Quickie QM-7 Series Single Powered Tilt Seating K0856, K0848, K0877 EIPW11, March 2018

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1 Quickie QM7 Series Single Pwered Tilt Seating K0856, K0848, K0877 EIPW11, March 2018 Accunt: Date: PO#: Buyer: Marked Fr: Ship T: Name: Address: City,State,Zip: Phne: The HCPCS CODES prvided are based n cde verificatin thrugh PDAC r ur interpretatin f the cde definitins. The use f HCPCS CODES des nt ensure cverage r payment. Fr cverage infrmatin, verify the apprpriate payer's cverage plicy. a Optin # HCPCS Definitin Price a Optin # HCPCS Definitin Price 1. QUICKIE QM7 Series SinglePwer Tilt Seating (Select One) QUICKIE QM710 SC (Grup 3 K0856/K0011) Quickie QM710 SC fr ASAP II Tilt(Fig 1.1) 172PC68 K0856 / K0011 Base Package $6, $6, PC80 QUICKIE QM715 HD SC (Grup 3 K0858/K0011) Quickie QM715 HD SC fr ASAP II Tilt $8, K0858 / K0011 Base Package $8, QUICKIE QM720 SD (Grup 4 K0877/K0014) Quickie QM720 SD fr ASAP II Tilt (Fig 1.1) $9, PC86 K0877 / K0014 Base Package $9, HCPC Cde Typical Chair Weight Transit Seat Type ISO ccupied apprved ASAP II Seat size range Width 12"22" STFH range ASAP II 16.6" 20.6" Pwer Seating Optins SC Seating Specificatins K0856 / K0858 / K W/battery 350lbs W/O Battery Depth 12"22" 50º CG tilt Pwer Swing away Elevating/Articulating Legrest Pwer Elevating/Articulating Centermunt 12" Seat elevatr 260lbs Actuatrs Required by Pwer Seating Functin 50º CG tilt 1 actuatr 12" Seat Elevate: 1 actuatr Pwer Leg Functin (Centermunt r Swing away): 2 actuatrs Cmbinatin : Tilt and Seat Elevate: 2 actuatrs Cmbinatin : Tilt and Pwer Elevating Legrest. (Centermunt r Swing away): 3 actuatrs Cmbinatin : Tilt, Elevate and Pwer Legrest (Centermunt r Swing away): 4 actuatrs QUICKIE QM710 Base Specificatins Drive Wheel Psitin Midwheel Drive Drive Wheels 14" Drive Wheels w/ flat free insert (Black) User weight Cap 300 lb 400lbs Tires/Casters 6" Frnt / 6" rear (Black) Base size Width 25" Length 36" Turn Radius 20" Charger 8A Dual Mde Charger (Cmpact) CTE Drive Cntrl RNet PM120 (NnExpandable and Expandable) Battery Size Grup 24 / Grup 34. Driving Range Up t 13.5 miles Shrud Clrs 12 standard clrs, 6 upgrade prints. Drive Mtrs 4ple 6 mph, Optinal 5mph and 8mph Grund Clearance 4" Custmer Service: Fax: rders@sunmed.cm Web: 3/2018 MK REV J Page 1

2 2. BASE CHAIR OPTIONS Speed Package (4ple) 172PF85 172PF91 172PF90 QM710 Standard 6 mph mtr package QM710 5 mph High Trque mtr package QM710 8 mph Cmmunity mtr package $ $1, Drive Wheel 172DW59 14" Cast Wheel Slid Dual Density Inserts Black Knbby Tires and Black Caster Std 172PF84 QM715 HD Standard 5 mph mtr package 172PF89 QM720 Standard 8 mph mtr package Suretrac Drive Tracking 172MI01 Suretrac Mdule and Mtr Encders $1, EZ10 Pearl Pink 172WL42 Wheel lcks 172HT44 Psitin "0" +.5" STFH 172WG06 Less than 150lbs 172HT45 +1" STFH 172WG lb 172HT46 172WG lb 172HT47 +3" STFH Shrud Clr 172EZ01 172EZ02 172EZ03 172EZ04 172EZ05 172EZ08 172EZ09 172EZ11 172EZ12 172EZ13 172EZ15 172EZ06 172EZ07 Candy Apple Red High Glss Black Candy Blue Silver Cpper Yellw Candy Purple Matte Black Midnight Blue Pearl White 172WG lb Transit Package NA 172WG lb Wheel lcks Wdland Cam. $ PreSet Seat Frame Angle Green Apple Digital Cam. American Flag. 172EZ17 Pink Cam Grunge Skulls $ EZ14 Carbn Fiber Print $ EZ16 172EZ18 User weight 172WG lb $ $ $ Transit Optin 172TO25 172TO40 Ventilatr Optins 172FA10 172HT49 172LI04 Omit Transit Tiedwn Seat Height (Use STFH Matrix belw) LED Light Package 0 (Measured in the frnt) Obtain Qute t verify est. STFH 4Pint Transit Tiedwn Package Meets ISO7176 fr Occupant Use 172VT4 E1029 Fixed Vent Tray (Pulmnetic LTV Mdels) +2" STFH Requires Grup 34 Batteries LED Light