q Little Wave Flip XP - Rigid Base KF-XPRIGID $

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1 Phone Fax Effective /06/207 Funder: Account Number: Date: Quote PO Number: Therapist: Marked For: Little Wave Flip XP - Rigid Base KF-XPRIGID $ 9.8kg weight capacity. One time free growth kit included. Little Wave Flip XP - Folding Base KFL-XPFOLDING $ 9.8kg weight capacity. One time free growth kit included. Ship To: Address: City: Post Code: Phone: /Fax: Notes: Frame Frame Width Select box corresponding to desired Frame Width Frame Width 0 2 Frame Depth Select Frame Depth in desired Frame Depth Range Frame Depth Frame Depth Range Short Medium - 8 Transit Option Transit System N/C Offset Hanger Option Offset Hanger $ Available only Rigid Base. Not available 2 Frame Depth. Tilt Mechanism Hand N/C Foot N/C Long 6-20 $ Backrest 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 N/C (Folding) Tall 2 Fixed Height Adjustable Handle (Folding) New! N/C Short 22 Tall 26 Adjustable Height Adjustable Handle (Folding) $ KFL8 Not available Seating Dynamics Rocker Back Stroller Handle Back Post Option Available only Stroller Handle Back Post Removable Stroller Handle Extension $ Short Tall Other Backrest Options Non Folding Back N/C Standard Seating Dynamics Rocker Back Seating Dynamics Rocker Back KFL $ Not available Flip Up Armrests. Available only Non Folding Back. Adjustable Height Rigidizer Bar KFL7 $ Pricing and specifications subject to change out notice Page of 7

2 Phone Fax Footrest Hanger / Front Frame Bend 60º N/C Available only Extension Tube Hangers 70º N/C 80º N/C Not available 8 Casters 90º N/C Available only Front Mount Hangers. Not available 8 Casters. Pro Elevating Leg Rests (PRO ELR) KFL20 New! $ Not available Frame Widths less than out Offset Hangers or Frame Widths less than 2 Offset Hangers Omit Hangers N/C Footplate Composite N/C Not available Front Mount Hangers, Frame Widths less than out Offset Hangers, Frame Widths less than 2 Offset Hangers or PRO ELR Composite Angle Adjustable KFL2- $ Not available Front Mount Hangers, ELR or 0-2 Frame Widths. and Frame Widths reuire Offset Hangers. Aluminum Angle Adjustable KFL2 $ One Piece Flip Up Angle Adjustable KFL22 $ Not available Front Mount Hangers, ELR, PRO ELR, Frame Widths less than out Offset Hangers or Frame Widths less than 2 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 2.5 shorter than Front Seat Height recommended. Extension Tube Hanger measurements based on 70º Hanger Bend. Footrest Extension Seat to Footrest Length Extension Tube Hangers (60º, 70º, 80º) Short Medium Long.5.5 Front Mount Hangers Short (70º, 80º, 90º) Medium (70º, 80º, 90º) Long (70º, 80º) Standard Selections Reuires Extension for $ Elevating Leg Rests (ELR) Extended Length ELR PRO ELR Low Pivot Short Long Short Long Short Long - 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 Hanger Length Short Medium Long Hanger Bend 70º 80/90º 70º 80/90º 70º 80º Minimum Front Seat Height Standard Selection Minimum Front Seat Height Extension Extension Available only Front Mount Hangers. Provided as parts. Extension for Front Mount Hanger KFL9 $ Pricing and specifications subject to change out notice Page 2 of 7

3 Phone Fax Footrest continued Heel Loop Heel Loops KFL2 $ Not available One Piece Flip Up Angle Adjustable Footplates, Frame Widths less than out Offset Hangers or Frame Widths less than 2 Offset Hangers Omit Heel Loops N/C Calf Strap Velcro Adjustable KFL26 $ Padded Velcro Adjustable KFL25 $ Bodypoint Padded AeroMesh KFL2 $ Residual Limb Support Residual Limb Support E020 Left KFL28 $ Right KFL29 $ Omit Left Hanger N/C Omit Right Hanger N/C Cover Smooth Air Mesh Smooth Air Mesh Pad Size 5 x 8 9 x 5 x 8 9 x 7 x 0 x 0 7 x 0 x 0 9 x 0 x 9 x 0 x Hanger Release If no selection is made -Way - In line will be used hangers or Classic will be used ELR and PRO ELR Classic Std -Way - In line New! N/C A See reference A to the right. Allows chair to be folded out removing footrest hanger. Not available ELR or PRO ELR. -Way - Out New! N/C See reference B to the right B Pricing and specifications subject to change out notice Page of 7

