Orderform UK / IR Valid from Version 2.1 LUCA QLASS. Date:

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1 LUCA QLASS 1 / 8 0,8 Dealer: Date: Reference No.: Quantity: Delivery address: Basic configuration Excluding VAT - 4mph/6 km/h RWD - Fixed joystick bracket, right hand - PU side cushions - Drive wheels 14", air - Shark Drive only - Lapstrap standard 190 cm - Castor wheels 9", air - Standard contour seat, 46 X 48 cm - Anti-tip - Frame type "Standard" - Contour standard backrest, 46 X 50 cm - Suspension on the drive wheels - Frame colour: Dark grey - Standard swingaway legrests with calf straps - 4 sets of coloured covers - Batteries: 50 Ah (C20) AGM - Armrests standard removable - Battery charger 8A -24 V - Armpads PU Price Price Art. no. Rear wheel drive Maximum user weight : 160 kg. S = Standard (base configuration) Transport brackets: ISO RWD Basic Basic B S 4mph/6 km/h Luca RWD B mph/10 km/h Luca RWD* Recommended with DX2 or R-net * also choose lights and mirror B Kerb climber Not possible with central mounted legrest FWD Price Price Art. no. Front Wheel Drive 0 0 B mph/6 km/h Luca FWD B mph/10 km/h Luca FWD* Highly recommended with Gyro-Qontrol * also choose lights and mirror MWD Price Price Art. no. Mid Wheel Drive B Mid-Wheel drive 0 0 B mph/6 km/h Luca MWD B mph/10 km/h Luca MWD * also choose lights and mirror B Gyro-Qontrol Only with DX2 or R-net

2 2 / 8 Price Price Art. no. BASE FRAME Drive wheels 0 0 B Drive wheels 12", air Indoor wheels, only with 8" castor wheels B Drive wheels 12", puncture proof Indoor wheels, only with 8" castor wheels Basic Basic B S Drive wheels 14", air Outdoor wheels B Drive wheels 14", puncture proof Outdoor wheels Castor wheels 0 0 B Castor wheels 8", air B Castor wheels 8", puncture proof Basic Basic B S Castor wheels 9", air B Castor wheels 9", puncture proof Anti-tip wheels 0 0 B Anti-tip wheels 6", puncture proof Only MWD Mudguards B Mudguards drive wheels 14" B Mudguards castor wheels 9" Frame type Basic Basic B S Luca frame type "Standard" Maximum 60 Ah batteries 0 0 B Luca frame type "Max" Maximum 78 Ah batteries; min. seat height + 3 cm Frame colour Basic Basic B S Dark grey B White B Red With black coloured covers B Blue With black coloured covers B Purple B Custom (spray) colour, please specify Mono-colour, RAL: Batteries & charger Basic Basic B S 50 Ah (C20) AGM B000006A 60 Ah (C20) GEL B000007A 78 Ah (C20) GEL Choose also frame type "Max" Basic Basic B000363A S Battery charger 8A -24 V Price Price Art. no. POWERED SEAT OPTIONS & LIGHTS B Qlass, powered seat lift with powered tilt in space!seat height +4.0 cm + 2 actuators B Qlass, powered tilt in space 45 (No influence on the seat height) + 1 actuator B Qlass, powered seat lift (30 cm)!seat height +4.0 cm + 1 actuator B Qlass, powered backrest recline actuator B Powered elevating legrests With depth adjustable PU calfplates + 2 actuators, Other legrests and options, see: Qlass legrests B Powered central legrest Limitation legrest angle depending on + 2 actuators configuration (RWD + MWd). Limited ground clearance at the lowest seat heights B Lights & indicators

3 3 / 8 Price Price Art. no. CONTROLS Dynamic Basic Basic Basic B S Shark Drive only 0 actuators, no lights B Shark Lights 0 actuators, lights Dynamic Advanced B DX2 REM 420, LED 4 actuators, lights B DX2 REM 550, Colour LCD 6 actuators, lights B DX 12-keys flat (Tray control) 5 actuators, lights Also choose a tray PGDT Advanced B R-net LED B R-net Colour LCD 6 actuators, lights B R-net Tray control 6 actuators, lights Mounting Basic Basic B S Right hand B Left hand Basic Basic B S Fixed joystick bracket B Swingaway mounting bracket B Flip down joystick bracket B Mushroom knob B U-Grip vertical B U-Grip horizontal B Dual control right On backframe B Dual control left On backframe B Push button switch small, red Only with DX2 or Rnet B Push button switch small, green Only with DX2 or Rnet B Push button switch big, red Only with DX2 or Rnet B Push button switch big, green Only with DX2 or Rnet

