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Home My WebLink AboutHLP2016-2278June 21, 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 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 21, 2016 Attached is a request for a helicopter lift scheduled for June 27, 2016 at 6:30 A.M., for 3000 Grapevine Mills Pkwy #534 with rain date of June 28, 2016 at 6:30 A.M. if it meets your approval, please sign below: Melanie Hill, Risk Manager OACCook \HelicopterM emorandum HOLD HARMLESS AND INDEMNITY AGREEMENT PROJECT ADDRESS: Grapevine Mills Mall - 3000 Grapevine Mills Pkwy, Grapevine, Tx. 76051 Helzberg Diamonds suite 534 NATURE OF OPERATION: Air lifting Air Conditioning Units DATE OF OPERATION: 6 -27 -2016 with rain date of 6 -28 -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),JU,,f,_2016 COMPANY: 5 -STATE HELICOPTERS INC. BY: LINDA NORMAN (printed) TITLE: OWNER (signature) STATE OF 1 ,� �_ COUNTY OF This instrument was acknowledged before me on this the Day off_ 2016 NOTARY PUBLIC IN AND FOR THE STATE OFD My commission expires signature —?/lier� ! UNOA MqE NAUGHT My Commission Expires May 6, 2017 a ;-McGriff, Seibels & Williams, Inc. Certificate of Insurance Certificate No. Rev. Date: Jan 15, 2016 This is to certify that the poliry(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 ri ghts upon the holder. This Certificate neither affirmatively nor negatively amends, extends or alters the coverage afforded by such policy(ies) 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 am Local Standard Time at the address of the Named Insured shown above Insurer(s): Company Policy No(s). StarNet Insurance Company through Berkley Aviation, LLC Aircraft Covered: Sikorsky S58T, N4XY; Sikorsky S58T, N68L Coverage & Limits 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 5500,000 each occurrence, subject to a deductible of S1,000 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. AwbirzedRepirk1tintativ. 3023 80th Avenue S.E., Suite 300 Mailing Address: P.O. Box 60, Mercer Island Washington 98040 -0060 Certificate No: Page 1 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 -16 -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: Elite Service Company 3826 Cavalier Dr. Garland, Texas 75042 JOB SITE: Grapevine Mills Mall Helzberg Diamonds Suite 534 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 HEIGHT OF BUILDING: 40 Ft. TOTAL OF LIFTS: 1 rtu down and 1 rtu up 1500 lbs DATE OF LIFTS: 6 -27 -2016 with rain date of 6 -28 -2016 Time: approx. 6:30 am CONTACTED: 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. City of Grapevine, Tx. Mr. Scott Williams (Connie Cook) 817410 -3158 Police and Fire (Dispatch) Supervisor: Kame Ballard 817 - 410 -8127 Mall Manger: Cooper Black 972 -724 -4900 DFW FAA Airport Control Tower: SIGNATURE OF RESPONSMPANY 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 -16 -2016 CONGESTED AREA PLAN - EXTERNAL LOAD LIFT TO: FAA OFFICE: NORTH TEXAS FSDO 214 -277 -8500 JOB SITE Grapevine Mills Mall Helzberg Diamonds Suite 534 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 SCHEDULED DATE AND TIME OF OPERATION: 6 -27 -2016 approximately 6 :30 am With rain date of 6 -28 -2016 CONTRACTOR: Elite Service Company 3826 Cavalier Dr. Garland, Texas 75042 CONTACT PERSON: JP Broown 214- 843 -5178 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's down and I rtu up 1500 Ibs CARRYING HAZARDOUS MATERIAL: no DESCRIPTION: CONTACTS: City of Grapevine, Tx. Mr. Scott Williams (Connie Cook) 817 -410 -3158 Police and Fire (Dispatch) Supervisor: Kame Ballard 817 -410 -8127 Mall Manger: Cooper Black 972 - 724 -4900 DFW FAA Airport Control Tower: SIGNATURE OF RESPONSIB $ C PA OFFICIAL Linda Norman NARRATIVE OF PLAN OF OPERATIONS: 5 -STATE HELICOPTERS, INC. Congested Area Plan Job Site: Grapevine Mills Mall Helzberg Diamonds Suite 534 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 DATE OF JOB: 6 -27 -2016 with rain date of 6 -28 -2016 END OF JOB: 6 -27 -2016 with rain date of 6 -28 -2016 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 up site will be the emergency landing area. Additional Information: This is a existing Mall. The section of the Mall being 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 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 RESPONSIBLE COMPANY OFFICIAL Linda Norman CSIJtw� a�— 2016-06 -17 10:07 FAA NTX FSDO 2142778570 >> 4726361300 p 1/1 PAN: -1 5 -S I A 11% I I1:I,I('0I'1•I HS, INC Congested Area Plan ,IOR SI'I I.; 0rapevinc Mills Mall I lcizhcrg Diamonds Suite 314 3000 (impo lne Mills Pk%NN (irapevine, *1vxas 700:1 DAM: 01:.1013: 6- 27-016 NNith ruin date 6 -28 -016 11M1-.: approximalcly 6:45 am I here arc power lines and light poles in the area hut, %611 not cause a sati ty hazard to dic till. TODAY'S i)A'('P: 6 -16 -2016 PLAN PRITARI:D BY : Lin •a Nor • t 1 t♦ILlJC W o -- Should u wenther, mechanical or material delay be experionced this C,M' is epprowd t1or the date turd tints liflcd above plus 10 Jays. + +Kith this extension 5 Slate I lellcopwN, tile. NNlll rc- noti1% all Contacts listed on CA 11 FAA: NOR "III "I'l'XAS 15DO APPROVID BY: e FAA STAMP: APPROVED NT D SW19 BY: •I'l llS C'OMPAN'Y ('OMI'I.II:S \UA ti: OF TI II'. I II.LlC'tll'I'lft( ASSOCIA I ION 01 ANILRICA. 