Frame Width. Seating Setup. q 16 q 15 q 14 q 17 q 16 q 15 q 14 Short q 18 q 17 q 16 q 15 q 14 q 19 q 18 q 17 q 16 q 15 q 14

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1 Phone Fax Funder: Account Number: Date: Quote PO Number: Therapist: Marked For: Focus CR $ 36kg weight capacity. Tilt range: -5º anterior to 50º posterior. Effective /0/0 Ship To: Address: City: Post Code: Phone: /Fax: Notes: Frame Width Frame Width Range / Frame Width Select Frame Width in desired Frame Width Range Frame Width Frame Width Range Small 4-8 Medium 6-0 Large 8 - Seating Setup Make one selection from either Option at right or Option below based on desired seating setup OPTION : Setup By Frame Depth Select Frame Depth in desired Frame Depth Range Frame Depth Range Short 4-8 $ KF $ $ $ KF5 KF6 KF Frame Depth OPTION : Setup By Ki Mobility Select Seat Depth corresponding to desired Frame Depth Range row and Backrest Offset column. Note: All Seat Depths in a column and in the same frame depth range are achievable future adjustment. Backrest Offset A Frame Depth - - Flush Range Seat Depth Short Medium Long Price is $ Price is $ A Medium 6-0 Long 8 - $ KF8 $ $ $ KF8 KF9 KF0 Back Canes Rearward Flush Forward 4 Forward Front of Chair Pricing and specifications subject to change out notice Page of

2 Phone Fax Frame Options Heavy Duty Option kg Weight Capacity KF $ Available only Long Frame Depth Range and 8 x or 6 x Casters Transit Option (Tie Downs) Transit System KF3 $ Tilt Mechanism Hand Hand Tilt - Right Hand Tilt - Left Hand Tilt - Dual Foot Foot Tilt - Right Foot Tilt - Left Backrest Offset Hanger Option Offset Hanger KF4 $ Tilt Stop included. No anterior tilt. Vent and Battery Tray Not available on 4 or 5 Frame Widths, Foot Tilt Mechanism, Attendant Foot Lock or 5 casters. Reuires minimum 6 Seat Height. Vent Tray KFA $ Reuires Anti-Tip Battery Box Holder KFB $ Power Tilt Not available Vent Tray, Battery Box Holder or Heavy Duty Option. Includes anterior and posterior tilt stops. Power Tilt - Right KFA $ Power Tilt - Left KFA $ Interface for Adaptive Switching New! $ Back Post / Height Range / Back Height Select Back Height in row corresponding to desired Back Post and Height Range Back Post Price Height Range Back Height Stroller Handle Short Back Post (Folding) Tall 4 Fixed Height Adjustable Handle (Folding) New! Short Tall 6 Adjustable Height Adjustable Handle (Folding) $ Short, KF3D Tall Reclining Back Adjustable Handle, (Non-folding) $ KF Short Tall 6 Not available O Holder Not available Seating Dynamics Rocker Back Stroller Handle Back Post Option Available only Stroller Handle Back Post Removable Stroller Handle Extension KF3B $ Other Backrest Options Non Folding Back Standard Reclining Back and Seating Dynamics Rocker Back Seating Dynamics Rocker Back KF3 $ Not available Angle Adjustable Locking Extendable Flip Up Armrests, Heavy Duty Option or Reclining Backrest. Available only Non Folding Back. Adjustable Height Rigidizer Bar KF3C $ Footrest Hanger / Front Frame Bend 60º Available only Extension Tube Hangers 0º 80º Not available or 8 Casters 90º Available only Front Mount Hangers. Not available or 8 Casters. Reclining Backrest Options Select options below if Reclining Back is selected on chart above Recline Angle: 0º - 65º KFA 0º - 5º KFA º - 85º KFA Gas Spring: Standard Spring Heavy Duty Spring Elevating Leg Rests (ELR) KF33 $ Pro Elevating Leg Rests (PRO ELR) KF35 New! $ Omit Hangers Pricing and specifications subject to change out notice Page of