4 Phone Fax 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 2 Pneumatic or Pneumatic Airless Insert 2 Full Poly 6 Pneumatic, Pneumatic Airless Insert or Full Poly Caster Size x 2 New! x 2 Seat Height Low Poly Self Propel Axle Plate selections limit tilt 2 Not available 2 Frame Depth Not available 2-6 Frame Depth Not available 7-20 Frame Depth 5 Not available in combination Spoke Self Propel 22 Self Propel.5 range 2 Self Propel , x 2 Seat Height New! 6 x Drum Brake 5 Caster Size.5.5 Rear Wheel Size 9 7,8 wheels and Full Poly Rear Type Not available in combination Spoke wheels, Full Poly Rear Type and 7-20 Frame Depth 7 Not available in combination Mag wheels and 7-20 Frame Depth 8 Not available in combination Spoke wheels, Pneumatic tires and 7-20 Frame Depth Frame Depth reuires Spoke wheels and Full Poly Rear Type Pricing and specifications subject to change out notice Page of 7

5 Phone Fax Seat Height, Casters and Rear Wheels continued Caster Type Poly N/C Poly Aluminum KFL0 $ Not available 6, 7 and 8 Caster Sizes Pneumatic KFLA, KFL $ Not available 5 and 7 Caster Sizes.5 Poly KFL2, KFL2A $ Not available 7 and 8 Caster Sizes.5 Soft Roll Aluminum KFL, KFLA $ Not available 7 and 8 Caster Sizes 2 Poly KFL $ Not available 5, 7 and 8 Caster Sizes 2 Pneumatic w/ Foam Insert KFL5 $ Not available 5, 6 and 7 Caster Sizes Axle No selection needed Drum Brake Fixed N/C Not available Folding Base Frame and Standard Wheel Locks Quick Release N/C Rear Wheel Type Mag (Black) N/C Colored Mag KFL7 $ Available only in 20 and 22 rear wheels Color: Florescent Red White Blue Pink Spoke KFL8, KFL8A, KFL8B $ Not available in 2 or 6 rear wheels Wheel Locks Wheel Lock Push to Lock N/C Rear wheels must be removed to fold chair this wheel lock selection. Pull to Lock N/C Not available 2 or 6 Full Poly tires. Rear wheels must be removed to fold chair this wheel lock selection. Attendant Foot Lock N/C Available only 2 and 6 Mag wheels. Drum Brake KFL0 $ Not available Hand Tilt Mechanism. Available only 6 rear wheel. Axle is Quick Release. Omit Wheel Locks N/C Armrests Rear Type Full Poly N/C Low Poly New! N/C Available only 6 rear wheel Pneumatic KFL8 $ Pneumatic Airless Insert KFL9 $ Handrim Handrims not available on 2 or 6 rear wheels Standard Handrims Aluminum Anodized Std Plastic Coated KFL5 $ Projection (8 Vertical Projections) KFL52 $ Available on 2 rear wheel Omit Handrims N/C Natural Fit Handrims Not available on 20 rear wheel or 22 Mag wheels. Not recommended Mag wheels. Natural Fit LT Regular Grip $ Natural Fit Standard Regular Grip $ Natural Fit LT Super Grip $ Natural Fit Standard Super Grip $ Natural Fit LT Omit Grip $ Natural Fit Standard Omit Grip $ Handrim Option Not available on Plastic Coated or Projection Handrims M Micro Grip KFL5 $ Wheel Lock continued Dual - Attendant Foot Lock KFL0C $ Available only 2 and 6 Mag wheels. Rear wheels must be removed to fold chair this wheel lock selection. Push to Lock Pull to Lock Dual - Drum Brake KFL0A, KFL0B $ Not available Hand Tilt Mechanism. Available only 6 rear wheel. Axle is Quick Release. Rear wheels must be removed to fold chair this wheel lock selection. Push to Lock Pull to Lock Wheel Lock Options Extension Handles KFL55 $ Available only Push to Lock or Pull to Lock Wheel Locks. Armrests Please select Arm Pad option Height Adjustable Pediatric Desk (6.5-9 ) KFL $ Best fit Frame Depths less than Height Adjustable Pediatric Desk Tall (8-0.5 ) KFL2D $ Best fit Frame Depths less than Height Adjustable T-Arm ( ) KFL $ Not available 2 Frame Depth Height Adjustable T-Arm Low ( ) KFL $ Not available 2 Frame Depth Angle Adj. Locking Extendable Flip Up (9.5-5 ) KFL5 $ Not available Seating Dynamics Rocker Back Arm Pad Arm Pads not available Tubular Flip Up Armrest. Full Arm Pad not available Height Adjustable Pediatric Desk Armrests. Standard Arm Pad N/C Desk Full Waterfall Arm Pad KFL7 $ Desk Full Not available Angle Adjustable Locking Flip Up Extendable armrests Foam Grip N/C Desk Full Available only Angle Adjustable Locking Extendable Flip Up Armrest Armrests Continued Tubular Flip Up N/C Not available Seating Dynamics Rocker Back Omit Armrests N/C Pricing and specifications subject to change out notice Page 5 of 7

