leu1.I•SI)O APPIt(IM) IiY: APPROVED BY: IUWrP) DATE: r2/ I 0 I I IIS C thIPANY ('O1II'LII's W i l l 11 II ASSt)(•IAHONOI A411•ItICA. kt AyZ_avtlle Lake Park _ .__— _ _. 5 STATE HELICOPTERS, INC. -ki 1— `�' I 77V I I 1 IM t� x) M O� F -M 1 71 HiF FlbWer N r _ rc m Marshall C e tit, 1 GRAPEVINE MILLS MALL BOIo Poi .m 'I? 3000 GRAPEVINE MILLS PKWY oc P GRAPEVINE, TX 76051 Grove Park DATE OF LIFT: 2 - ?y -2016 BACK UP DATE: 2 -25 -2016 TIME: APPROX. 7:00 AM ,,Walnut COPTER WILL NOT edge 114 BE ' D MORE THAN 125 FT. Oak Grove Pa k ABOVE r7L A 40 FT. BUILDING WHEN 7 AIR LIFTING EQUIPMENT TO ilver La ..... F- THE �. COPPELL DD ROOF. aa2 ra evinje PILOT WILL BE IN _ 114 ti r CONTACT Aye WITH DFW CONTROL m v �s Mag 12.00 Tue Feb 09 14:56 2016 Scale 1:125,000 (at center) 2 Miles 2 km A v O < w Z LL �. M B P4 � R q� ID CITIES — Local Road — Trail Interstate /Limited Access Major Connector State Route Exit Railroad Small Town N320 57.947' W970 02.659' z / 1 72- 1 Ila z°— y 0 RD G Airfield Geographic Feature +Park/Reservation Schad Service Airport Locale Cemetery County Boundary Water 121 S 448B Oo vart East m i Sandr Lake \\ a` �4• e�j os I- 161 - `^�-�GF N^ROYAL E ROYAL LN 4 3 IY J� o 111 x' WgLNN 11a 31aA y _ HigF z n Califon _ �L i 1 �. 5 STATE HELI Mag 14.00 Tue Feb 09 14:52 2016 Scale 1:31,250 (at center) 2000 Feet 1000 Meters Svc GRAPEVINE MILLS MALL 3000 GRAPEVINE MILLS PKWY eek GRAPEVINE, TX 76051 1 Pa DATE OF LIFT: 2,21-2016 BACK UP DATE: 2 -Q5 -2016 TIME: APPROX. 7:00 AM Grapevine Golf Co Ord! o� / —<-26 BASS PF Lake Park CO Y$ COPTERS, INC. County Boundary Water River /Canal n 26 K I x O COPPELL RD 0oM' 0 A; C 2001 GDT. Inc.. Rel. 01,2001 — Local Road — Trail Interstate /Limited Access Major Connector State Route Exit Railroad Point of Interest County Boundary Water River /Canal �G O O F I I � 7 I� 9 Cmplax MJIs Caek \ Y X n Linda N a Page 1 of 1 From: "Linda Norman" < `� ✓ Date: Thursday, February 18, 2016 9:25 AM To: < Attach: 2016- 02- 18- 09- 16- 39- 01.pdf Subject: Request to enter into DFW Airspace See Attachment 5 State Helicopters, Inc. is requesting to enter into DFW airspace for the purpose of air lifting equipment to the roof of: Grapevine Mills Mall 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 Date: 2 -24 -2016 with back up date of 2 -25 -2016 Time: landing approx. 6:45 am Lifting: approximately 7:00 am Helicopter: Sikorsky S58T Call Sign: N4xy or N6bl or N6vy Pilot: Bradford S Ladue Comm. Cert. 2760587 Scott Bradford Ladue Comm. Cert. 3250744 Pilot will request to enter into DFW Airspace. When permisison is granted the pilot will let the control tower know when he is over the job site and will be landing for approximately 30 minutes to gig the helicopter and get crew on the roof. Then the pilot will radio the control tower and ask for permission to lift up and start lifting. 4 rtu's (approx. 10 minutes) When the lifting is complete the pilot will let the control tower know and that he will be landing on the ground to approximately 30 minutes to load the crew and rigging equipment. Then the pilot will radio the control tower and and for permission to lift up and depart to the east and leave DFW Airspace. 