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Home My WebLink AboutHLP2016-3467 GRAPEVINE T F X A S°" September 7, 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: SEPTEMBER 7, 2016 Attached is a request for a helicopter lift scheduled for September 13, 2016 at 6:30 A.M., for 3000 Grapevine Mills Pkwy #214 with rain date of September 14, 2016 at 6:30 A.M. if it meets your approval, please sign below: Bruno Rumbelow, City Manager f -Melanie Hill, Risk Manager' OACCook\HelicopwMemorandum 5-State Helicopters, Inc. 285 Blackland Rd. Royse City, Texas 75189 Brad Ladue Linda Norman 972-636-4009 Office 972-636-1300 Fax City of Grapevine, Texas Aircraft Information: SIKORSKY S-58T: N# N4XY, N6BL ORN6VY STANDARD CATEGORY This letter with the location, dates, and time of a external load project that is being done by 5-State Helicopters, Inc. is to make sure that there is no restrictions or regulations that prevent the helicopter form landing within the city limits of the city of Grapevine, Texas 5-State Helicopters, Inc. assures the City of Grapevine, Texas that it will comply with all State, Federal and Local regulations, holds and required permits and is licensed to do the type of work as described in this request. 5-State Helicopters, Inc. agrees to provide a Certificate of Insurance with liability coverage of$10,000,000.00 showing the City of Grapevine, Texas as an additional insured. Could you please sign and fax back to 972-636-1300 or e-mail to Location of lift: Grapevine Mills Mall Bath& Body Suite 214 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 Date of lift: 9-13-2016/ 9-R- 110 PLEASE FEEL FREE TO CONTRACT ME AT THE FOLLOWING NUMBER WITH ANY QUESTIONS AND/OR CONCERNS THAT YOU MAY HAVE. 972-636-4009 SINCERELY, LIND N APPROVED BY DATE e mail back to HOLD HARMLESS AND INDEMNITY AGREEMENT PROJECT ADDRESS: Grapevine Mills Mall (Bath& Body) (Suite 214) 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 NATURE OF OPERATION: Air Lifting equipment DATE OF OPERATION: 9-13-2016 with rain date of 9-14-2016 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 7'4 day and (month)52016 COMPANY: 5-STATE HELICOPTERS, INC. BY: LINDA NORMAN (printed) { eJ TITLE: OWNER (signature) STATE OF"rrCOUNTY OF,AA&46/Z This instrument was acknowledged before me on this the -7-;% Day of 2016 NOTARY PUBLIC IN AND FOR THE STATE OF x _ My commission expires signatur T � � �� MAE VAUGHr MY y Com Comrrpasion Expires May 6.2017 a W McGriff, Seibels & Williams, Inc. Certificate of Insurance Certificate No. _. Rev.Date:Jau 15,2016 This is in certify that the policy(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(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 751894746 Policy Type: Aircraft Hull&Liability and Aviation General Liability Policy Policy Period: February 0 t,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,N6BL Coverage&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. Autlt rizedRepre native 3023 80th Avenue S.E.,Suite 300 Mailing Address:P.O.Box 60,Mercer Island Washington 98040-0060 Certificate No: Page 1 of Phone:(206)232-9870-Fax:(206)232-9515 60274 5- STATE HELICOPTERS INC. "AERIAL CRANE SERVICE" 285 BLACICLAND ROAD ROYSE CITY. TEXAS 75189 972-636-4009 800-543-8442 FAX 972-636-1300 FAA CERT. LDUL599B PROCEDURES REQUEST PER 8900.1 CHG. 412 Congested Area Plan DATE: 9-7-2016 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 972-6364009 safe area 800-543-8442 972-636-1300 FAX N6BL, N4XY CONTRACTOR: Dallas Mechanical Group 789 North Grove Rd. SIKORSKY S-58T Richardson, Texas 75081 STANDARD CATEGORY JOB SITE: Grapevine Mills Mall Bath and Body Suite 214 3000 Grapevine Mills PILOT: Bradford S. Ladue Grapevine, Texas 76051 1 Comm. Cert. . 