Package: Includes headlights, tail lights, turn indicatrs and flashers. $ NC $ $ $1, Seating Type and Pwer Optin Cmbinatins STFH Matrix SC ASAP II Tilt nly 16.6 SC ASAP II Tilt and 12" Lift cmb SeattFlr Height at 0 tilt SC ASAP II HD Tilt nly STFH measured with batteries but n user. Actual STFH may vary by.5" *Adding seat angle will increase STFH by 1" fr each incremental change. **Ultra lw STFH may cause grund clearance f Pwer Centermunt t drp belw 2" " +1" +2" +3" BATTERIES and CHARGERS Batteries 172AG21 E2361 GP22 Flat Tp Batteries Pair w/strap $ Battery Charger 172BJ19 172BJ29 8A Dual Mde (Cmpact) CTE 10A Dual Mde Pwer First Upgrade $ AG04 E2363 GP24 MK Gel Flat Tp Batts Pair w/strap Recmmended fr Max Daily Range $ AG22 E2363 GP24 Brightway AGM Flat Tp Batteries Pair w/strap. $ AG11 E2359 GP34 MK Gel Flat Tp Batteries (Pair) w/straps, Required fr lwer STFH. $ AG23 E2359 GP34 Brightway AGM Flat Tp Batts (Pair) w/straps, Required fr lwer STFH. $ Custmer Service: Fax: rders@sunmed.cm Web: 3/2018 MK REV J Page 2

3 Drive Cntrl Optins NnExpandable Cntrllers 172ER05 172JM11 Fixed Munt 172HM2 Left Side Munt E2323 RNet NnExpandable Drive Cntrl 120A (Fr Use w/ 2 Thrudrive seat Functins) Jystick Munt (Fixed, SwingAway, Retractable, Midline) 172JM10 Jystick Munt (Lcatin) 172HM1 Swing Away Munt Jystick Handle (Optinal) 172JH1 172JH2 172JH6 1720A04 E2323 E2323 Attendant Cntrl E2331 Expandable Cntrllers 172ER06 RNet Expandable Drive Cntrl (120A) $ EX05 172EX06 Rnet Jystick 172JM15 E2377 E2313 Expandable 120A Cntrller Rnet 172J70 Std LED Jystick fr Rnet Cntrls 172J J J95 Omit JS. Fr use with OMNI 172JM14 172JH4 Ball Handle THandle Height Adjustable. Fam Ball Handle Galpst Attendant Cntrl fr Rnet 4. ELECTRONICS $ ON7 $ Mid Line Munt $ E2323 Harness fr 120A Expandable Cntrller $ CJSM1: Jystick Standard: w/stere Jacks & Clr Display CJSM2: Jystick Advanced: 3.5" Clr Display, Paddle Switches, Shrtcut Keys, IR, BT, and Stere Jack. Retractable Jystick munt w/45º stps $ Right Side Munt $1, Rnet OMNI and Output Optins 172ON6 172ON8 OMNI Munt 172DS04 Swing Away Left Side OMNI Munt $ DS03 Switch inputs fr Jysticks r OMNI 172SW22 172SW1 172SW4 172SW21 172SW35 172SW36 172SW37 172SW38 Switch Munt Bracket 172EM01 Rnet Bluetth Musemver fr Windws / Andrid Stere t 2 Mn Splitter Buddy Buttn Switch Micr Light Switch Egg SwitchBlack Rnet Electrnic Prgrammer 172PR5 (Fr expandable cntrls, chse all that apply) Rnet OMNI Input Cntrl Mdule and display with built in Infrared and armrest munt. Chse munt belw. (required fr Specialty Input Devices.) Dual tggle switch and bracket SwitchIt Mini 1 buttn n Mn plug $ SwitchIt Mini 2 buttn n 2 Mn plugs SwitchIt Mini 2 buttn n 1 Stere plug SwitchIt Mini 4 buttn n DB9 cnnectr Single Switch Munt Bracket Rnet PC Prgrammer with Dngle $ ON9 Rnet Bluetth fr Apple Devices $ SW24 (If used with Jystick must be munted ppsite side) Swing Away Right Side OMNI Munt $ Drive r Mde / Prfile Cntrl $1, E2351 Rnet Output Mdule (ECM) $1, $65.00 $ $ $ $ $ $ $ Attendant Munting lcatin 172DN1 Munting lcatin: Right Back Cane 172DN2 Munting Lcatin: Left Back Cane Custmer Service: Fax: rders@sunmed.cm Web: 3/2018 MK REV J Page 3

