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HomeMy WebLinkAboutHLP2016-4026 -(;RAREVVNE T F, X A S October 17, 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 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: OCTOBER 17, 2016 Attached is a request for a helicopter lift scheduled for October 20, 2016 at 7:00 P.M., for 3000 Grapevine Mills Pkwy #617 with rain date of October 21, 2016 at 7:00 P.M. if it meets your approval, please sign below: ==1- Z Bruno Rumbelow, City Manager Melanie Hill, Risk Manager OACCookiHelicopterMemomnduin HOLD HARMLESS AND INDEMNITY AGREEMENT PROJECT ADDRESS: Grapevine Mills Mall 3000 grapevine Mills Pkwy Suite 617 Grapevine, Texas 76051 NATURE OF OPERATION: air lifting air conditioning units DATE OF OPERATION: 10-20-2016 with rain date of 10-21-2016 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 /y"7day and (month)��2016 COMPANY: 5-STATE HELICOPTERS, INC BY: LINDA NORMAN (printed) ©e AXE TITLE: OWNER (signature) STATE OFj—�,T;_COUNTY OF. ,�s� This instrument was acknowledged before me on this the Lit Day of r 2016 NOTARY PUBLIC IN AND FOR THE STATE OFz,.,.,-. My commission expires Q/7 signature / T \1 LINDA MAE VAUGHT My Commission Expires �, �1 May 6.2017 m e W McGriff, Seibels & Williams, Inc. Certificate of Insurance Certificate No. Rev.Date:Jan 15,2016 This is to certify that the poliry(ics)of insurance as described below have been issued to the Insured for whom this Cerficate 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 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 12:0Iam 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 St0,000,000 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 51,000 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. Autla rized RepreWntative 3023 80th Avenue S.E.,Suite 300 Mailing Address:P.O.Box 60,Mercer Island.Washington 980404060 Certificate No: Page I of I Phone:(206)232-9870-1":(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. 412 Congested Area Plan DATE: 10-14-2016 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 N6BL, N4XY CONTRACTOR: Merit Service 1510 Randolph 4202 SIKORSKY S-58T Carrollton, Texas 75006 STANDARD CATEGORY JOB SITE: Grapevine Mills Mall 3000 Grapevine Mills Pkwy PILOT: Bradford S. Ladue Adidas Suite 617 Comm. Cert. . 2760587 Grapevine, Texas 76051 PILOT: Scott Bradford Ladue Comm. Cert. 3250744 HEIGHT OF BUILDING: 40 Ft. TOTAL OF LIFTS: Length of the cables estimated 75 Ft. 2 rtu's up and 2 rtu's down 5000 Ibs and down in weight DATE OF LIFTS: 10-20-2016 with rain date of 10-21-2016 CONTACTED: City of Grapevine,Texas Mr. Scott Williams(Connie Cook) 817-410-3158 Dispatch: Supervisor Karen Ballard 817-410-8127 Mall Manager: Cooper Black 972-724-4900 DFW : FAA: SIGNATURE OF RESPONSIBLE COMPANY OFFICIAL Linda Nonn Ea � c� 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: 10-14-2016 CONGESTED AREA PLAN-EXTERNAL LOAD LIFT TO: FAA OFFICE: North Texas FSDO 214-277-8500 JOB SITE Grapevine Mills Mall 3000 Grapevine Mills Pkwy Adidas Suite 617 Grapevine,Texas 76051 SCHEDULED DATE AND TIME OF OPERATION: 10-20-2016 with rain date of 10-21-2016 Approximately 7:00 am CONTRACTOR: Merit Service 1510 Randolph#202 Carrollton, Texas 75006 CONTACT PERSON: Carrie 972-245-2848 AIRCRAFT: S-58T N-6BL,N4XY STANDARD CATEGORY PILOT: BRADFORD S. LADUE COMM CERT.#2760587 SCOTT BRADFORD LADUE COMM. CERT. #3250744 LOADS: NUMBER TYPE WEIGHTS 2 rte's up and 2 rte's down 5000 Ibs and down in weight CARRYING HAZARDOUS MATERIAL : no DESCRIPTION: CONTACTS: City of Grapevine,Texas Mr. Scott Williams(Connie Cook)817-410-3158 Dispatch: Supervisor Karen Ballard 817410-8127 Mall Manager:Cooper Black 972-7244900 DFW : FAA: SIGNATURE OF NS COM Y OFFICIAL Linda Norman k NARRATIVE OF PLAN OF OPERATIONS: 5-STATE HELICOPTERS, INC. Congested Area Plan Job Site: Grapevine Mills Mall 3000 Grapevine Mills Pkwy Adidas Suite 617 Grapevine,Texas 76051 DATE OF JOB: 10-20-2016 with rain date of 10-21-2016 END OF JOB: 10-20-2016 with rain date of 10-21-2016 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 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 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 OF PONSIBLE COMPANY OFFICIAL Linda Norman ,/ 1 � fy PACE 