AES Custom Seating January 2019

Transcription

1 Mark Fr: Submitting fr: Qute Order Date: PO#: Dealer Acct #: Dealer ity: ST: Dealer Phne: ( ) Fax: ( ) ZIP: nfirmatin Ship T ity: ST: nfirm Via: Fax Ship T Phne: ( ) Fax: ( ) a Optin # HPS Definitin Price a Optin # HPS Definitin Price Seat Back Frame Width: Depth: Push Handle Ht: hair Type: Manual Pwer Installatin: T Frame Hinges: Dealer: Dealer ntact: Dealer Address: Mdel: lr: Tubing Size Mdel: 1.5" 3" Adj. Full Width Munt: Back Seat Btwn Rail Munt: Back Seat Mngram: MOD5900 BLOK MOD5901 SRIPT AES ustm Seating January 2019 Ship T: Attentin: Address: Address: ADDITIONAL SHIPPING INFORMATION The HPS ODES prvided are based n cde verificatin thrugh PDA r ur interpretatin f the cde definitins. The use f HPS ODES des nt ensure cverage r payment. Fr cverage infrmatin, verify the apprpriate payer's cverage plicy. Thank yu fr chsing AES. In rder t cmplete yur rder please cmplete the 3 sectins belw. - (1) Wheelchair Infrmatin - (2) lient Measurements - (3) Seat Dimensins After cmpleting these three sectins please select yur desired Seating System Package. (Seat & Back Package r Seat and/r Back Packages). Next yu can select frm all f ur mdificatins t custmize the size, shape, fam, and cuntless thers t fit yur clients unique needs. Then if needed pick frm a selectin f Lateral Supprts (Thracic, Medial, etc.). Once yur seating system is cmplete dn't frget abut Anterir Trunk Supprts, Pelvic Supprts, Knee Supprts, She Hlders, and much mre. Of curse if yu have any questins please feel free t cntact ur experienced ustmer Service Team t help cmplete yur AES rder. 1. WHEELHAIR INFORMATION (REQUIRED) 3. SEAT DIMENSIONS 3/4" 7/8" Flush Bk t Seat 1" 1-1/8" X-ape Offset Bk t Seat Insert Measurements Fr Figure 3.1 in the ircles Prvided ZIP: Name: Thread lr: lient ntact Surface: lient ntact lr: A. Seat Width E. Usable Seat Depth Nn-cntact Surface: (Std) Black Other (specify) B. Back Width F. Ttal Seat Depth Naugahyde. Distance Between Thracic Laterals G. Back Height 2. LIENT MEASUREMENTS D. Distance Between Pelvic Laterals H. Seat t Tp f Lateral Thracic Pad Insert Measurements Fr Figure 2.1 in the ircles Prvided Figure Seat Dimensins NOTES: A. Shulder Width G. Seat t AXILLA B. hest Width H. Seat t PSIS. Hip Width K. hest Depth D. Width at Knee L. Back t Anterir f ITs E. Seat t TOP f head M. Seat Depth F. Seat t TOP f Shulder N. Seat t Ft Plate Figure lient Measurements ustmer Service: Fax: rders@sunmed.cm Web: Page 1

2 SEATING SYSTEMS PAKAGES (Seat & Back) PKG10XX E2609/E2617 Universal/E-Z Munt Seating Package $1,330 PKG11XX E2609/E2617 Universal Munt Seating Package A SBP10XX Slid Back Insert A SBP10XX Slid Back Insert B SSP10XX Slid Seat Insert 0 B SSP10XX Slid Seat Insert HDW1025 Std Seat T Back brkt $220 HDW1025 Std Seat T Back brkt D HDW6850 1" EZ Mnt Brackets (2) 2x $95 D HDW6810 Unvrsl Seat lamp (2) 2x E HDW6853 Fixed EZ mnt brkts (2) 2x $75 D HDW6813 Std Seat L brkt (2) 2x F HDW6820 Unvrsl Back lamp (2) 2x $120 E HDW6820 Unvrsl Back lamp (2) 2x F HDW6823 Std Back L Bracket (2) $70 E HDW6823 Std Back L Bracket (2) 2x Nte: Adjustment range up t 3" drp and up t 7" frward adjustment. F