4 Head Cntrl Prprtinal Packages SwitchIt Dual Pr Prprtinal Head Cntrl with Whitmyer and Facial Pads (Adult) 5. Specialty Driver Cntrl Optins Requires expandable Rnet cntrls and OMNI unless therwise nted. 5a. Prprtinal Cntrl Packages Chin Cntrl Prprtinal Jystick Packages $5, SwitchIt VersaGuide Chin Cntrl Cmpact Jystick and Egg Switch Package $2, ID72 E2328 SwitchIt Dual Pr Head Cntrl w/facial pad $5, IJ04 SA Bm Munt with Egg Switch Cntrl $ IM07 SwitchIt Dual Pr Prprtinal Head Cntrl with Spt Pads Package SwitchIt Dual Pr Prprtinal Head Cntrl with Facial Pads and Gseneck Munted Prximity Switch Pkg 172IJ11 Hand Cntrl Prprtinal Jystick Packages SwitchIt VersaGuide Cmpact Jystick Midline with Gatlin Package SwitchIt VersaGuide Cmpact Jystick Midline and prx flex switches with Gatlin Package 172IM08 E2328 Dual Flex Prximity Switches (requires n frce) 172IJ07 S/A Gatlin Munt $ SwitchIt MicrPilt Jystick with Space Disc Package 172IJ08 S/A SpaceDisc munt $ SwitchIt MicrGuide Jystick with SpaceDisc Package SA Gseneck Munt with Prximity Switch Cntrl SwitchIt Dual Pr Prprtinal Head Cntrl with Spt Pads and Gseneck Munted Prximity Switch Pkg 172ID70 172IJ11 SwitchIt Dual Pr Head Cntrl w/spt pads SA Gseneck Munt with Prximity Switch Cntrl SwitchIt VersaGuide Cmpact Prprtinal Jystick SwitchIt VersaGuide Cmpact Prprtinal Jystick $5, ID70 E2328 SwitchIt Dual Pr Head Cntrl w/spt pads $5, IJ04 SA Bm Munt with Egg Switch Cntrl $ ID72 E2328 SwitchIt Dual Pr Head Cntrl w/facial pad $5, $ $5, $5, IJ07 S/A Gatlin Munt $ $ $2, $ $3, $3, SwitchIt VersaGuide Bib Chin Cntrl Cmpact Jystick with Egg Switch Package Large 8" SwitchIt VersaGuide Cmpact Prprtinal Jystick SwitchIt VersaGuide Cmpact Prprtinal Jystick SwitchIt MicrPilt Bib Chin Cntrl with Egg Switch Package Std 6" 172ID62 E2312 MicrPilt Prprtinal Jystick SwitchIt MicrPilt Bib Chin Cntrl with Egg Switch Package Large 8" 172ID62 E2312 MicrPilt Prprtinal Jystick $2, IM06 Bib munt Large $ IJ04 SA Bm Munt with egg switch $ SwitchIt MicrGuide Bib Chin Cntrl with Egg Switch Package Std 6" 172ID63 E2312 MicrGuide Prprtinal Jystick $2, IM05 Bib munt Small $ IJ04 SA Bm Munt with egg switch $ SwitchIt MicrGuide Bib Chin Cntrl with Egg Switch Package Large 8" 172IM05 Bib munt Small $ IM06 Bib munt Large $ ID62 E2312 MicrPilt Prprtinal Jystick $2, IJ04 SA Bm Munt with egg switch $ $2, ID63 E2312 MicrGuide Prprtinal Jystick $2, IM05 Bib munt Small $ IJ08 S/A SpaceDisc munt $ IJ04 SA Bm Munt with egg switch $ IJ04 $1, IM08 $5, IM08 172IJ04 SwitchIt VersaGuide Bib Chin Cntrl Cmpact Jystick with Prximity Flex switches Package Std 6" 172IM08 172IM05 SwitchIt VersaGuide Cmpact Prprtinal Jystick Dual Flex Prximity Switches (requires n frce) SwitchIt VersaGuide Bib Chin Cntrl Cmpact Jystick with Prximity Flex Switches Package Large 8" 172IM06 SwitchIt VersaGuide Cmpact Prprtinal Jystick S/A Munt ff backrest Dual Flex Prximity Switches (requires n frce) SwitchIt VersaGuide Cmpact Prprtinal Jystick Dual Flex Prximity Switches (requires n frce) $2, $ Bib munt Small $ $2, $ Bib munt Large $ SwitchIt VersaGuide Bib Chin Cntrl Cmpact Jystick with Egg Switch Package Std 6" $ SA Bm Munt with egg switch $ SwitchIt VersaGuide Chin Cntrl Cmpact Jystick and Prximity Flex Switches Package SwitchIt VersaGuide Cmpact Prprtinal Jystick $2, $ IM07 S/A Munt ff backrest $ $2, SA Bm Munt with egg switch $ $2, $3, $3, $3, $3, ID63 E2312 MicrGuide Prprtinal Jystick $2, IM06 Bib munt Large $ IJ04 SA Bm Munt with egg switch $ Custmer Service: Fax: rders@sunmed.cm Web: 3/2018 MK REV J Page 4

5 SwitchIt Head Array Package 3 Switch Curved (Lng) SwitchIt Head Array Package 3 switch curved (Stubby) 5. Specialty Driver Cntrl Optins (cnt.) 5b. Switch Cntrl Requires Headrest and/r Headrest Munt 3 Switch Prximity Head Arrays Chse headrest munt belw Whitmyer Headrest Munt fr Specialty Cntrls 172IJ09 172II14 E2330 SwitchIt Prximity Head Array Stubby $4, II13 E2330 SwitchIt Prximity Head Array Lng $4, SA Bm Munt with Egg Switch Cntrl $ $4, $4, IJ09 SA Bm Munt with Egg Switch Cntrl $ MH23 172HE90 E0955 AdjustaAPlush Headrest Pad Narrw 172HE91 E0955 Whitmyer Linx Headrest Munt, Quick Release Whitmyer Headrest Pad fr Specialty cntrls AdjustaAPlush Headrest Pad Standard $ HE79 E0955 Plush Pad 