Serial Number: Manufacturing Date: /20
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1 Sunrise Medical Head Office: 237 Romina Drive, Unit 3 Concord, ON L4K 4V3, Canada Telephone: Fax: csrcanada@sunmed.com Distributor Name: Dealers Name: Contact Name: Client's Name: Address: Client's Weight: Client's Height: Postcode: Client's Disability: Country: Telephone: Notes/Coents: Purchase Order No: Delivery Address: Postcode: Contact Name: Telephone: Distributor: FOR RGK OFFICE USE ONLY A/C No: Net Value: $ Freight: $ Who Date Invoice Value: OK to Quote: $ Payment Received: OK to Confirm: $ Document No: DOC Page 1
2 Base product Mandatory information Information required for option Standard configuration Option with no extra cost Option with extra cost TGAXZ010 $ 5, TIGA A7020 XA070 XA080 Frame open design Frame closed design Max User Weight 125kg XW010 NC KEY FRAME MEASUREMENTS XY010 Seat width (Inside of sideguards) (Max - 500) (Min - 250) XY020 Seat length (Max - 500) (Min - 250) XY030 XY050 Seat frame additional length (Provides additional leg support & hand grip) Front frame height (Max - 550) (Min - 380) XY060 Rear frame height (Max - 550) (Min - 360) XY070 Frame length (Min = XY020 + XY ) XA020 Frame ergonomic seat $ Specify length (Standard = 120) Page 2
3 XY080 Front seat taper design FRONT FRAME AND FOOTREST Front Frame Options Footrest width Specify width Specify width (Optional, to provide additional leg support / positioning) (When combined with XY080, dimensions must be smaller) XY100 Footrest round design (Minimum 60) Footrest Design & Measurements (Choose One) XY105 Footrest square design (Square design allows higher position) (Minimum 60) Please indicate front footrest height: Please indicate front footrest height: Individual Individual Max Height Castor Wheel Max Height With XB200 Castor Wheel Size Achievable Size Achievable With XB200 3" " " " " " XB200 Footrest with high level riser system (Only with XB200 $ XB010, XB080 & XB150) $ Footrest Individual Measurements Rear footrest height XB010 Optimise measurements (Std = Footrest height - 20) Footrest length Optimise measurements (Std = 100) Footrest height adjustable lightweight tubular aluminium - (Standard when no option selected) Footrest Style (Choose One) XB030 $ Footrest with high level riser system (Only with XB010, XB080 & XB150) Footrest height and angle adjustable flip up left and right (Not with XA070) XB070 Footrest height & angle adjustable aluminium plate XB150 Footrest height adjustable tubular heavy duty $ $ TGAXB080 Footrest fixed position welded into frame $ Footrest Cover XB050 Footrest cover carbon fibre (Not XB070 & XB170 $ XB030) $ Footrest cover - aluminium (Not XB070 & XB030) XB040 Footrest cover - ABS (Not XB070 & XY030) XB160 Footrest grip tape fitted to any footrest cover $ $ (Standard with XB070, not XB030) Page 3
4 XC150 $ Serial Number: CASTOR WHEELS, FORKS & WHEEL LOCKS Castor Wheels 3" Castor wheel 3x1.4" aluminium centre frog legs (Silver hub and black urethane tyre) 4" XC060 Castor wheel 4x1.3" soft roll black XC110 $ Castor wheel 4x1" aluminium centre frog legs (Silver hub & black urethane tyre) Choose one castor option only XC130 Castor wheel 4x1.4" aluminium centre with urethane tyre frog legs $ Choose colour below (XC130 Only) : Silver hub & black tyre (Std) Black hub & black tyre Black hub & red tyre Black hub & blue tyre Red hub & black tyre Blue hub & black tyre 5" Purple hub & black tyre Gold hub & black tyre Green hub & black tyre Silver hub & blue