3 Phone Fax Footrest continued Footplate Composite Not available Front Mount Hangers or PRO ELR Composite Angle Adjustable KF3 $ Not available Front Mount Hangers, ELR or 4 Seat Width out Offset Hangers Aluminum Angle Adjustable KF3 $ One Piece Flip Up Angle Adjustable KF38 $ Not available Front Mount Hangers, ELR, PRO ELR or or Seat Widths in combination Offset Hangers Footrest / Extension / Seat to Footrest Length Select Seat to Footrest Length in row corresponding to desired Footrest and Extension. Footrest Length of at least.5 shorter than Front Seat Height recommended. Extension Tube Hanger measurements based on 0º Hanger Bend. Footrest Extension Seat to Footrest Length Extension Short Tube Hangers Medium (60º, 0º, 80º) Long.5.5 Front Mount Hangers Short (0º, 80º, 90º) Medium (0º, 80º, 90º) Long (0º, 80º) Standard Selections Reuires 3 Extension Elevating Leg Rests (ELR) Extended Length ELR PRO ELR Low Pivot Short Long Short Long Short Long 3-9 PRO ELR Short High Pivot Long Available only Aluminum Angle Adjustable Footplates. See Minimum Front Seat Height chart below. Minimum Front Seat Height Front Mount Hangers 3 Extension Hanger Length Short Medium Long Hanger Bend 0º 80/90º 0º 80/90º 0º 80º Minimum Front Seat Height Standard Selection Minimum Front Seat Height 3 Extension Heel Loop Heel Loops KF40 $ Not available One Piece Flip Up Angle Adjustable Footplate Omit Heel Loops Calf Strap Velcro Adjustable KF43 $ Padded Velcro Adjustable KF44 $ Bodypoint Padded AeroMesh KF45 $ Available only Front Mount Hangers. Provided as parts. 3 Extension for Front Mount Hanger KFL9 Residual Limb Support Residual Limb Support KF3A Left $ Right $ Omit Left Hanger Cover Omit Right Hanger Smooth Air Mesh Smooth Air Mesh Pad Size 5 x 8 9 x 4 5 x 8 9 x 4 x 0 x 0 x 0 x 0 9 x 0 x 4 9 x 0 x 4 Pricing and specifications subject to change out notice Page 3 of

4 Phone Fax Footrest continued Hanger Release If no selection is made Classic Hanger Release will be used Classic 4-Way - In line New! A Std B See reference A to the right. Not available ELR or PRO ELR. 4-Way - Out New! See reference B to the right Seat Height, Casters and Rear Wheels Seat Height / Caster Size / Rear Wheel Size Select Seat Height corresponding to desired Rear Wheel and Caster Size Rear Wheel Size 5 Pneumatic or Pneumatic Airless Insert 5 Full Poly 6 6 Pneumatic, Pneumatic Airless Insert or Full Poly Caster Size x 8 8 x Seat Height Rear Wheel Size Drum Brake Low Poly x 8 8 x Seat Height Pricing and specifications subject to change out notice Page 4 of Caster Size Available only Full Poly tire Not available Full Poly tire 3 Available only spoke wheel and Full Poly tire combination 4 Not available spoke wheel and Full Poly tire combination 5 Not available Vent and Battery Tray combination 6 Seat heights higher than rear wheel are not available Vent and Battery Tray combination Not available Heavy Duty Option

5 Phone Fax Seat Height, Casters and Rear Wheels continued Caster Type Poly Poly Aluminum KF60 $ Not available 6, or 8 Caster Sizes Pneumatic KF69 $ Not available 5 and Caster Sizes.5 Poly KF6 $ Not available and 8 Caster Sizes.5 Soft Roll Aluminum KF63 KF6 $ Not available and 8 Caster Sizes Poly KF68 $ Not available 5, or 8 Caster Sizes Pneumatic w/ Foam Insert KF0 $ Not available 5, 6 or Caster Sizes One Arm Drive One Arm Drive E0958 $ Available only 4 Mag wheels. Not available Vent Tray, Battery Box Holder or Self Propel Axle Plate. Standard Handrim will be Aluminum Anodized. Axle not uick release. Drive Handrim Side: Left Right Drive Handrim Type: Aluminum Poly Coated KF555B $ Axle No selection needed One Arm Drive or Drum Brake Fixed Quick Release Self Propel Axle Plate Self Propel Axle Plate KF48A $ Not available Vent Tray or or 6 rear wheels Wheel Locks Wheel Lock Push to Lock Pull to Lock Not available or 6 Full Poly tires Attendant Foot Lock KF5 $ Drum Brake KF58 $ Not available Hand Tilt Mechanism or Reclining Backrest or 6" Low Poly tire. Axle is Quick Release. Omit Wheel Locks Armrests Rear Wheel Type Mag 4 Spoke $ Rear Type Full Poly Low Poly KF49 Available only 6" rear wheel Pneumatic Pneumatic Airless Insert $ Handrim Handrims not available on or 6 rear wheels. No selection needed One Arm Drive Standard Handrims Aluminum Anodized Std Plastic Coated KF53 $ Projection (8 Vertical Projections) KF5 $ Available on 4 rear wheel Omit Handrims Natural Fit Handrims Not available on 0 rear wheel or Mag wheels. Not recommended Mag wheels. Natural Fit LT Regular Grip KF5 $ Natural Fit Standard Regular Grip KF5A $ Natural Fit LT Super Grip KF5B $ Natural Fit Standard Super Grip KF5C $ Natural Fit LT Omit Grip KF5D $ Natural Fit Standard Omit Grip KF5E $ Handrim Option Not available on Plastic Coated or Projection Handrims 3M Micro Grip KF50 $ Wheel Lock continued Combination Attendant Foot Lock KF5. $ Available only or 6 rear wheels. Includes Extension Handles. Push to Lock only. Dual - Drum Brake KF58A KF58B $ Not available Hand Tilt Mechanism, Reclining Backrest or 6" Low Poly tire. Axle is Quick Release. Push to Lock Pull to Lock Wheel Lock Options Extension Handles E096 $ Available only Push to Lock or Pull to Lock Wheel Locks. Armrest Please select Arm Pad option Height Adjustable T-Arm (8-3 ) KF4D KF4F $ Not available Heavy Duty option Height Adjustable T-Arm Low ( ) KF4D KF4F $ Not available Heavy Duty option Height Adj. Dual Post Flip Back ( ) KF5D KF5F $ Angle Adjustable Locking Extendable Flip Up KF6D KF6F $ Not available Seating Dynamics Rocker Back or Heavy Duty option. Minimum armrest height Reclining Backrest is. Arm Pad Standard Arm Pad Desk Full Waterfall Arm Pad KF30 $ Desk Full Not available Angle Adjustable Locking Extendable Flip Up Armrests Foam Grip Desk Full Available only Angle Adjustable Locking Extendable Flip Up Armrest Omit Armrests Pricing and specifications subject to change out notice Page 5 of