8" fr Specialty cntrls 172HE80 E0955 Plush Pad 10" fr Specialty cntrls 172HE81 E0955 Plush Pad 14" fr Specialty cntrls 5 Switch Prximity Head Array (N Egg Switch Needed) Chse "Headrest Munt fr Special Cntrls" 172II04 Sip N Puff Package Chse headrest and HR munt belw 172IB05 Micr Light Switch Quickie Sip n' Puff System E2330 SwitchIt Head Array 5 switch flat $4, Single Switches Extra Swing Away Head Bm Egg Switch and Munt 172IJ05 Extra S/A Bm Munt with egg switch #1 $2, IB06 Egg SwitchBlack $ ID34 E2325 Sip N' Puff Kit $1, IB07 SwitchIt Mini 1 buttn n Mn plug $ IH1 E2326 Sip n' Puff Tubing and SA Hardware $ IJ10 S/A Bm Munt with egg switch $ IB02 $ IJ06 Extra S/A Bm Munt with egg switch #2 $ Buddy Buttn Switch Custmer Service: Fax: rders@sunmed.cm Web: 3/2018 MK REV J Page 5

6 6. SEAT TYPE 172ST56 Quickie A.S.A.P II (Adjustable Seating and Psitining) Chse Seat Frame Size Platfrm. ASAP II Frame Size Platfrm (each frame is width and depth adjustable within given range. ) 172FU17 Adjustable 12x12 t 16X19 ( A ) 172FU18 Adjustable 16x12 t 20x20 ( B ) 172FU19 Adjustable 18x16 t 22x22 ( C ) 7. SEAT SIZE A = ASAP II Seat Frame (Adjustable frm 12x12 t 16X19) B = ASAP II Seat Frame (Adjustable frm 16X12 t 20X20) C = ASAP II Seat Frame (Adjustable frm 18X16 t 22X22) 12" 13" 14" 15" 16" 17" 18" 19" 20" 22" 12" A A A A A,B B B B B 13" A A A A A,B B B B B 14" A A A A A,B B B B B 15" A A A A A,B B B B B 16" A A A A A,B B B,C B,C B,C C 17" A A A A A,B B B,C B,C B,C C 18" A A A A A,B B B,C B,C B,C C 19" A A A A A,B B B,C B,C B,C C 20" B B B,C B,C B,C C 21" C C C C 22" C C C C Seat Width Seat Depth 172R21 12" Seat width 172RF20 12" 172R22 13" Seat width 172RF21 13" 172R23 14" Seat width 172RF22 14" 172R24 15" Seat width 172RF23 15" 172R5 16" Seat width 172RF5 16" 172R6 17" Seat width 172RF6 17" 172R7 18" Seat width 172RF7 18" 172R8 19" Seat width 172RF8 19" 172R9 20" Seat width 172RF24 20" 172R25 22" Seat width 172RF26 21" 24" Seat Width Seat Depth Seat Size Matrix. Seat type is chsen in sectin 5. ASAP II Seat Width 172RF25 22" 172VU16 E " Seat width (fixed width, depth is adjustable 16" t 22" deep) N/A with Pwer r manual recline back r sling back uphlstery. $ SEAT CUSHIONS JAY Cushin Bundling 172JC14 JAY Cushin On Chair Order Chse Cushin in sectin 17c NC Custmer Service: Fax: rders@sunmed.cm Web: 3/2018 MK REV J Page 6

7 9. POWERED SEATING Pwer Seating Optins 172PJ7 E1002 Quickie SPOT 50 CG Tilt (1 Actuatr) 172PJ5 E1002 Quickie HD SPOT 50 CG Tilt (400lbs weight limit) (1 Actuatr) $5, $5, Pwered Seat Elevatr (AKA: Pwer Lift) 172PA27 E " Pwer Seat Elevate fr use with tilt (Must be rdered with SPOT tilt, NA with QM715 HD)(1 Actuatr) $2, Pwer Seating Cntrl (Fr use with pwer seating actuatrs. Switch activatin is standalne and des nt require expandable r thrudrive electrnics. Pwered Seating Switch Cntrl Methd 172EO10 Single Actuatr Switch Cntrl (Tilt) Switch Cntrl 1 actuatr with Dual Tggle Pwered Seating Thrudrive Cntrl Methd. ThruDrive 1 Seat Functin 172EO28 E2310 Thru Drive 1 seat Functin (Fr perating Tilt thru Jystick.) Includes Ctrl+5 ThruDrive 2+ Seat Functin $1, EO11 Switch Cntrl 1 actuatr with Buddy Buttn 172EO29 E2311 Thru Drive 2+ Seat Functins: (Fr perating Tilt, lift, pwer legs) Includes Ctrl+5 $3, EO19 172EO20 172EO21 172EO23 172EO12 172EO22 Switch Munt Switch Cntrl 1 actuatr with SwitchIt Mini 1 buttn Switch Cntrl 1 actuatr with SwitchIt Mini 2 buttn 23 Actuatr Switch Cntrl (Tilt/Legs, Lift/Tilt) Switch Cntrl 23 actuatr with Dual Tggle Switch Cntrl 23 actuatr with 4way tggle Switch Cntrl 23 actuatr with SwitchIt Mini 2 buttn Switch Cntrl 23 actuatr with SwitchIt Mini 4 buttn (fr use with switch cntrl pwered seating) $ PM01 Enable Assignable