HDW6303 Std Seat Tabs (2) 2x Nte: Seat t Back Brackets can limit adjustment range. Nte: Hardware change required if urved Back (MOD5500/5501/5502) is selected. Nte: Please select tubing size required 3/4", 7/8", and 1". Nte: When W20 is added apprpriate transit apprved hardware must be selected. Nte: Hardware change required if urved Back (MOD5500/5501/5502) is selected. $1,404 0 $220 $125 $35 $120 $70 $12 PKG13XX E2609/E2617 Universal Space-Saver Seating Package $1,394 PKG20XX E2609/E2617 Adj J Hk Bracket Seating Package $918 A SBP10XX Slid Back Insert A SBP10XX Slid Back Insert B SSP10XX Slid Seat Insert 0 B SSP10XX Slid Seat Insert 0 HDW1025 Std Seat T Back brkt $220 HDW1025 Std Seat T Back brkt $220 D HDW6820 Unvrsl Back lamp (2) 2x $120 D HDW Hle J Hk (4) 4x $16 D HDW6813 Std Back L brkt (2) 2x $35 E HDW Hle L brkt (4) 4x $18 E HDW6820 Unvrsl Back lamp (2) 2x $120 F HDW Hle J Hk 1" (2) 2x $15 E HDW6823 Std Back L Bracket (2) 2x $70 G HDW Hle L brkt (2) 2x $16 F HDW6303 Std Seat Tabs (2) 2x $12 H HDW6430 Seat Stp (2) Nte: Hardware change required if urved Back (MOD5500/5501/5502) is selected. I HDW6465 Stp w/ Rtatn Hld (2) Nte: Please select tubing size required 3/4", 7/8", and 1". Nte: Hardware change required if urved Back (MOD5500/5501/5502) is selected. Nte: When W20 is added apprpriate transit apprved hardware must be selected. Nte: Between rail r full width back ptin available. Nte: X-Brace cut ut may need t be added (MOD4175) additinal charges will apply. Nte: Please select tubing size required 3/4", 7/8", 1", 1-1/8", r Xcape Tubing. PKG23XX E2609/E2617 Ind Adj J Hk brkt Seating Package $936 PKG30XX E2609/E2617 E-Z Munt Seating Package $1,230 A SBP10XX Slid Back Insert A SBP10XX Slid Back Insert B SSP10XX Slid Seat Insert 0 B SSP10XX Slid Seat Insert 0 HDW1025 Std Seat T Back brkt $220 HDW1025 Std Seat T Back brkt $220 D HDW6300 Flush Hks (4) 4x $15 D HDW6850 EZ Mnt w brkt (4) 4x $95 E HDW6310 Spacer (4) 4x $12 E HDW6853 EZ Mnt Fix brkt (2) 2x $75 F HDW Hle J Hk (2) 2x $16 F HDW6465 Stp w/ Rtating Hld (2) G HDW Hle L brkt (2) 2x $18 H HDW6430 Seat Stp (2) 2x I HDW6465 Stp w/ Rtatn Hld (2) 2x Nte: Please select tubing size required 3/4", 7/8", and 1". Nte: Hardware change required if urved Back (MOD5500/5501/5502) is selected. Nte: urved back (MOD5501/MOD5502) use HDW6856. Nte: Between rail r full width back ptin available. Nte: Seat hardware accmmdates up t 1-1/4" drp adjustment. Nte: Please select tubing size required 3/4", 7/8", 1", 1-1/8", r Xcape Tubing. Nte: Back hardware accmmdates up t 1-3/8" frward adjustment. SEAT PAKAGES SSK10XX E2609 Universal / E-Z Munt Seat Package $710 SSK17XX E2609 Universal Munt Seat Package $544 A SSP10XX Slid Seat Insert 0 A SSP10XX Slid Seat Insert 0 B HDW6810 Unvrsl Seat lamp (2) 2x $125 B HDW6303 Std Seat Tabs (2) 2x $12 B HDW6813 Std Back L brkt (2) 2x $35 HDW6810 Unvrsl Seat lamp (2) 2x $125 HDW6850 1" EZ Munt brkts (2) 2x $95 HDW6813 Std Back L brkt (2) 2x $35 Nte: nfigured t be rdered with SBK17XX. Nte: When W20 is added apprpriate transit apprved hardware must be selected. Nte: When W20 is added apprpriate transit apprved hardware must be selected. Nte: MOD4800 Seat