tyre Silver hub & red tyre XC070 Castor wheel 5x1.3" soft roll black XC100 $ Castor wheel 5" pneumatic aluminium centre XC120 $ Castor wheel 5x1" aluminium centre frog legs (Silver hub & black urethane tyre) XC140 $ Castor wheel 5x1.4" aluminium centre frog legs (Silver hub & black urethane tyre) Castor Forks XC190 Castor fork low ride daily use XC210 Castor fork suspension XC220 (Std when no option selected) $ frog legs $ Castor fork single sided uni tine frog legs Black Silver Black Silver Black Silver XY330 Castor pin width Castor Pin Width Optimise measurements (Minimum width for clear castor rotation and maximum wheelbase length) Scissor Wheel Lock Options Other XD020 Wheel locks underseat scissor XD050 Wheel locks push to lock XD040 $ XD030 $ XD035 $ Wheel locks scissor levers drilled Wheel locks compact scissor Wheel locks compact scissor with lightweight fixing (Only with fixed centre of gravity) XD010 Wheel locks omit Page 4
5 Sideguard Aluminium Options SIDEGUARDS AND ARMRESTS Sideguard with Fender Aluminium Options Choose optimised or individual measurements XE030 Sideguards screw on aluminium XE040 Sideguards screw on aluminium with fender $ $ XE080 Sideguards lift out aluminium XE090 Sideguards lift out aluminium with fender $ $ TGAXE130 Sideguards fold flat aluminium TGAXE140 Sideguards fold flat aluminium with fender $ $ XE180 Sideguards flip back aluminium XE190 Sideguards flip back aluminium with fender $ $ TGAXE220 $ Sideguards welded with 6 bead Carbon Fibre Options TGAXE230 Sideguards welded aluminium sport $ (Extra strong) XE060 Sideguards screw on carbon fibre with fender Carbon Fibre Options $ XE110 Sideguards lift out carbon fibre with fender XE050 Sideguards screw on carbon fibre $ $ TGAXE160 Sideguards fold flat carbon fibre with fender XE100 Sideguards lift out carbon fibre $ $ XE210 Sideguards flip back carbon fibre with fender TGAXE150 $ Sideguards fold flat carbon fibre $ XE200 Sideguards flip back carbon fibre Sideguard Measurements $ Optimised measurements ABS Plastic Options Fender sideguard height above XE070 Sideguards screw on ABS plastic tyre (Min = 10) $ XE120 Sideguards lift out ABS plastic $ TGAXE170 Sideguards fold flat ABS plastic $ Optimise 10 above tyre (Std if not indicated) Armrest Options Individual measurements XF010 $ Armrest fixed height, lift out with plastic sideguard (Indicate height) Fender sideguard to centre of tyre XF020 Armrest fixed height, lift out with aluminium sideguard (Standard if no option selected) $ (Indicate height) Height (Top of seatrail to top of armrest) Sideguard Measurements Optimised measurements Sideguard 25 above tyre (Follow tyre - Std if not indicated) Sideguard individual above tyre (Follow tyre) Sideguard level with tyre (Follow tyre) Sideguard length Sideguard height Individual measurements Choose optimised or individual measurements Fender sideguard to outside of tyre Page 5
6 XG010 Backrest height fixed Specify height Backrest fixed (Non-folding) BACKREST Backrest Height - Fixed or Adjustable (Choose One) XY245 $ Backrest height adjustable (Upward range 50) Backrest Design - Fixed or Folding (Choose One) TGAXG020 $ Ergonomics - Rearward Positioning (Choose One) Indicate lowest height Backrest folding with 2 position snap lock and angle adjust ( ± 5 Deg) XY Individual XG110 Backrest inward taper XG120 $ (Above sideguards) $ XG070 $ XG080 $ XG085 $ Backrest angle Width +5 Deg (Max -10/+20 Deg) Backrest with screw in push handles (N/A with XY245) Backrest with flip down push