6 Phone Fax Accessories Removable Side Guard Not available Height Adjustable Armrests Adult Composite Side Guards ( - 6 ) KFL60 $ Pediatric Composite Side Guards (0 - ) KFL6 $ Positioning Belt Auto Buckle KFL6 $ Padded Auto Buckle KFL6 $ /2 Auto Buckle KFL65 $ /2 Padded Auto Buckle KFL66 $ 2 Airline Buckle KFL67 $ Bodypoint Evoflex - Pelvic Stabilizer KFL68 $ Size: Small (6-2 ) Medium (9-29 ) Large (25-7 ) Belt Mounting Kit Bodypoint Band Clamp Belt Mounting Kit KFL70 $ Seat Belt Mounting Hardware KFL70A $ Anti-Tip Rear Anti-Tips KFL72 $ Seat Pan Growing Solid Seat Pan KFL7 $ Spoke Guards Clear Spoke Guards KFL75 $ Not available Mag wheels Black Spoke Guards KFL76 $ Available only 22 and 2 Spoke wheels Designer Spoke Guards KFL77 $ Available only 20 and 22 Spoke wheels Design: Blue Monster Fairy Garden Havin a Hoot Robo Fun Rockin Reptiles Super Puppies Tutu Cute Other Accessories Tuxedo Time Tool Kit KFL80 $ Removable Underseat Pouch KFL8 $ Pediatric Ki Mobility Backpack KFL82- New! $ Ki Mobility Backpack KFL82 $ Black Neoprene Impact Guards KFL8 $ Tilt Stop (Pair) KFL8 $ Color Frame and Accent Select desired frame and accent colors. Accent color is used on side panel; if no accent color is selected, frame color will be used. Gloss Finish Frame Accent Matte Finish Frame Accent Black N/C Army Green N/C Blue Skies N/C Charcoal Gray N/C Bubblegum Pink N/C Emerald Green N/C Candy Blue N/C Iridescent Burgundy N/C Candy Purple N/C Iridescent Navy N/C Candy Red N/C Retro Red N/C Copper N/C Royal Blue N/C Fuchsia N/C Shadow Black N/C Granny Smith N/C Smooth White N/C Silver N/C Teal N/C Yellow N/C Pricing and specifications subject to change out notice Page 6 of 7

7 Phone Fax Half Tray Not compatible Tubular Flip Up Armrest 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 STEP : Choose Tray if Ordering Chair KCTRAY Chair Width Tray Dimension ( W x D ) Body Cutout ( W x D ) Price Communication Mount Hardware Choose Device Holder AND Mount STEP : What DEVICE will be used? Smart Phone WA8 $ Large Smart Phone WA857 $ I-Pad WA80 $ I-Pad Mini WA80. $ 7 Tablet WA80.2 $ 0 Tablet WA8 $ STEP 2: Where does it need to MOUNT? Armrest WA805. $ Not compatible Tubular Flip Up Armrest Tray WA806 $ 0 7 x x.5, H2.75 $ 7 x x.5 $ 7 x 5 8 x 5 $ 2 8 x x 5 $ 8 x x 5.5 $ 9 x x 5.5 $ 9 x x 6 $ 20 x x 6 $ 20 x 8.5 x 6.5 $ 5 2 x 8.5 x 6.5 $ 2 x x 7 $ 6 22 x x 7.5 $ 22 x 2.5 x 8.5 $ STEP 2: Choose Tray Hardware E-Z Lock Clamps, Tube Arm WA87 $ Available only Tubular Flip Up and Angle Adjustable Locking Extendable Flip Up Foam Grip Armrests. Sold in Pairs. E-Z Lock Clamps, Standard WA826 $ Not available Tubular Flip Up and Angle Adjustable Locking Extendable Flip Up Foam Grip Armrests. Sold in Pairs. Pricing and specifications subject to change out notice Page 7 of 7