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Home My WebLink AboutHLP2016-2526July 11, 2016 The attached application is for a Helicopter Lift Request. Please sign the attached memo and forward packet to the City M'anager's Office. Once City Manager has signed please return to Connie Coo Development Services. ,reg aic@ra,G = 17 jHin Risk n anaaer Bruno Rumbelow, City Manager Thank you, Connie Cook Development Services (817) 410 -3158 l 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: JULY 11, 2016 Attached is a request for a helicopter lift scheduled for July 19, 2016 at 6:30 A.M., for 3000 Grapevine Mills Pkwy #234 with rain date of July 20, 2016 at 6:30 A.M. if it meets your approval, please sign below: Bruno Rumbelow, City Manager OACCook \HelicoptaMemormdum (-e9 HOLD HARMLESS AND INDEMNITY AGREEMENT PROJECT ADDRESS: Grapevine Mills Mall,' 000 Grapevine Mills Pkwy Forever 21 suite 23y, Grapevine, Texas 76051 NATURE OF OPERATION: Air lifting air conditioning units DATE OF OPERATION: 7 -19 -2016 with rain date of 7 -20 -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, INC. BY: LINDA NORMAN (printed) _ ( = � LINDA MAE YAUGNT =J TITLE: OWNER (signature My Commission Expires �„ _ ) May 6. 2017 STATE OF'r �` COUNTY This instrument was acknowledged before me on this the _Day of 2016 NOTARY PUBLIC IN AND FOR THE STATE OFT- My commission expires - =/o -17 signatur �� - ;W 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 Insured for whom this Certificate is executed and islare in force at this time. This Certificate is issued for information only and confers no rights upon the holder. This Certificate neither affionatively nor negatively amends, extends or alters the coverage afforded by such policy(ics) or binden(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 0 1. 2016 to February 01, 2017 both days at 12:0 lam 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 510,000,000 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 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 rized Repn ntative 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: 7 -11 -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: Cool Tech Mechancial 325 Crowley Rd. Arlington, Texas 76012 JOB SITE: Grapevine Mills Mall Forever 21 Suite 243, 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 HEIGHT OF BUILDING: 40 Ft. TOTAL OF LIFTS: 4 rtu's down and 4 rtu's up 2400 Ibs DATE OF LIFTS: 7 -19 -2016 with rain date of 7 -20 -2016 Time: approximately 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 Cook) 817 -410 -3158 Dispatch: Karen Ballard 817 - 410 -8127 Mall Operation Manger: Cooper Black 972- 724.4910 DFW control tower MIMI' DATE: 7 -11 -2016 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 CONGESTED AREA PLAN- EXTERNAL LOAD LIFT TO: FAA OFFICE: North Texas FSDO 214 - 277 -8500 JOB SITE Grapevine Mills Mall Forever 21 Suite 243, 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 - SCHEDULED DATE AND TIME OF OPERATION: 7 -19 -2016 with rain date of 7 -20 -2016 CONTRACTOR: Cool Tech Mechancial 325 Crowley Rd. Arlington, Texas 76012 CONTACT PERSON: Cody 817 -983 -8723 AIRCRAFT: S -58T N -6BL , N4XY , N6VY STANDARD CATEGORY PILOT: BRADFORD S. LADUE COMM CERT. # 2760587 SCOTT BRADFORD LADUE COMM. CERT. #3250744 LOADS: NUMBER 4 rtu's down and 4 rtu's up 2400 Ibs CARRYING HAZARDOUS MATERIAL: no DESCRIPTION: TYPE WEIGHTS CONTACTS: City of Grapevine, Texas Mr. Scott Williams (Connie Cook) 817 -410 -3158 Dispatch: Karen Ballard 817- 410 -8127 Mall