5 State Helicopters Inc. Linda Norman Tel:972- 636 -4009 Fax:972 -636 -1300 Cell: 214 - 212 -6062 www.5state.com 2/18/2016 TRANSMISSION VERIFICATION REPORT DATE,TIME FAX N0. /NAME DURATION PAGE(S) RESULT MODE 5 -STATE HELICOPTERS, INC. 285 BLACKLAND RD ROYSE CITY, TEXAS 75189 972- 636 -4009 972 - 636 -1300 FAX linda @5stat6.com Linda Norman City-of Grapevine, Texas Att: Supervisor Karen Ballard and all Supervisors 02/18 09:39 18174103260 00:00:44 03 OK STANDARD ECM TIME 02/16/2016 09:40 NAME 5 STATE HELICOPTERS FAX 9726361300 TEL 9726361300 SER.# A3J152697 11, Ref: 5 -State Helicopters, Inc. landing for purpose of air lift equipment: 5 -State Helicopters, Jnc, will be in the city of Grapevine, Texas Date: 24At - -2016 wtrti 64k up IoAa o-q � -7.5 - Aa For the purpose of air lifting air conditioning units to the roof of: Location: Grapevine Mills Mail 3000 Grapevine Mills Pktvy Grapevine, Texas 76051 This memo is to let Communications / dispatch know the helicopter will be at the site from approximately 6:45 am to approximately 9:30 am If you have any questions please call Linda Norman at 972- 636 -4009 or cell at rav McGriff, Seibels & Williams, Inc. Certificate of Insurance Certificate No. Rev. Date: Jan 15.2016 • This is to certify that the policy(ies) of insurance as described below have been issued to the lasurcd for whom this Certificate is executed and istme in force at this time. This Certificate is issued for information only and confers no rights upon the holder. This Certificate neither affirmatively nor negatively amends, extends or alters the coverage afforded by such policyties) or binder(s) stated herein. This certificate cancels and supersedes all previously issued certificates. Certificate Holder: City of Grapevine PO Box 95104 Grapevine, TX 76051 Named Insured: 5 - State Helicopters, Inc. and California Helicopter Airways, Inc. 285 Blackland Road Royse City, TX 75189.4746 Policy Type: Aircraft Hull & Liability and Aviation General Liability Policy Policy Period: February 01, 2016 to February 01, 2017 both days at 12;01 sm Local Standard Time at the address of the Named Insured shown above Insurer(s): Company PolicyNo(s). StarNet Insurance Company through Berkley Aviation, LLC Aircraft Covered: Sikorsky S58T, N4XY; Sikorsky S58T, N6BL Coverage & Limits Aircraft Liability Coverage Limit Combined Single Limit Bodily Injury, including Personal Injury and SI0,000,000 each occurrence as respects Sikorsky S-58BT and Sikorsky Property Damage Liability(Excluding Passenger Liability) S -58ET type aircraft. Cargo Legal Liability Coverage Limit Cargo Legal Liability including Slung Loads S500,000 each occurrence, subject to a deductible of SI,000 each claim. Certificate Provisions Additional Insured It is agreed that the Certificate Holder is included as an Additional Insured under the Aircraft Liability Coverages, but only to the extent of liability vicariously imposed upon the Certificate Holder solely as the result of an act or omission of the Named Insured or its employees in connection with the Named Insured's Aircraft operations, subject to all policy terns, conditions and exclusions. Amh sized Repr atative 3023 80th Avenue S.E., Suite 100 Mailing Address: P.O. Box 60, Mercer Island, Washington 98040.0060 Certificate No: Page I of 1 Phone: (206) 232.9870 - Flu: (206) 232-9515 60274