Rail Fam Overlay nt available with Transprt Optin. SSK20XX E2609 Adj J Hk & Rtate Hld Seat Package $302 A SSP10XX Slid Seat Insert 0 A SSP10XX Slid Seat Insert B HDW Hle J Hk 1" (2) 2x $15 B HDW6850 1" EZ Munt brkts (4) 4x HDW Hle L brkt (2) 2x D HDW6460 Stp w/ Fixed Hld (2) E HDW6465 Stp w/ Rtating Hld (2) $16 SSK30XX E2609 E-Z Munt Seat Package $580 0 $95 Nte: Optinal Full width ptin available Via 2 Hle J Hk and 5 Hle L Bracket. Nte: MOD4175 Mid-seat utut fr X-Braces is included. SSK50XX E2609 Drp Hk & Rtate Hld Seat Package $288 SSK55XX E2609 Flush Hk & Rtate Hld Package $348 A SSP10XX Slid Seat Insert 0 A SSP10XX Slid Seat Insert 0 B HDW /2" Drp Hks (4) 4x $12 B HDW6300 Flush Hks (4) 4x $15 HDW6460 Stp w/ Fixed Hld (2) HDW6310 Spacer (4) 4x $12 D HDW6465 Stp w/ Rtating Hld (2) D HDW6460 Stp w/ Fixed Hld (2) E HDW6465 Stp w/ Rtating Hld (2) Nte: 1-1/2" drp is standard, specify if ther is required. ustmer Service: Fax: rders@sunmed.cm Web: Page 2

3 SBK10XX BAK PAKAGES E2617 Universal Munt Back Package $880 SBK12XX E2617 Drp Hk & Fixed Hlds(Between) $348 A SBP10XX Slid Back Insert A SBP10XX Slid Back Insert B HDW6820 Unvrsl Back lamp (4) 4x $120 B HDW /2" Drp Hks (4) 4x $12 B HDW6823 Std Back L brkt (4) 2x $70 HDW6460 Stp w/ Fixed Hld (4) 2x Nte: Up t 3" rear adjustment Nte: Up t 7" frward adjustment can be attained by reversing rientatin f clamp bracket (B). Nte: When W20 is added apprpriate transit apprved hardware must be selected. Nte: Munts between back uprights. Nte: Nt recmmended fr use with URVED Wd backs, please use MOD5530 urved Fam. Nte: Standard hardware has 1-1/2" drp. Specify if ther is required. SBK20XX E2617 Adj J Hk & Fixed/Rtate Hld $436 SBK24XX E2617 Munt Hk & Fixed Hld (Frward) $420 A SBP10XX Slid Back Insert A SBP10XX Slid Back Insert B HDW Hle J Hk (4) 4x $16 B HDW6331 Mnting Hk 1" Lift (4) 4x $30 HDW Hle L brkt (4) 4x $18 HDW6460 Stp w/ Fixed Hld (4) 2x D HDW6460 Stp w/ Fixed Hld (2) E HDW6465 Stp w/ Rtate Hld (2) Nte: Munts frward f back uprights. Nte: Std 7-Hle L brkt allws fr up t 1" drp and up t 1-1/2" frward adjustment & mnts frward f back uprights. Nte: Optinal between uprights available (6-Hle J-Hk allws fr drp range: 7/8" up t 3") Nte: If rdering a urved back (MOD5500) switch bracket t 110 degree (HDW6175), r use urved Fam (MOD5530) instead. Nte: Standard 1" f Lift Nte: Nt recmmended fr use with URVED backs, please use MOD5530 urved Fam. SBK25XX E2617 E-Z Munt Back Package $490 A SBP10XX Slid Back Insert B HDW6850 EZ Mnt w brkt (4) 2x $95 HDW6465 Stp w/ Rtate Hld (4) 2x Nte: 10 t 15 angle adjustment Nte: Up t 1-3/8" drp and frward adjustment Nte: lamp accmmdates 7/8" r 1" diameter W/ tubes. Nte: Nt available fr use with URVED backs, please use MOD5530 urved Fam. SEATING SYSTEM TRANSIT OPTION MODW20 TRANSIT OPTION HARDWARE $225 ustmer Service: Fax: rders@sunmed.cm Web: Page 3

4 Fam nstructin Single Layer Fam 2 Layer Fam 3 Layer Fam Omit Back Fam Fam Layer Density Tp Middle Bttm HR Fam-50 HR Fam-70 T Fam-XS (Yellw) T Fam-S (Pink) Sunmate-Sft Sunmate-Medium Sunmate-MediumSft Sunmate-Firm Pudgee Stimulite - Hneycmb Gel JAY - Flw Fluid N/A N/A SEAT MODIFIATIONS ustmer Service: Fax: rders@sunmed.cm Web: Page 4