2760587 PILOT: Scott Bradford Ladue HEIGHT OF BUILDING: 40 Ft. Comm. Cert. 3250744 TOTAL OF LIFTS: Length of the cables estimated 75 Ft. 2 rtu's down and 2 rtu's up under 5000 lbs DATE OF LIFTS: 9-13-2016 with rain date of 9-14-2016 Time; approximately 6:30 am CONTACTED: City of Grapevine, Texas: Mr. Scott Williams (Connie) 817-410-3158 Dispatch: Karen Ballard(Supervisor) 817-410-8127 DFW: FAA:Alan Phillips<Keith Alexander,Giovanni Dipierro, Wayne Eckenrode, Larry Allen,Greg Juro 972-615-2650 Mall Manager: Cooper Black: 972-724-4910 SIGNATURE OF RESPONSIBLE COMPANY OFFICIAL Lind Orman jt�& Va, 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: 9-7-2016 CONGESTED AREA PLAN-EXTERNAL LOAD LIFT TO: FAA OFFICE: North Texas FSDO 214-277-8500 JOB SITE Grapevine Mills Mall Bath and Body Suite 214 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 SCHEDULED DATE AND TIME OF OPERATION: 9-13-2016 with rain date of 9-14-2016 CONTRACTOR: Dallas Mechanical Group 789 North Grove Rd. Richardson,Texas 75081 CONTACT PERSON: Jim Smith 972-234-4822 AIRCRAFT: S-58T N-6BL,N4XY STANDARD CATEGORY PILOT: BRADFORD S. LADLE COMM CERT. # 2760587 SCOTT BRADFORD LADUE COMM. CERT.#3250744 LOADS: NUMBER TYPE WEIGHTS 2 rtu's off and 2 rtu up tinder 5000 Ibs CARRYING HAZARDOUS MATERIAL : no DESCRIPTION: CONTACTS: CONTACTED: City of Grapevine, Texas: Mr. Scott Williams (Connie) 817-410-3158 Dispatch: Karen Ballard(Supervisor) 817-410-8127 DFW: FAA: Alan Phillips<Keith Alexander,Giovanni Dipierro, Wayne Eckenrode, Larry Allen,Greg Juro 972-615-2650 Mall Manager: Cooper Black:972-724-4910 SIGNATURE OF BLE COMPANY OFFICIAL. an Linda Norm NARRATIVE OF PLAN OF OPERATIONS: 5-STATE HELICOPTERS, INC. Congested Area Plan .lob Site: Grapevine Mills Mall Bath and Body Suite 214 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 DATE OF JOB: 9-13-2016 with rain date of 9-14-2016 END OF JOB: 9-13-2016 with rain date of 9-14-2016 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 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 East 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 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 F &P [BL PANY OFFICIAL Linda Norm PAGE 5-STATE HELICOPTERS, INC. Congested Area Plan JOB SITE: Grapevine Mills Mall Bath and Body Suite 214 3000 Grapevine Mills Pkwy Grapevine,Texas 76051 DATE OF JOB: 9-13-2016 with rain date of 9-14-2016 TIME: approximatley 6:30 am There are power lines and light poles in the area but, will not cause a safety hazard to the lilt. TODAY'S DATE: 9-7-2016 PLAN PREPARED BY : Linda Norm i 01� 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. 2016-09-07 15:12 FAA NTX FSDO 2142778570 >> 9726361300 P 1/1 VAC 1;d 5.5'1 A'I F I11TICu11 l MS. INC. Vongesled Area I'lun .11111 sl I Li Orapc,i11e Mills Mall Nash and lfud) tiailc:I.1 3000 tirapceinc Mills PW (irapc,inn.]csa, %Io;I I)AMOFJUIi; 11.11.?ult„rilhrniud:ueuf )-1� .(Iin 1'1�11i; uppnniuunl.y h:lnlun Illov are pmwr line.and light poles is the urca hut. „ill floe rui.e n satin hauird lo the lilt. PLAN PRlil'ARlil) 111' Should a ,eeaiher. medlanieal or na11Ci;il LIAli Ise esprrie0eed Ihik CAA' is nppm,ed 161111v dale and time tilled above plus Ito da±s. *"aWll this ommio11 5 saae Ilclicuplers, tut•• hill rc-nulill Al Colll lets listed 4111 CAP APPROVED NTX FSCP,0 W19 I Ar1: North Y ens l tit It) BY• i DATE: 7 / AI'PRI)VHI) BY: 7'I IIS COMPANY c'1111PLII S' N•I 111 '1'111. -CI DI• (IF I,I I I R's: t II I I Ih I IHI. O)P I I:R ASSO CIM ION (11; ANWRICA. 5 STATE HELICOPTERS, INC. 121 �Grapeline Recreational Park z ledge Park GRAPEVINE MILLS MALL ~^ W SANDY LAKE RD BATH AND BODY SUITE 214 A R fE SANDY R 3000 GRAPEVINE MILLS �N II Grapevine Co e PKWY 121 x GRAPEVINE.TEXAS 76051 2e l DATE OF LIFT:9-13-2016 ei S `o Y WITH RAIN DATE OF {eETHEL y o ' Coppe111v@grHE RD o C < < L 9-14-2016 , cr 4t+ke Park TIME: APPROXIMATELY 6:3 11 r HELICOPTER WILL NOT BE AM N32°57.920' MORE THAN 125 FT.ABOVE v I LL W97 02.597 A 40 FT.MALL WHEN AIR in _y COFFEE p RD ,P1 LIFTING EQUIPMENT'TO ° 1FF tlas W WA 1111 THE -Grapevine '//j]],I ROOF. 4 PILOT WILL BE IN nh �° �I I� \CONTACT WITH P H _� 2P�N DEW CONTROL TOWER. z AIRFIEI N Q¢ F 9 �RDN 9 t2t 9T m F w ?