6 5 STATE HELICOPTERS INC. GRAPEVINE MILLS MALL 3000 GRAPEVINE MILLS PKWY GRAPEVINE, TEXAS 76051 DATE OF LIFT: 6 -27 -2016 WITH RAIN DATE OF 6 -28 -2016 TIME: APPROXIMATELY 6 AM I \ C m N N (,1 V Z in A O Meg 13.00 Thu Jun 16 16:32 2016 Scale 1:62,500 (at center) 1 Miles 2 km .Grapevine Recreational ae Park %leer Lake Park 26 (LL COPPELL RD 362 N� in u SA: Z200 I--GDT, Inc., Rel. 01120011 _ _ AlIL_ — Loral Road — Trail C== Interstate /Limited Access Major Connector State Route _ Exit Railroad Point of Interest N320 57.981' t z!. Pa W97° 02.579' w' N [ -..W SANDY LAKE RD�'f n 1 ?SANDY- R A ___ Copg'el HELICOPTER WILL NOT 3' BE o' MORE THAN 125 FT. -` ABOVE A 40 FT. MALL WHEN All LIFTING EQUIPMENT TO THE ROOF. "\ PILOT WILL BE IN CONTACT WITH DFW CONTROL ew ~ i tea,. TOWER. Small Town Airfield Park/Reservation Sched Service Airport Locale Cemetery County Boundary Water �y2 r W R DALTONS / 26 BASS PRO gqJ. n. /CNOIGDT,Inc.'Rel.01/�1001 5 STATE HELICOPTERS, INC. Thu Jun 16 16:27 2016 GRAPEVINE MILLS MALL Scale 1:15,625 (at center) C Interstate /Limited Access 1000 Feet 3000 GRAPEVINE MILLS 500 Meters " .. State Route PKWY Point of Interest GRAPEVINE, TEXAS 76051 County Boundary NGRAPEVINE MILLS NGWEVINE Z M DATE OF LIFT: 6 -27 -2016 WITH N320 57.981' f c RAIN DATE OF 6 -28 -2016 W970 02.579srARSANOStRwss v TIME: APPROXIMATELY 63C 0 AM g 21 w 2 _Grapevine Gol - -- - - _ C7 NORTRPOINT O u,� 2 12i Y G n K �f GATEVIEW 26 �y �� „ped8tata�1' COttOP T arc' CREEKVIEW 0 t GOSa1pO pN� F _35A C °%— Water River /Canal n 0 Z E 0 a :L m s iuK s, / 26 BASS PRO gqJ. /CNOIGDT,Inc.'Rel.01/�1001 r, 2001 DeLonn'. Street Atlas V _ Ma9 15.00 Thu Jun 16 16:27 2016 — Local Road Scale 1:15,625 (at center) C Interstate /Limited Access 1000 Feet -- - -- Major Connector 500 Meters " .. State Route Exit Point of Interest Park/Reservation County Boundary F _35A C °%— Water River /Canal n 0 Z E 0 a :L m s iuK s, \ \ \ � ��. ,,L,OV TRANSMISSION VERIFICATION REPORT DATE,TIME FAX NO. /NAME DURATION PAGE(S) RESULT MODE TIME : 06/16/2016 15:47 NAME : 5 STATE HELICOPTERS FAX : 9726361300 TEL : 9726361300 SER.# : A3J152697 06/16 15:46 10174103260 00: 00: 25 02 OK STANDARD ECM (/ J $-STATE HELICOPTERS, NC. 285 BLACKLAND RD ROYSE CITY, TEXAS 75189 972- 636 -4009 972- 636 -1300 FAX Linda Norman City of Grapevine, Texas Att: Supervisor Karen Ballard Ref: 5 -State Helicopters, Inc. landing for purpose of air lift equipment: 5 -State Helicopters, Inc. will be in the city of Grapevine, Texas Date: 4 -27 -2016 with rain date of 6 -28 -2016 For the purpose of air lifting air conditioning units to the roof o£: Location: Grapevine Mills Mall 3000 Grapevine Mills Pkwy Grapevine, tExas 76051 This memo is to let Communications/ dispatch know the helicopter will be at the site from approximately 6:30 am to approximately 9:00 am TF,,., ..ell T ;,A. ATn+ -- .,+ oO7_$;'4-Anno n.11 a+ Page 1 of 1 Linda Norman From: "Linda Norman' < u' Date: Thursday, June 16, 2016 4:49 PM To: < Attach: 2016- 06- 16- 16- 48 -16- Ol.pdf Subject: Request to enter into DFW Airspace for purpose of doing a 133 external load job See Attachment 5 State Helicopters, Inc. is requesting to enter into DFW Airspace for the purpose of doing a 133 external load job at: Grapevine Mills Mall 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 Date: 6 -27 -2016 with rain date of 6 -28 -2016 Time: approximately 6:45 am Helicopter S58T Call Sign: N4xy or N6bl or N6vy Pilot: Bradford S. Ladue: Comm. Cert. 2760587 Scott B. Ladue Comm. Cert. 3250744 'Pilot will request 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 permission to lift up and start lifting (approximately 10 minutes. (1 lift up and 1 lift down ) When the pilot has completed lifting he will radio the control tower and let the tower know he has completed the lift and will be landing on the ground for approximately 30 minutes to load crew and rigging. Then the pilot will radio the control tower and ask for permission to lift up and depart DFW Airspace 5 State Helicopters Inc. Linda Norman Tel:972- 636 -4009 Fax:972.636 -1300 Cell: 214 - 212 -6062 www.5state.com 6/16/2016