Operation Manger: Cooper Black 972 - 724 -4910 DFW control tower SIGNATURE - *1) I*bMV%9FFICIAL Linda Nor an NARRATIVE OF PLAN OF OPERATIONS: 5 -STATE HELICOPTERS, INC. Congested Area Plan Job Site: Grapevine Mills Mall Forever 21 Suite 243) 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 DATE OF JOB: 7 -19 -2016 with rain date of 7 -20 -2016 END OF JOB: 7 -19 -2016 with rain date of 7 -20 -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 exiting 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 Q ))O ' LE ��Y Ok'FICIAL Linda Norman `ems PAGE i- STA,rE HELICOPTERS, INC. Congested Area Plan JOB SITU: Grapevine Mills Mall Forever 21 Suite 243) 3000 6rapeeine Mills Pkwy Grapevine. I exas 76051 DATE OF JOB: 7 -19 -3016 TIME: approximately 6:30 ant There are poker lines and light poles in the area but, will not cause a safety hazard to the lift. TODAY'S DATE: 7 -11 -2016 PLAN PRFPARED BY : Linda Norman,' l ,� Yv1C 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: APPROVED NTX FSDO SW19 - BY s DATE: -7- / -1 --4- J Ze.�� THIS COMPANY COMPLIES WITH THE "CODE OF ETHICS: OF THE HELICOPTER ASSOCIATION OF AMERICA. 111 T 5 STATE HELICOPTERS, INCA GRAPEVINE MILLS MALL FOREVER 21 SUITE 24313 GRAPEVINE MILL PKWY GRAPEVINE, TEXAS 76051 rapevine Rec e .ledge Park DATE OF LIFT: 7 -19 -2016 I WITH RAIN DATE OF r 7 -20 -2016 1 26 W BETHEL Rq cer Lake Park o a 0 26 � — W RTHW COPPELL RD P 11a '' 'l'.LI u. _E'b'QLL ill W; WA I Y�� 3182 II J i2001 DcMhAi. S f% t ATfes I Mag 13.00 Mon Jul 11 14:14 2016 Scale 1:62,500 (at center) 1 Miles 2 km c in N Y <'— A C) III M :\ inters Chapel* [ -0 \01k DT. Inc, Ref. 01'2001 — Loral Road — Trail O lnterstatef- Imited Access — - Major Connector State Route Exit Railroad Point of Interest Izi N320 58.035'1 01 W %97° n02. 549'1 z c / ~ W SANDY LAKE RD A (I 1 s cop 00 RD LL I II L HELICOPTER WILL NOT BE MO. THAN 125 FT. ABOVE A 40 FT. MALL WHEN AIR LIFTING EQUIPMENT TO THE ROOF. PILOT WILL BE IN CONTACT WI DFW CONTROL TOWER, H n \O I I I __Iy z +IallaIFt Worth Intemati i ` W Z Small Town -- Airfield +Park/ReseNation Schad Service Airport Locale Cemetery County Boundary Water No, a W �gITa )< 7 t 1 �r i y i_ r vii 8� i is €F 1/ 0 5� of x �h m' 9 "� �.S y m@uu �U 0 axzses III rtx�Agax�+d off 0 of xrg�ask3i ':35: a � j < °< Page I of 1 Linda Norman From: "Linda Norman" < Y Date: Monday, July 11, 2016 2:19 PM To: < Attach: 2016- 07- I1- 14- 16 -42- Ol.pdf Subject: request to enter DFW airspace 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: 7 -19 -2016 and weather date of 7 -20 -2016 Time: approximately 6:30 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 20 minutes. (4 lift up and 4 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 7/11/2016 TRANSMISSION VERIFICATION REPORT DATE,TIME FAX ND. /NAME DURATION PAGE(S) RESULT MODE 5 -STATE HELICOPTERS, INC. 285 BLACKLAND RD ROYSE CITY, TEXAS 75189 972 - 636 -4009 972 - 636 -1300 PAX linda@5state.com Linda Norman City of Grapevine, Texas 07/11 14:26 18174103260 00:00:25 02 OK STANDARD ECM ' 1 TIME 07/11/2016 14:27 NAME 5 STATE HELICOPTERS FAX 9726361300 TEL 9726361300 SER.0 A3J152697 I� Att: Supervisor 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: 7 -19 -2016 with rain date of 7 -20 -2016 For the purpose of air lifting air conditioning units to the roof of- Location: Grapevine Mills Mall Forever 21 Suite 243 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 8:00 am If you have any questions please call Linda Norman at 972 -636 -4009 or cell at 214- 212 -6062,