buttns 172QG05 Omit Ctrl+5 172EY01 Switch Munt Right 172EY03 Push buttns Ctrl+5 Switchbx Optins Ctrl+5 allws direct cntrl t 5 pwer seating functins (10 ttal switches). Switches can als be used with assignable buttns fr greater flexibility. Bx includes 3Amp USB prt fr charging prtable devices 172QG01 Ctrl+5 Switchbx munted behind jystick 172EY02 Switch Munt Left 172EY04 Tggle switches $ $ $ Pwered Seating Thrudrive Cntrl Optins Assignable Buttns "Assignable Buttn" feature allws fr custmizatin f jystick buttns and/r Ctrl+5 Switches allwing access t varius wheelchair and seating functins. When enabled, chair will be preprgrammed with seating functins assigned t buttns n the jystick. Assignments can be changed via PC Dngle. 172QG02 172QG03 Ctrl+5 Switch Type Ctrl+5 Switchbx munted ppsite jystick Ctrl+5 Switchbx munted n back cane $ $ Backrest Frame Type 172BT8 172BT98 172MN02 Angle Adjustable (ASAP II Seat nly) Manual Recline 40 (ASAP II Seat nly) nt width adjustable Angle Adjustable Backrest Optins 172OD8 E1225 Manual Recline Adjustment Methd Optin 172MN01 172OD9 Tl Back Cane Height 23". Knb (NA with Cantilever r dual pst arms.) (NA with Manual recline) NnFlding Backrest Flding Backrest 10. BACKREST AND BACK OPTIONS $ $ Back Type 172BU76 172BU78 172BU14 S.P.O.T. Curved JAY SPO Psterir Psitining (ASAP II nly) Jay 3 Optin (select Omit abve) 172BU77 172JC08 E2617 ART SPO Custm Back (ASAP II nly) See appendix 1 Omit Back. Jay J3 On Chair Order Chse back, headrest, laterals in sectin 17a,b,c $ See Pg. 8 NC Cane Angle 172BP40 172BP41 Twel Bar Depth 172B132 14" 172B36 16" 172B38 18" 172QT03 Shallw (NA with Uphlstery backs.) 172B40 20" 172QT04 Back Cane Back Height Required fr SPOT Curved, SPO Backs. Straight Back Pst (Limited cmbinatins f widths) Measured frm pan t tp f slid back. 8 Bend Back Pst (Avail. nly w/ Uphlstery r J3 Back) Deep (Extends 4" frm back canes fr deep backs) (Uphlstery Height Measured pan t tp f uphlstery.) Lw (15.5") 172B1 Med (17.5")172B5 Tall (19.5") 172B9 $ B42 22" 172B44 24" 172B140 26" Custmer Service: Fax: rders@sunmed.cm Web: 3/2018 MK REV J Page 7

8 12. HEADREST OPTIONS Chse One Each. Whitmyer Headrest Munt Whitmyer Headrest Pad 172MH10 Axys Munt & Bracket 172HE65 E0955 Plush Head Supprt Pad 8" 172MH11 Cbra Munt and Bracket $ HE66 E0955 Plush Head Supprt Pad 10" 172MH1 Linx Munt and Bracket 172HE78 E0955 Plush Head Supprt Pad 14" 172HE82 E HE83 E0955 AdjustaPlush Head Supprt Pad Narrw AdjustaPlush Head Supprt Pad Std 13. POSTURAL SUPPORTS LATERAL THORACIC SUPPORT (Swing Away) Available n all Slid Backs. LAT 4X4 S/A MOUNTS W/ 1" OFFSET PR 172ZV14 LATERAL 4X4 W/ 1" OFFSET PAIR $ ZS07 LATERAL SWING AWAY MOUNT PAIR $ LAT 4X5 S/A MOUNTS W/ 1" OFFSET PR 172ZV15 LATERAL 4X5 W/ 1" OFFSET PAIR $ ZS07 LATERAL SWING AWAY MOUNT PAIR $ LAT 4X6 S/A MOUNTS W/ 1" OFFSET PR 172ZV16 LATERAL 4X6 W/ 1" OFFSET PAIR $ ZS07 LATERAL SWING AWAY MOUNT PAIR $ LAT 6X4 S/A MOUNTS W/ 1" OFFSET PR 172ZV17 LATERAL 6X4 W/ 1" OFFSET PAIR $ ZS07 LATERAL SWING AWAY MOUNT PAIR $ LAT 6X5 S/A MOUNTS W/ 1" OFFSET PR 172ZV18 LATERAL 6X5 W/ 1" OFFSET PAIR $ ZS07 LATERAL SWING AWAY MOUNT PAIR $ LAT 6X6 S/A MOUNTS W/ 1" OFFSET PR 172ZV19 LATERAL 6X6 W/ 1" OFFSET PAIR $ ZS07 LATERAL SWING AWAY MOUNT PAIR $ CHEST STRAP 172ZR03 E0960 Padded Chest Strap Swing Away Knee Adductr Supprts 172KB5 172KB6 172KB8 172TV2 172TV1 172TX2 Available nly with Fixed and Pwer Center Munt Legrests. Nt available with Dual Pst Arm Rests r 2pint Lcking Cantilever Arms Knee Adductr Supprts LEFT (chse Pad and Arm) 172KB7 172XX04 172XX06 Knee Adductr Pad LG Left S/A Arm Size Swing Away Shrt Left Knee Adductr Pad LG Right Lng Thigh Supprt w/remvable Munt SPOT Lng Thigh Supprt Left Pad