5-STATE HELICOPTERS, INC. Congested Area Plan JOB SITE: Grapevine Mills Mall 3000 Grapevine Mills Pk-,y Adidas Suite 617 Grapevine,Texas 76051 DATE.OF JOB: 10-20-2016 with rain date of 10-21-2016 TIME: approximately 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: 10-14-3016 PLAN PREPARED BY : Linda\off 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,Ina will re-notify all Contacts listed on CAP APPROVED W19 FAA: North Texas FSDO sY, IKE aUCKNFR St DATE: p APPROVED BY: FAA STAMP: THIS COMPANY COMPLIES WI'11-1 '11IE"CODE OF ETHICS: OF THE HELICOPTER ASSOCIATION OF AMERICA- PAGE 4 5-STATE HELICOPTERS, INC. Congested Area Plan JOB SITE: Grapevine Mills Mall 3000 Grapevine Mills Pkwy Adidas Suite 617 Grapevine, Texas 76051 DATE OF JOB: 10-20-2016 with rain date of 10-21-2016 TIME: approximately 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: 10-14-2016 PLAN PREPARED BY : Linda Norma / 1 �XJ �✓ Cr 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, nnI Q TnICK 1 5 STATE HELICOPTERS, INC. _ 3000 GRAPEVINE MILLS N l PGRAYEV'INE MILLS MALL M j F7 er� br �n CI 1�5� 1� �'�d50 qMarshall C all L F. 1 Bolo Point., t ADIDAS SUITE 617 ESTv L ock Poi GRAPEVINE.TEXAS 76051 �° —EtORP .Walnut Grucc Park N32`58.038' MA DATE.OFLIF1 :00AM NV97 0 02.627' 4488 TIME: APPROX.TEF 0-2 AM RAIN DATE OF 10-21-2016 0 qG p w S . edge Park ryC \ i y(�, 4 D VE DI w Oak Grave Pak � B <gPQc UI ''j, - ' r<4 � !C ` v 26 1 I CO I P.P y HELICOPTER WILL NOT BE SiherLa � 11'i` MORE THAN 125 FT. ABOVE J I 0 A 40 FT. MALL WHEN AIR 382 \\ m °I COPPELL D LIFTING EQUIPMENT. Gca�evin � �` P � wz 0 La" PILOT WILL BE IN CONTACT m—Zi14 `' -r4 3061 WITH DFW CONTROL - 4—-30 �c I TOWER. a D Ilas'Ft 'onh 6nem nal` a 360 , �yFgC w, YAL N E ROYAL LN _ u � a \M�r�ers Cha i GIi• 4` ,1301 ey"Vr Iea=�1rD R `26 II 121 ARBONRD 114 _i. WALI \ 0 RIJ .\ r���- y isi Q 346A H t d 9� l' %d-�E 1\ o c PA ER RD ID CITIES O 4� E ell _ D 1 fl� \ L. w RocR E RD \. 121.[�n z �,� W AIRP , 183 183L! FFFA,D�?'� '�y�,T�j . _ _ _-_-i^�1 _ _1L i63= .. [ E 17A P.- D.eLgopel 1 1- 0 U a . r :I T�Inc,Rel. ILI?OUjh 36 �Pl A[ VI Mag 12.00 Fri Oct 14 14:45 2016 — Local Road — Airfield Scale 1:125,000(at center) — Trail Geographic Feature - 2 Miles O Interstate/Limited Access Park/Reservation 2 km Major Connector Schad Service Airport State Route Locale Exit * Public Airport Railroad Cemetery Small Town County Boundary nu t 'ga e;Ty p} yAy $ m4mfiYiB '' tom/ FfC / „�.. p r NN ki f� �be\ 4emy}gc� yy B Z1 s r iy G a p a_ y� x rrf FU - m 1 --------�; e-- ar3 1 0 51 9 Page 1 of 1 Linda Norman From: "Linda Norman"< Date: Friday,October 14,2016 2:58 PM To: < Attach: 2016-10-14-14-51-22-0I.pdf Subject: Request to enter into DFW Airspace See Attachment Grapevine Mill Mall 3000 Grapevine Mills Adidas suite 617 Grapevine, Texas 76051 Date: 10-20-2016 rain date of 10-21-2016 Time: approximately 7:00 am Helicopter: Sikorsky S58T Call Sign: N4xy or N6bl or N6vy Pilot: Bradford s Ladue Comm. Cart. 2760587 Scott B. Ladue Comm. Cart. 3250744 Pilot will request to enter into DFW Airspace. When permission is granted the pilot will let the control tower know when he is landing for approximatley 30 minutes to rig the helicopter 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 15 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 and leave DFW airspace 5 State Helicopters Inc. Linda Norman Tel:972-6364009 Fax:972-636-1300 Cell: 214-212-6062 www.5state.com 10/14/2016 TRANSMISSION VERIFICATION REPORT TIME : 10/14/2016 14:01 NAME : 5 STATE HELICOPTERS FAX : 9726361300 TEL : 9726361300 SER. 0 : A3J152697 DATE,TIME 10114 14:00 FAX N0./NAME 18174103260 n PAGE(S) 000:00:3? L 1U LT O MODE STANDARD I ECM 1 5-STATE HELICOPTERS,INC. 285 BLACKLAND RA ROYSE CITY,TEXAS 75189 Alf� 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(rrapeyine,Texas Date: 10-20-2016 with rain date of 10-21-2016 For the purpose of air lifting air conditioning units to the roof of: Location: Grapevine Mills Mall 3000 Grapevine Mills Pkwy Grapevine, Texas 76051 This memo is to let Communications/dispatch 1wow the helicopter will be at the site from approximately 7:00 am to approximately 9:30 am If you have any questions please call Linda Norman at 972-636-4009 or cell at ')I A-')