_14 z N A 121 I l 'I \ +1 alla.'R Worth Internal at z 360 0 Iw 121 T z Minters Chapel- DO = o c RD LADW REL$GLADE R W 29TH Ll C � , ~ �, 121 w 161 rr V'ry CARBON RD Y 7!`2001 Dc Lo c.5lrcifilTas`A_SKLf`2011✓(iD �CRe1.01'2001 I __. I A`I Mag 13.00 Wed Sep 07 09:19 2016 — Local Road Small Town Scale 1:62,500(at center) — Trail — Airfield 1 Miles Clnterstate/Limited Access Park/Reservation 2 km Major Connector Schad Service Airport State Route Locale Exit Cemetery Railroad County Boundary Point of Interest Water DALTONS �_ Q° 5 STATE HELICOPTERS , INC. • GRAPEVINE MILLS MALL BATH AND BODY SUITE 214 3000 GRAPEVINE MILLS PKWY GRAPEVINE,TEXAS 76051 DATE OF LIFT: 9-13-2016 V26 57.920'ILLS G GR-MVINE M WITH RAIN DATE OF z N n 9-14-2016 02.597 A TIME: APPROXIMATELY 6:3 y STARS AND STRIPES v t AM h NORTHPOINi Grapevine Golf Course r� 121 GATEVIEW l�y1b 110 N'p0a 8t nj1Ct1 Co n ¢° T p ^ "O CREEKVIEW � GIBSON0.0 121 PNOE0.501't n 2fi 0 li a G 121 26 BASS PRO 3� ae 2001 D,Lurtne.Strcct Atlas USA:4 2O/GDT1nc., d 01 1001 Mad Sep 15.00 Wed Sep 07 09:14 2016 — Local Road Water Scale 1:15.625(at center) O Interstate/Limited Access River/Canal 1000 Feet Major Connector 500 Meters State Route Exit Point of Interest Park/Reservation County Boundary wri �L' G G J^` lot mm�nrv+n� t i k_A �'$b ID rte' j — Oil" §T1 w l W g i B m�C r<y# �• S'}p '349 f '' '�9S •4�� a ,t 1�� 0�'c.0}�%�.•�,�5 p /i S. �ava"'w'•"`/ /im A `4• /`� I 3��R 44Y�� ^ $?83� ��1 � `} .y T� Ss�b�j, g a ffi Aw 9E\� TRANSMISSION VERIFICATION REPORT TIME : 09/07/2016 08:24 NAME : 5 STATE HELICOPTERS FAX : 9726361300 TEL : 9726361300 SER.# : A3J152697 DATE,TIME 09/07 08:24 FAX NO. /NAME 18174103260 PAGE(S) N 00 :00: 24 RESULT OK fc MODE ECMNDARD e o r' 5-STATE HELICOPTERS, IINTC. --. 285 BLACKLAND RD ROYSE CITY, TEXAS 75189 972-636-4009 tats 972-636-1300 FAX . linda @Sstate.com 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: 9-13-2016 with rain date of 9-14-2016 For the purpose of air lifting air conditioning units to the roof of: Location: Grapevine N ills\Mall (Suite 214) 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 This memo is to let Communications/dispatch know the helicopter will be at the site from approximately 630 arm to approximately 9:00 am . If you have any questions please call Linda Norman at 972-636-4009 or cell at 214-212-6062. Page 1 of 1 Linda Norman From: "Linda Norman"< �) Date: Wednesday, September 07,2016 9:29 AM To: < Attach: 2016-09-07-09-27-33-0 l.pdf Subject: Request to enter into DFW Airspace 9-13-20161 rain date 9-14-2016 See Attachment Grapevine Mills Mall 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 Date: 9-13-2016 with rain date of 9-14-2016 Time: approximately 6:30 am Helicopter: Sikorsky S58T Call Sign: N4xy or N6b1 or N6vy Pilot: Bradford s Ladue Comm. Cart. 2760567 Scott B. Ladue Comm. Cent. 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 school and will be landing for approximatley 30 minutes to rig the helicopter for lifting and getting crew on the roof. Then the pilot will radio the control tower and ask for permission to lift up and start lifting. (2 lifts) approximatley 12 minutes.) When the lifting is completed the pilot will let the control tower know he has completed the lifting and will be landing on the ground for approximately 30 minutes to load crew and rigging equipment. Then the pilot will radio the control tower and ask 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 9/7/2016