Size Knee Adductr Pad SM Left Swing Away Lng Left Knee Adductr Supprts RIGHT (chse Pad and Arm) 172XX05 172XX07 Pad Size Knee Adductr Pad SM Right Remvable Munt Left $ $ $ $ $ $ Available with Cantilever Arms, NA with Manual Recline Back, Dual Pst, Single Pst r Cantilever w/ 2 pt Lcking arms. 172TX1 S/A Arm Size Swing Away Shrt Right Swing Away Lng Right Lng Thigh Supprt Left $ $ SPOT Lng Thigh Supprt Right $ Lng Thigh Supprt Right $ Remvable Munt Right 14. ARMREST AND ARMPAD OPTIONS Cantilever Armrest Munting Cantilever Armrests (Adjustable length arm pad included (chse Pad setting belw, except fr Lw Arm Optin) NA with Manual Recline Back 172EG12 172EG13 172EG10 172EG11 STD Cantilever Arm 9"12" Ht Range Lw Cantilever Arm 7"10" Ht Range (Chse ASAPII pad type and size belw) Standard Cantilever Arm w/ 2 Pint Lcking Pst. (9"10" Ht Range.) NA w/ seat depths belw 16" Standard Cantilever Arm w/ 2 Pint Lcking Pst. (11"12" Ht Range.) NA w/ seat depths belw 16" Cantilever Arm pad Std NC $ $ Single Dual Pst Armrest Munting Single Pst Armrests 172EG14 Single Pst Height Adjustable Std. $ EG15 172EG09 172AE01 172AE03 172AE04 Single Pst Height Adjustable Lw Dual Pst Armrests (NA with Infinite Seat Depth) 172EG23 Left Arm Pad () Shrt Dual Pst Flip Back HT Adj 10"15" Lng Dual Pst Flip Back HT Adj 10"15" Pad Type / Size Optins fr Dual Pst / Single Pst / Lw Cantilever 172AE02 Desk Length Waterfall (10") Full Length Waterfall (14") NA w/lw Cantilever arm Desk Length Standard (10") Full Length Standard (14") NA w/lw Cantilever arm Right Arm Pad () $ $ $ AB01 172AB02 172AB03 172AB04 Pad Setting Optins fr Standard Cantilever Arm Left Arm Pad (Std) Right Arm Pad (Std) 172AE11 Full Length Cantilever (14") 172AB11 172AE10 Desk Length Cantilever (10") 172AB10 Custmer Service: Fax: rders@sunmed.cm Web: 3/2018 MK REV J Page 8

9 15. HANGERS AND FOOTRESTS Swingaway Hangers NnPwered Swing Away Legrests 172H2 172H6 172H138 E0990 Sld as Pairs 70 Swing Away (B) 90 Swing Away (B) (5.59") Manual ELR S/A (B) (Avail. with Fixed Centermunt, chse belw) $ Centermunt Legrests NnPwered Center Munt Legrests Fixed Center Munt Legrests (includes ftplate) Plus ptins belw 172H H135 Fixed Center ASAP II Munt Shrt Fixed Center ASAP II Munt Lng Pwer Elevating Legrests (2 Actuatrs) Swing Away Pwer ELR w/ Articulatin Pair 172H126 E1010 (B ftplates) (N/A fr 12" r 13" wide) Ftplates Fr Swing Away Hangers 172F HL10 172F HL10 195F LS13 195F LS13 195F279 B Adult Angle Adjust w/heel Lp fr use with 70 hanger and ELR (Pair) E0951 Heel Lp $50.00 B Adult Angle Adjust w/heel Lp fr use with 90 hanger (Pair) E0951 Adult Angle Adjustable Ftplate Heel Lp $2, $ K0038 Leg Strap $35.00 K0038 Adult Angle Adjustable Ftplate C Kids Angle Adjust w/leg Strap fr use with 70 hanger (Pair) Kids Angle Adjustable Ftplate C Kids Angle Adjust w/leg Strap fr use with 80 and 90 hanger(pair) $ $50.00 $ $ Kids Angle Adjustable Ftplate Leg Strap Omit Ftplate and extensin tube $35.00 Angle Adjustable Center Munt Legrests fr ASAP II 172H IE01 Pwer Centermunt (2 Actuatrs) Pwer Centermunt ELR w/7.5" Pwer 172H127 E1012 Articulatin (F) Centermunt ftplates plus $2, Custm Optins Belw Pwer Centermunt Ftplate Extensin Optin (Fr ThruDrive Operatin) 172H IE02 Centermunt Ftplates Angle adjustable Center Munt Medium 3" 11.25" Chse Ftplate (I r J) infinite and Independent leg length and angle adjustable Angle adjustable Center Munt Lng 3" 13.25" Chse Ftplate (I r J) infinite and Independent leg length and angle adjustable Enable 7.5" Pwered ftplate extensin fr transfer assist. (Electrnics prgrammed t allw ftplates t be extended with r withut legrest being raised) Disable Ftplate extensin fr transfers. (Electrnics prgrammed t ONLY extend ftplates when legs are raised.) $ $ $1, Omit Hangers. 