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Home My WebLink AboutHLP2016-2199June 8, 2016 The attached application is for a Helicopter Lift Request. Please sign 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 FAA Approval 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: JUNE 8, 2016 Attached is a request for a helicopter lift are scheduled for June 16, 2016 at 6:30 A.M., with a rain date of June 17, 2016 at 6:30 A.M. for 3000 Grapevine Mills Parkway #525, if it meets your approval, please sign below: I Melanie Hill, Risk Manager O:\CCook \HelicopterMemorandum JUN 0 8 2016 HOLD HARMLESS AND INDEMNITY AGREEMENT PROJECT ADDRESS: Grapevine Mills Mall, 3000 Grapevine Mills Pkwy, Grapevine, Tx. 76051 Sealif6Aquarium Suite 525 NATURE OF OPERATION: Air lifting a air conditioning unit DATE OF OPERATION: 6 -16 -16 a;rh Ra.;N Ov +e 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, hams, 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 j f�day and (month) u u 2016 COMPANY: 5 -STATE HELICOPTERS, INC. BY: LINDA NORMAN (printed) L a r7 TITLE: OWNER (signature) STATE OF COUNTY OF �1,� This instrument was acknowledged before me on this the Z7� Day of(J ` 2016 NOTARY PUBLIC IN AND FOR THE STATE OF My commission expires signature LINDA MAE NAUGHT My COmmission Expires May 6. 2077 rtk asm McGriff, Seibels & Williams, Inc. Certificate of Insurance Certificate No. Rev. Date: Jan 15, 2016 This is in certify that the poficy(ies) 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(ics) or biudcr(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. Combined Single Limit Bodily Injury, including Personal Injury and 285 Blackland Road Property Damage Liability(Excluding Passenger Liability) 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 12:01am Local Standard Time at the address of the Named Cargo Legal Liability including Slung Loads Insured shown above Insurer(s): Company Aircraft Covered: Sikorsky S58T, N4XY; Sikorsky S58T, N6BL Coverage At Limits Aircraft Liability Coverage Limit Combined Single Limit Bodily Injury, including Personal Injury and S 10,000,000 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 S 1,000 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 terms, conditions and exclusions. Auth cd Repr0w4intative 3023 80th 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: 6 -7 -2016 5 -STATE HELICOPTERS, INC. If a problem or safety hazard exists 285 Blackland Rd. the ground persons /crew with radios will Royse City, Texas 75189 notify the pilot to move the helicopter to a 972- 636 -4009 safe area 800 -543 -8442 972- 636 -1300 FAX CONTRACTOR: 4 Seasons Air Systems 6100 Huddleston Ft. Worth, Texas 76137 JOB SITE: Grapevine Mills Mall Sea] ife Aquarium Suite 525 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 HEIGHT OF BUILDING: 40 Ft. TOTAL OF LIFTS: 1 rtu 500 lbs DATE OF LIFTS: 6 -16 -2016 with rain date of 6 -17 -2016 Time: Landing at 6:30 am 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, Texas: Mr. Scott Williams (Connie) 817 -410 -3158) Police and Fire Dispatch Karen Ballar 817 - 410 -8127 SIGNATURE OF RESPONSIBLE COMPANY OFFICIAL Linda Norman 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: 6 -7 -2016 CONGESTED AREA PLAN - EXTERNAL LOAD LIFT TO: FAA OFFICE: NORTH TEXAS FSDO 214 -277 -8500 JOB SITE Grapevine Mills Mall Sealife Aquarium Suite 525 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 SCHEDULED DATE AND TIME OF OPERATION: 6 -16 -2016 with rain date of 6 -17 -2016 CONTRACTOR: 4 Seasons Air Systems 6100 Huddleston Ft. Worth, Texas 76137 CONTACT PERSON: Mike Watkins 817 -514 -7680 Cell 817- 992 -3811 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 1 rtu 500 Ibs CARRYING HAZARDOUS MATERIAL: no DESCRIPTION: CONTACTS: City of Grapevine, Texas: Mr. Scott Williams (Connie) 817- 410 -3158) Police and Fire Dispatch Karen Ballar 817410 -8127 DFW Control Tower SIGNATURE OF RESM�l OMPA N�L Linda Norman NARRATIVE OF PLAN OF OPERATIONS: 5 -STATE HELICOPTERS, INC. Congested Area Plan Job Site: Grapevine Mills Mall Sealife Aquarium Suite 525 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 DATE OF JOB: 6 -16 -2016 with rain date of 6 -17 -2016 END OF JOB: 6 -16 -2016 with rain date of 6 -17 -2016 ENCLOSED ON SKETCH ATTACHED TO THIS REQUEST Flight path front 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 up site will be the emergency landing area. Additional Information: This is a existing Mall . The section of the Mall being lifted 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 West 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 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 