4 4 / 8 Price Price Art. no. SEAT HEIGHT Seat height (floor to top seat frame in cm) Frame type: 'standard' 60 Ah batteries 12" wheels std. or Lift or 45 tilt Lift & tilt 14" wheels std. or Lift or 45 tilt Lift & tilt Frame type: 'max' 78 Ah batteries 12" wheels std. or Lift or 45 tilt Lift & tilt Basic Basic B S pos.1 40,0 44,0 41,0 45,0 43,0 47,0 44,0 48,0 B pos.2 42,5 46,5 43,5 47,5 45,5 49,5 46,5 50,5 B pos.3 45,0 49,0 46,0 50,0 48,0 52,0 49,0 53,0 std. or 45 tilt 14" wheels Lift or Lift & tilt Price Price Art. no. SEATS Seat width X depth B X 48 cm Basic Basic B S 46 X 48 cm B X 48 cm B X 48 cm Dimensions seat cushion B B B B X 55 cm 46 X 55 cm 50 X 55 cm 54 X 55 cm Seat type Basic Basic B000592A S Standard contour seat 7 cm, ProSkin (vinyl) upholstery B Support seat, anatomic form Partially strapped, 9 cm, stretch rubber upholstery B Support seat Visco, anatomic form, Partially webbed, 9 cm, stretch rubber upholstery part. memory foam B Balance seat, trochanter support 9 cm, stretch rubber upholstery 0 0 B Seat board, flat 2 cm B Seat board, with cushion guide, rear 2cm, depth adj.cushion guide, rear B Seat board, with cushion guide, front & rear 2cm, depth adj.cushion guide, rear (front guide: 55 mm ) B Partially strapped Only in combination with the seat boards above B Q-Tone fabric seat upholstery Instead of ProSkin or stretch rubber upholstery P.O.R. P.O.R. B Different dimensions cushion Please write desired deviation at the remarks B No seat B Abduction support (12 x 12 x 7 cm) Not with central legrest

5 5 / 8 Price Price Art. no. BACKRESTS Backrest width X height B X 50 cm Basic Basic B S 46 X 50 cm B X 50 cm B X 50 cm Dimensions backrest cushion B B B B X 57 cm 46 X 57 cm 50 X 57 cm 54 X 57 cm Backrest type Basic Basic B S Contour standard backrest ProSkin (vinyl) upholstery B Contour backrest, with inflatable lumbar support ProSkin (vinyl) upholstery B Contour backrest, with vertical elastic straps Q-Tone (fabric) upholstery B Contour backrest, with horizontal adj. straps Q-Tone (fabric) upholstery B Deep contour backrest ProSkin (vinyl) upholstery B Deep contour backrest, with vertical elastic straps Q-Tone (fabric) upholstery B Deep Contour backrest, with horizontal. adj. Straps Q-Tone (fabric) upholstery B Deep contour backrest, with horizontal adj. Straps, Flex Q-Tone (fabric) upholstery B Extra deep contour backrest, with horizontal adj. Straps Q-Tone (fabric) upholstery B Q-Tone fabric backrest upholstery Instead of ProSkin P.O.R. P.O.R B Different size backrest Please write desired deviation at the remarks B No backrest B Thoracic support right, settable (17 x 15 x 4 cm), not with flip-up armrests B Thoracic support left, settable (17 x 15 x 4 cm), not with flip-up armrests B Shoulder support right, settable (24 x 17 x 3,5 cm), not with flip-up armrests B Shoulder support left, settable (24 x 17 x 3,5 cm), not with flip-up armrests B Shoulder support right, fixed (24 x 17 x 3,5 cm), not with flip-up armrests B Shoulder support left, fixed (24 x 17 x 3,5 cm), not with flip-up armrests

6 6 / 8 Price Price Art. no. LEGRESTS Central legrest 0 0 B Central legrest Settable angle, Limitation legrest angle depending on configuration (RWD + MWD) B Calfplate upholstered Only for central legrest Swingaway legrests Basic Basic B S Standard swingaway legrests with calf strap B Standard swingaway legrests with calf plates With depth adjustable PU calfplates B Comfort legrests With depth adjustable PU calfplates B Calfplates upholstered instead of PU 190 x 190 x 55 mm B Kneepad right B Kneepad left B Canvas heel support right B Canvas heel support left B Toestrap right B Toestrap left B Amputation support right B Amputation support left

7 7 / 8 Price Price Art. no. ARMRESTS Armrests Basic Basic B S Armrests standard removable Height, width & depth settable, quick release B Flip-up armrests, set not with armrest hemiplegia and/or thoracic support B Armrests angle adjustable, set not with armrest hemiplegia Armpads Basic Basic B S Armpad PU, right 340 x 80 x 25 mm Basic Basic B S Armpad PU, left 6 5 B Armpad upholstered 30 cm right 300 x 80 mm 6 5 B Armpad upholstered 30 cm left 6 5 B Armpad upholstered 40 cm right 400 x 80 mm 6 5 B Armpad upholstered 40 cm left 6 5 B Armpad P-shape upholstered right 400 x 120 mm 6 5 B Armpad P-shape upholstered left B Armpad hemiplegia right B Armpad hemiplegia left Side cushions Basic Basic B000170A S PU side cushion, right Basic Basic B000589A S PU side cushion, left 7 6 B Side cushion padded, right 7 6 B Side cushion padded, left B Side cushion wedge-shaped, right B Side cushion wedge-shaped, left Price Price Art. no. HEADRESTS Metal parts B Adjustable metal bracket B Width adjustable metal bracket B Metal bracket with quick release levers Headrest cushions B PU small B Padded small B Padded flexible small B Padded flexible big

8 8 / 8 Price Price Art. no. TRAYS Mounting side B Right Not with joystick side right B Left Not with joystick side left Trays B Tray with joystick recess B Tray for tray control B College tray B Partial padding Not with elbow pads B Raised edges acrylic B Elbow pads Not with partial padding Price Price Art. no. ACCESSORIES Basic Basic B S Lapstrap standard 190 cm B Lapstrap longer 290 cm 0 0 B Mirror on joystick side 0 0 B Mirror not on joystick side B Cane/crutch holder for two walking canes B Frame preparation for Dahl docking station Only for FWD REMARKS

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