172H144 Omit Hangers F Centermunt Dual Ftplate and Heel Blck (Pair) (Individually Height (3"19") and Angle Adjustable) 172F315 CMT Angle Adjustable Ftplates 172HL14 E0951 Padded and Adjustable Heel Blck Hanger Extensins. (See range listed in matrix belw) I Angle adj Centermunt Ftplate Pair Small NOTE: Nt all extensin tube will be available; depending n the seat height, sme extensin tube ptins may nt ffer enugh grund clearance. 172F125 Small Adjustable Ftplates 5.75" x 6" each 172E16 K0037 High Munt Hanger $ E1 Shrt 172E2 Medium 172E5 Lng Ftrest Accessries 1725A01 E0952 Te Lp (Pair) Only avail n (pt B). $ LS14 K0038 Extra Leg Strap $ F DI26 172DI27 J Angle adj Centermunt Ftplate Pair Large Custm Centermunt Optins Large Angle Adjustable Ftplates 5.75" x 10" each Extra Large Single Ftplate fr Centermunt Ftrest. Size 16"W x 14"D Gel Ft Pads fr XL Single Centermunt Ftplate. $ $ DI28 E0995 Extra Large Pair Curved Calf Pads fr Center Munt Legrests. Fully adjustable $ Hanger Type 70 Swing Away 90 Swing Away Manual ELR S/A Pwer ELR S/A 12"14" Medium 16"18.5" 14"17" 16.5"19" Fixed Cntrmnt ASAP 12.5"15.5" 14.5"19.5" Angle Adj Cntrmnt Pwer Cntrmnt Lwer Leg Length Matrix (measured seat pan t the tp f the ftplate surface) Standard 3"19" High Munt 7"14" Shrt 13.5" 16" 5.59" Ftplate munts t frnt f hanger. 3"13" Lng 18"20.5" 12.5"17" 14.5"19" 17"21" 3"15" Ftplate Matrix B F I J X X X X Single Ftplate X X X Custmer Service: Fax: rders@sunmed.cm Web: 3/2018 MK REV J Page 9

10 16. ACCESSORIES Wheelchair Tray Table Psitining Belt Select fr any style seat 1727A01 E0950 TRAY TABLE SM TUFFAK 12"14" PWR 172EJ01 Aut Style Buckle 1727A02 E0950 TRAY TABLE MED TUFFAK 15"17" PWR 1727A03 E0950 TRAY TABLE LRG TUFFAK 18"20" PWR 172EJ02 E0978 Belt 2" Aircraft Buckle $ EJ03 E0978 Belt 2" Aircraft Buckle Padded $70.00 Backpack 172A1 Black Utility $55.00 Accessries 1728A A A A12 Ram Phne Munt n Rund JS tube $50.00 Ram Tablet Munt n Rund JS tube $ Ram Cup hlder $50.00 SwitchIt Remte Stp Switch $ JAY Signature Series Backrest and Accessries Nte: Nt all sizes and cnfiguratins shwn belw, fr full ffering visit 17a. JAY BACKREST Seat width must can be equal t r 2" less than selectin in sectin 7. JAY J3 Back PA (2.2" Cntur Depth) UT Shells Heavy Duty TH 2 Pint Hardware 172JT01 J3PAUTS16TH 16" Wide J3 Back w/ 16.5" Shell Height $ JT02 J3PAUTS18TH 18" Wide J3 Back w/ 16.5" Shell Height $ JT03 J3PAUTS20TH 20" Wide J3 Back w/ 16.5" Shell Height $ JT04 J3PAUTM16TH 16" Wide J3 Back w/ 18" Shell Height $ JT05 J3PAUTM18TH 18" Wide J3 Back w/ 18" Shell Height $ JT06 J3PAUTM20TH 20" Wide J3 Back w/ 18" Shell Height $ JT07 172JT08 172JT09 E2614 J3PAUTM22TH 22" Wide J3 Back w/ 18" Shell Height $ J3PAUTT16TH 16" Wide J3 Back w/ 19.5" Shell Height $ J3PAUTT18TH 18" Wide J3 Back w/ 19.5" Shell Height $ PA Back 172JT10 J3PAUTT20TH 20" Wide J3 Back w/ 19.5" Shell Height $ SH Shells 4 Pint Standard Hardware 172JT11 J3PASHS18TH 18" Wide J3 Back w/ 21" Shell Height $ JT12 172JT13 J3PASHS20TH 20" Wide J3 Back w/ 21" Shell Height $ E2614 J3PASHS22TH 22" Wide J3 Back w/ 21" Shell Height $ TH Hardware JAY J3 Back PD (6" Cntur Depth) 172JT14 172JT15 172JT16 172JT17 172JT18 172JT19 UT Shells Heavy Duty TH 2 Pint Hardware E2620 J3PDUTM16TH 16" Wide J3 Back w/ 18" Shell Height $ E2620 J3PDUTM18TH 18" Wide J3 Back w/ 18" Shell Height $ E2620 J3PDUTM20TH 20" Wide J3 Back w/ 18" Shell Height $ SH Shells Heavy Duty TH 2 Pint Hardware E2620 J3PDSHS16TH 16" Wide J3 Back w/ 21" Shell Height $ E2620 J3PDSHS18TH 18" Wide J3 Back w/ 21" Shell Height $ E2620 J3PDSHS20TH 20" Wide J3 Back w/ 21" Shell Height $ PD Back 172JT20 172JT21 172JT22 172JT23 172JT24 172JT25 