handles (N/A with XY245) Backrest with flip down push handles height adjustable (N/A with XY245) Push handle Options Backrest Options XG100 Backrest ergonomic $ Vertical height (Min 250) Ergonomics - Lateral Positioning (Choose One) XG090 $ Rearward position Backrest outward flare (Above sideguards) Width Optimise (1000 from floor) XG040 Backrest fixed heavy duty (Recoended for hand XG130 Backrest brace tube extra deep $ cycling) (Not with XY245) $ (Std - 90) Backrest with height adjustable stroller push handles Height from floor ILSA Backrest Options Depth XG140 $ A - Left Backrest integrated lateral support clamp (ILSA) A - Right B - Left B - Right C - Left C - Right D - Left D - Right Page 6
7 Adjustable Centre of Gravity CAMBER BAR Fixed Centre of Gravity Centre of gravity - Choose one XH110 XH120 Camber bar adjustable position square back frame (25-150) (Open or closed frame) Centre of gravity adjustable round back frame (60-150) (Open or closed frame) Centre of gravity - Choose one TGAXH100 Camber bar fixed position $ welded into frame single post (25-125) (Max seat width 430) (Open frame only) TGAXH090 Camber bar fixed position $ integrated into frame V design (25-125) (Open or closed frame) Specify Camber Angle Specify Camber Angle XY390 Camber angle XY390 Camber angle Camber Bar Options Camber Bar Options XH030 Suspension camber bar XH040 $ frog legs $ Handbike camber bar fixed welded XH040 $ Handbike camber bar fixed welded Camber angle (Handbike camber bar) 0 5 Castor height from floor for handbike fitting (Standard 30 if not indicated) Camber angle (Handbike camber bar) 0 5 Castor height from floor for handbike fitting (Standard 30 if not indicated) Anti-Tip Options XJ010 Anti tip swingaway LEFT side (Only with square XJ020 $ back frame. Not with XH040) $ Anti tip swingaway RIGHT side (Only with square back frame. Not with XH040) Page 7
8 XY420 XY460 REAR WHEELS Wheel Size Wheel size 24" XY430 Wheel size 25" XY440 Wheel Gap Rear wheel gap Wheel size 26" Spinergy Colour Options Wheel Options (Choose one) XK010 Wheel Sun Fusion 16 spoke daily use XK320 Wheel Spinergy XLX 12 spoke cross spoked $ daily (select colour below) XK050 Wheel Spinergy LX 12 spoke daily use XK060 Wheel Spinergy SPOX 18 spoke daily (select $ (select colour below) $ colour below) XK210 Wheel Topolino carbon core with red accents XK070 Wheel Spinergy BLXL 18 blade spoke daily, rivnut $ (24", 25" only) $ handrim mounting (select colour below - Note: Black hub only) Black spoke / Silver hub White spoke / Black Hub XK180 Spinergy spoke colour custom $ (Specify below) Red spoke / Black hub Blue spoke / Black hub Colour inside Yellow spoke / Black hub Green spoke / Black hub Colour outside Pink spoke / Black hub Orange spoke / black hub Note: Supply picture for custom designs XK190 Spinergy black hub with black spokes XK200 Spinergy silver hub with coloured spokes $ $ XK040 Wheel omit / supply without $ (206.00) (Specify wheel type / size / tyre) Handrim set narrow (Standard if no option selected) Handrim Position Handrim set wide XY500 Handrim Options XL010 Handrim aluminium hard anodised 6 tab XL040 Handrim titanium 6 tab (Standard if no option selected) $ XL030 Handrim surge LT 6 tab XL050 Handrim stainless steel 6 tab $ $ XL020 Handrim tetra grip 6 tab XL090 Handrim remove excess mounting tab $ $ (Recoended when XY460 is 20 or XL100 Handrim para grip 6 tab less) (Narrow set only) $ Tyre Options XM010 Kenda Tyre High Pressure Grey Blue Red (Standard if no option XM130 Kenda black