OF�LE OMPANY OFFICIAL n Linda Norma 2016 -06 -08 11:46 FAA NTX FSDO 2142778570 >> P 1/1 PAGE 4 5 ST:A'f13 IIl ?LIC'OP "11;85, INC. Congested Area Plan JON SI "I'li: Grapevine Mills Mall Sea life Aquarium Suite 525 3000 Grapevine Mills Pkwy Grapevtne,Texas76051 DATE OF,W13: 6.16 -16 with rain date of 6 -17.16 TIME: approximately 6;30 urn There are power lines and light poles in the area hut, will not cause a safety hazard to the lift. TODAY'S DATE: 6 -7 -2016 PLAN PREPARED 13Y : Linda Normant�7 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 Ifelicopters. Inc. will re- notify all Cnntaois listed nn CAP FAA: North Texas Fsdo APPROVED BY: ^ n; ( J t ; \:; +'•.I FAA STAMP: APPROVED NTX FSDO W19 BY, �z DATE: TI IIS COMPANY COMPLIES WITH T}IE "CODE' OF E'1 "I IICS: OF THE HELICOPTER ASSOC'IAT'ION OF AMERICA. PAGE 5 -STATE HELICOPTERS, INC. Congested Area Plan JOB SITE: Grapevine Mills Mall Sealife Aquarium Suite 525 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 DATE OF JOB: 6 -16 -16 with rain date of 6 -17 -16 TIME: approximately 6:30 am There are power lines and light poles in the area but, will not cause a safety hazard to the lift. TODAY'S DATE: 6 -7 -2016 PLAN PREPARED BY: Linda Normanc"2) � y 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. 5 STATE HELICOPTERS, INC. GRAPEVINE MILLS MALL HIS S 20¢1 De Lome. jtaL: � Mag 13.00 Tue Jun 07 17:27 2016 Scale 1:62,500 (at center) 1 Miles 2 km_ _. _.. 3000 GRAPEVINE MILLS N32- 1zi S 57.965' 1 o PKWY Grapevine Recreational W97° 01.571' w. GRAPEVINE, TEXAS 76051 dgc Park D W SANDY LANE RD DATE OF LIFT: 6 -16 -2016 R� SANDY R '. TIME: LANDING APPROX. r e > Cy I I 6:30 AM 21 x U HELICOPTER WILL NOT BE z6 � MORE THAN 125 FT. ABOVE �Lj W aEFHEL R m A 40 FT. MALL WHEN AIR C z' LIFTING EQUIPMENT TO .S cer Lake Park j a THE 'I ti cr ROOF. 26 iMW COPPE RD PILOT WILL BE IN CONTACT �i I E p438 11121 p WITH CONTROL 3B2 11 TOWER. �i 0 \�PF m a — Local Road — Trail C== Interstate /Limited Access Major Connector Slate Route Exit Railroad Point of Interest allai R Worth latema C W 2 J' F i � m U P A 161 Small Town Airfield +Park/Resemation Sched Service Airport Cemetery County Boundary Water River /Canal Ll lags i/ l a e sill IMf i 6 s_� pe Wry 7 y.� f yt c ��N S� V�a4 f 0 e 0 L� n a � � o ?B68a3fi5Cs "s�agaE3�xgP�� R REffS:l:xp.^V I:2EC��.Rp'R a a 1 gSU �.:o ab ic_va; &M 8: a i [!p l Page 1 of l Linda From: "Linda Norman" < �/ 1 Date: Tuesday, June 07, 2016 5:42 PM To: < Attach: 2016- 06- 07- 17- 39 -30 -0 l .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 doing a 133 external load project at: Grapevine Mills Mall 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 Date of Lift: 6 -16 -2016 Time: approx. 6:30 am Helicopter: Sikorsky S58T Call Sign: N4xy or N6bl or N6vy Pilot: Bradford s. Ladue Comm. Cert. 2760587 Scott B Ladue Comm. Cert. 3250744 5 State Helicopters, Inc. pilot will be requesting to enter into DFW Airspace. When permission 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 rig the helicopter and get crew on the roof. Then the pilot will radio the control tower and ask for permission the lift up and start lifting. (one lift) (approximately 5 minutes) When the lifting is complete the pilot will let the control tower know and that he will be setting the helicopter on the ground for approximately 30 minutes to load rigging and crew. Then the pilot will radio the control tower and ask for permission to lift up and leave DFW Airspace 5 State Helicopters Inc. Linda Norman Tel:972- 636 -4009 Fax:972 -636 -1300 Cell: 214 - 212 -6062 www.6state.com 6/7/2016 TRANSMISSION VERIFICATION REPORT TIME : 06/07/2016 16:52 NAME : 5 STATE HELICOPTERS FAX : 9726361300 TEL : 9726361300 SER.# : AW152697 DATE,TIME 06/07 16:52 FAX N0. /NAME 18174103260 DURATION 00 :00:29 PAGE(S) 02 RESULT OK MODE STANDARD ECM �Cw 5 -$TATE HELICOPTERS, INC. 285 BLACKLAND RD ROYSE CITY, TEXAS 75189 972 -636 -4009 972- 636 -1300 FAX Linda Norman City.of Grapevine, Texas Att. Karen Ballard and all Supervisors Ref: 5 -State helicopters, Inc, landing for purpose of air lift equipment: 5 -State helicopters, Inc, will be in the city of Grapevine, Texas ]date: 6 -16 -2016 with rain datc of 6 -17 -2016 For the purpose of air lifting aix conditioning units to the roof of: Location: Grapevine Mills Mall 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 l�r its ['I This memo is to let Communications/ dispatch know the helicopter will be at the site from approximately 6:30 am to approximately 7:30 am TF'.,.,.. L....e --,., .....,..a:..- ,...de -..e ...11 T :..A- AY.......n., nT 011 _aa4 AMID , n-11 e4 firL