172JT26 172JT27 172JT28 172JT29 172JT30 JAY J3 Back PL (3" Cntur Depth) UT Shells Heavy Duty TH 2 Pint Hardware J3PLUTS16TH 16" Wide J3 Back w/ 16.5" Shell Height $ J3PLUTS18TH 18" Wide J3 Back w/ 16.5" Shell Height $ J3PLUTS20TH 20" Wide J3 Back w/ 16.5" Shell Height $ J3PLUTM16TH 16" Wide J3 Back w/ 18" Shell Height $ J3PLUTM18TH 18" Wide J3 Back w/ 18" Shell Height $ J3PLUTM20TH 20" Wide J3 Back w/ 18" Shell Height $ J3PLUTT16TH 16" Wide J3 Back w/ 19.5" Shell Height $ J3PLUTT18TH 18" Wide J3 Back w/ 19.5" Shell Height $ J3PLUTT20TH 20" Wide J3 Back w/ 19.5" Shell Height $ SH Shells 4 Pint Standard Hardware J3PLSHS18TH 18" Wide J3 Back w/ 21" Shell Height $ J3PLSHS20TH 20" Wide J3 Back w/ 21" Shell Height $ PL Back JAY Custm Back T rder any JAY Back nt listed abve, please see the JAY price list. Cushin name r part number must be filled ut w/ desired width and depth 172JB01 JAY Bundled Back Back Name r Part # Width: Height: Price List Custmer Service: Fax: rders@sunmed.cm Web: 3/2018 MK REV J Page 10

11 17b. JAY BACKREST ACCESSORIES 172HD01 172HD02 172HD05 172HD06 172HD03 172HD04 172HD07 172HD08 JAY J3 Back Headrest AXYS Munt and Pad (includes remvable munt) E0955/ J3HEDX10 AXYS Headrest with 10" Plush Pad $ E0955/ J3HEDX14 AXYS Headrest with 14" Plush Pad $ E0955/ J3HEDXAAPS AXYS Headrest with Narrw AdjustaPlush $ E0955/ J3HEDXAAPN AXYS Headrest with Standard AdjustaPlush $ LINX Munt and Pad (includes remvable munt) E0955/ J3HEDL10 LINX Headrest with 10" Plush Pad $ E0955/ J3HEDL14 LINX Headrest with 14" Plush Pad $ E0955/ J3HEDLAAPS LINX Headrest with Narrw AdjustaPlush $ E0955/ J3HEDLAAPN LINX Headrest with Standard AdjustaPlush $ JW02 172JW03 172JW04 JAY J3 Back Laterals Swing Away Laterals With Pad Pair / J3LAT4X4SA SwingAway Let with 4"x4" Pad (PR) $ / J3LAT4X5SA SwingAway Let with 4"x5" Pad (PR) $ / J3LAT4X6SA SwingAway Let with 4"x6" Pad (PR) $ c. JAY CUSHIONS Seat width must match selectin in sectin 7. can be +/ 2" f selectin in sectin 7 JAY Fusin Cushin JAY X2 Cushin 172JU01 E2622 JFUSION1616 JAY Fusin 16" x 16" $ JU22 E2622 JX21616 JAY X2 16" x 16" $ JU02 E2622 JFUSION1618 JAY Fusin 16" x 18" $ JU23 E2622 JX21618 JAY X2 16" x 18" $ JU03 E2622 JFUSION1816 JAY Fusin 18" x 16" $ JU24 E2622 JX21816 JAY X2 18" x 16" $ JU04 E2622 JFUSION1818 JAY Fusin 18" x 18" $ JU25 E2622 JX21818 JAY X2 18" x 18" $ JU05 E2622 JFUSION1820 JAY Fusin 18" x 20" $ JU26 E2622 JX21820 JAY X2 18" x 20" $ JU06 E2622 JFUSION2018 JAY Fusin 20" x 18" $ JU27 E2622 JX22020 JAY X2 20" x 20" $ JU07 E2622 JFUSION2020 JAY Fusin 20" x 20" $ JAY Unin Cushin JAY In Cushin 172JU15 E2607 JU1616 JAY UNION 16" x 16" $ JU08 E2607 JION1616 JAY ION 16" x 16" 172JU16 E2607 JU1618 JAY UNION 16" x 18" $ JU09 E2607 JION1618 JAY ION 16" x 18" 172JU17 E2607 JU1816 JAY UNION 18" x 16" $ JU10 E2607 JION1816 JAY ION 18" x 16" 172JU18 E2607 JU1818 JAY UNION 18" x 18" $ JU11 E2607 JION1818 JAY ION 18" x 18" 172JU19 E2607 JU1820 JAY UNION 18" x 20" $ JU12 E2607 JION1820 JAY ION 18" x 20" 172JU20 E2607 JU2018 JAY UNION 20" x 18" $ JU13 E2607 JION2018 JAY ION 20" x 18" 172JU21 E2607 JU2020 JAY UNION 20" x 20" $ JU14 E2607 JION2020 JAY ION 20" x 20" JAY Custm Cushin T rder any JAY cushins nt listed abve, please see the JAY price list. Cushin name r part number must be filled ut w/ desired width and depth 172JC20 JAY Bundled Cushin Cushin Name r Part # Width: Depth: Price List 18. CUSTOM OPTIONS Lking fr mre ptins? Cntact ur custm "built 4 me" department. T Inquire abut any unique custmizatin fr Quickie prducts, cntact: Phne: (800) , Optin #3 r Fax: (800) Sunrise Medical (US) LLC 2842 Business Park Ave. Fresn, CA USA Custmer Service: Fax: rders@sunmed.cm Web: 3/2018 MK REV J Page 11