6 Phone Fax Accessories Removable Side Guard Composite Side Guards KF9 $ Not available T-Arm or Dual Post Flip Back Armrests Anti-Tip Rear Anti-Tips KF $ Reuired Reclining Backrest and Vent Tray Positioning Belt / Auto Buckle KF3 $ / Padded Auto Buckle KF4 $ Airline Buckle KF5 $ Bodypoint Evoflex - Pelvic Stabilizer KF6S KF6M KF6L $ Size: Small (6-4 ) Medium (9-9 ) Large (5-3 ) Belt Mounting Kit Ki Mobility Belt Mounting Brackets KFB $ Bodypoint Band Clamp Belt Mounting Kit KFBC $ Seat Pan Growing Adjustable Aluminum Seat Pan KF $ O Holder O Holder KFC $ Not available Reclining Backrest or Rocker Back Other Accessories Tool Kit KF80 $ Removable Underseat Pouch KFL8 $ Ki Mobility Backpack KF8 $ Black Neoprene Impact Guards KF8 $ Clear Spoke Guards KF83 $ Available only Spoke wheels Black Spoke Guards KF84 $ Available only Spoke wheels Tilt Stop (Pair) KF85 $ Included Offset Hangers IV Pole KF86 $ Frame Color Gloss Finish Black Blue Skies Bubblegum Pink Candy Blue Candy Purple Candy Red Copper Fuchsia Granny Smith Yellow Matte Finish Army Green Charcoal Gray Emerald Green Iridescent Burgundy Iridescent Navy Retro Red Royal Blue Shadow Black Smooth White Pricing and specifications subject to change out notice Page 6 of

7 Phone Fax Half Tray Power tilt switch may interfere standard trays Standard Shape, Clear, Flip-Away KHTCFA $ Right Side Left Side Standard Shape, Padded, Flip-Away KHTPLA $ Right Side Left Side Trimline Shape, Padded, Flip-Away KHTPFA $ Right Side Left Side Clear Tray Border and Pre-Drilled Holes Power tilt switch may interfere standard trays STEP : Choose Tray Chair Width Tray Dimension ( W x D ) Body Cutout ( W x D ) Price 0 x x 6 $ 0 x 8.5 x 6.5 $ x 8.5 x 6.5 $ x 8.5 x $ x.5 x.5 $ x 3.5 x 8.5 $ 3.5 x 3.5 x 8.5 $ 3.5 x 4.5 x 9.5 $ 4.5 x 4.5 x 9.5 $ 4.5 x 5.5 x 0.5 $ 6.5 x 5.5 x 0.5 $ 6.5 x 6.5 x $ 6.5 x x $ 6.5 x 8 x $.5 x x $.5 x x $ 8.5 x x $ 8.5 x x $ Communication Mount Hardware Choose Device Holder AND Mount STEP : What DEVICE will be used? Smart Phone WA84 $ Large Smart Phone WA85 $ I-Pad WA80 $ I-Pad Mini WA80. $ Tablet WA80. $ 0 Tablet WA83 $ STEP : Where does it need to MOUNT? Frame WA805 $ Armrest WA805. $ Tray WA806 $ Cup Holder Heavy Duty WA85 $ Compatible only Height Adjustable Dual Post Flip Back Armrests STEP : Choose Tray Hardware E-Z Lock Clamps, Tube Arm WA83 $ Available only Angle Adjustable Locking Extendable Flip Up Foam Grip Armrest. Sold in Pairs. E-Z Lock Clamps, Standard WA86 $ Not available Angle Adjustable Locking Extendable Flip Up Foam Grip Armrest. Sold in Pairs. Pricing and specifications subject to change out notice Page of