selected) $ XM020 Tyre Schwalbe Marathon Plus XM060 Tyre Schwalbe One (24",25" only) $ $ XM040 Tyre Shox solid airless black only XM050 Tyre Kenda K885 mountain bike tyre $ (24",25" only) $ (24",25" only) Inner Tube Valve Options Schraeder inner tube valve (Standard if no option selected) XY490 Presta inner tube valve XK220 Wheel titanium quick release axle pin (pair) $ (N/A with XK010 & XK070) XK240 Wheel quad release axle nut (pair) $ XK250 Wheel transparent polycarbonate spokeguard $ (pair) Wheel Accessories XK300 $ XK310 $ Offroad wheel set 22" rim with handrim, MTB tyre and axle pins (Replaces 24" wheel with XM010) Offroad wheel set 24" rim with handrim, MTB tyre and axle pins (Replaces 25" wheel with XM010) Page 8
9 XN010 Specify Code Frame Finish frame powder coated (Includes H-frame) FRAME FINISH OPTIONS XN150 Specify Code Components Finish components powder coated (Footrest, camber bar & sideguards) (Standard black if not Indicated) TGAXN030 Finish frame brushed XN160 Finish components brushed $ $ (Footrest, camber bar & sideguards) TGAXN050 Finish frame polished XN170 Finish components polished $ $ (Footrest, camber bar & sideguards) Accent Colour (Choose One) Finish accent colour black Finish accent colour red Finish accent colour silver Finish accent colour blue Finish accent colour purple UPHOLSTERY Seat Upholstery XP040 Upholstery seat sling adjustable tension with straps (Std if not indicated) XR050 $ Accessory carbon fibre seat plate in lieu of seat upholstery Backrest Upholstery XP050 Upholstery backrest Airtech adjustable tension with straps -(Std if not indicated) XP060 $ XP070 $ Upholstery backrest upgrade to full leather Leather colour black Leather colour red Leather colour grey (Standard if not indicated) Upholstery upgrade to leather corners on side wings - (N/A with XG080) Backrest Upholstery Leather Options Leather colour black (Standard if not Indicated) Leather colour red Backrest Upholstery Stitching Options Leather colour grey Silver Black Blue (Standard if not indicated) Red Light blue Purple Backrest Upholstery Logo Options Silver Black Blue (Standard if not indicated) Red Light blue Purple XP110 Backrest Accessories Upholstery backrest with zip fasten pocket XP170 Upholstery with individual embroidery $ $ (Please provide.jpeg file and positioning) Page 9
10 CUSHION XP080 $ Upholstery cushion foam with nylon cover Cushion foam soft Cushion foam medium Cushion foam hard (CMS040) (CMS050) (9lb recon) Cushion thickness 50 Cushion thickness 75 Cushion thickness 100 XP090 $ Upholstery cushion cover upgrade to Air Lite XP100 $ Upholstery cushion cover upgrade to leather Leather colour black Leather colour red Leather colour grey XR060 Accessory welded calf strap mounting loops $ (To locate calf strap on front frame) FRAME OPTIONS XR080 $ Accessory frontwheel assembly (Only with XB010, TGAXB080, XB150) Frontwheel serial number (Office use only) ACCESSORIES XP120 $ Upholstery frame protectors neoprene zip fasten with TIGA logo (Nylon with velcro fasten with XR060) XR010 $ Accessory seat pouch velcro attach (Black) XR020 $ Accessory large underseat storage bag (Black) XR090 XS060 Accessory toolkit Accessory calf strap Page 10
11 NOTES Page 11
Serial Number: Manufacturing Date: /20
Sunrise Medical Head Office: 237 Romina Drive, Unit 3 Concord, ON L4K 4V3, Canada Telephone: +1.800.263.3390 Fax:+1.800.561.5834 csrcanada@sunmed.com www.sunrise.ca Distributor Name: Dealers Name: Contact
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