5 SEAT MODIFIATIONS STRUTURAL MOD4075 Tw Piece ushin & Base Seat $165 MOD4150 Ntches fr Back Psts 2" X 2" N/ MOD4153 Ntches fr Back Psts 3" deep N/ MOD4155 Ntches Frnt Hngrs (Wd Only) N/ MOD4159 Ntches Back Pst, Seat, us $40 MOD4170 Sub 1/2" Plastitech Seat $40 MOD4175 Mid Seat utut fr X-Brace $110 MOD4200L Offset Seat, Lng n Left side $110 MOD4200R Offset Seat, Lng n Right side $110 MOD4300 T-style Seat $120 MOD4400 Anti-Thrust Seat $180 MOD4450 Quick-Fit Anti-Thrust Seat $425 MOD4460 Wedge Seat $185 MOD4500 ubed Seat (2"x2"x2" HR fam) $425 MOD4525 ustm ubes, Seat $495 MOD4600 E2294 ntur Seat $360 MOD4605 Leg Trugh ut Int Seat $140 MOD4611 ntured Md w/pel Well Mild $360 MOD4612 ntured Md w/pel Well Med $360 MOD4613 ntured Md w/pel Well Aggr $360 MOD4614 ntured Md w/pel Well ust $360 MOD4630 Quick-Fit ntured Seat $550 MOD4640L Lateral Reinfrcement, Seat, Left $110 MOD4640R Lateral Reinfrcement, Seat, Right $110 MOD4650 Substitute ABS fr Multi-Ply in Seat $150 MOD4655L Belt Strap Ntches, Seat, Left $24 MOD4655R Belt Strap Ntches, Seat, Right $24 MOD4700 Built-in Medial Thigh Supprt $215 MOD4725 ntur Lateral Adductr $215 MOD4800 MOD4825 Seat Rail Fam Overlay Seat - Frnt Edge Bevel Undercut $132 $132 MOD4850L Pelvic Obliquity Additin (Up t 1") Left $150 MOD4850R Pelvic Obliquity Additin (Up t 1") Right $150 MOD4900 Adjustable Split Seat $495 MOD5000 I-Style Seat $120 MOD5700 Substitute 3/4 Multi-Ply fr 1/2 $72 MOD6827 N Seat ushin N MOD6828 Add Flding Hinge Bracket $132 MOD6860L Seat Munt L Bracket, TRANS, L $30 MOD6860R SEAT MOUNT L brkt, TRANS, R $30 MOD6861L SEAT MOUNT L brkt, TRANS, SH/L $30 MOD6861R SEAT MOUNT L brkt, TRANS, SH/R $30 MOD8000 Omit T-Nuts N/ MOD9050 Oversize, ver 20 up t 24 $75 MOD9075 Oversize, ver 24 up t 28 $110 SEAT MODIFIATIONS - FOAM MOD0050 Omit Fam in Seat N/ HR FOAM MOD1005 1/2 HR Fam in Seat N/ MOD HR Fam in Seat N/ MOD /2 HR Fam in Seat N/ MOD HR Fam in Seat $35 MOD HR Fam in Seat $50 PUDGEE FOAM MOD1405 Additinal 1/2 Pudgee Fam in Seat $180 MOD Pudgee Fam in Seat $270 MOD Pudgee Fam Partial Insert 0 T FOAM MOD1605 1/2 T-Fam in Seat $60 MOD T-Fam in Seat $105 MOD /2 T-Fam in Seat $120 MOD T-Fam in Seat $150 SUNMATE FOAM GEL MOD1805 1/2 SunMate Fam in Seat $45 MOD SunMate Fam in Seat $85 MOD1815 MOD1900 MOD1816 MOD1817 JAY FLOW FLUID MOD1505 MOD /2 SunMate Fam in Seat $110 2 SunMate Fam in Seat $125 1/2" SSM ver 1" MSM Fam In seat $110 1" SSM ver 1/2" MSM Fam in Seat $110 Pressure Relief Pads/Ischial 5/8" Gel ver 1-1/2" HR Fam in Seat $230 MOD1525 1/2" ubed Gel ver 1-1/2" HR Fam St $270 MOD1595 5/8 Gel Partial Insert $182 STIMILITE HONEYOMB MOD1185 1/2 Stimulite Hneycmb, Seat $215 MOD Stimulite Hneycmb, Seat $270 MOD1195 Partial Stimulite Hneycmb, Insert $215 SEAT MODIFIATIONS - UPHOLSTERY MOD4125 Attaching Strips, Bttm, Lp (STD) $40 MOD4125H Attaching Strips, Bttm, Hk $40 MOD4126 Attaching Strips, Tp, Hk $40 MOD4130 Nn-Skid Added t Bttm $50 MOD4131 Nn-Skid Added t Tp $50 MOD5120 Add Velcr lsure, ustm $150 MOD5130 Add Synthetic Sheepskin ver, Beige $180 MOD5150 Incntinent Film vering $100 MOD5192 Add Zip Seat Tp Face Only $132 MOD5600 Sewn Psitining Strap Slt (Pair) $110 ADDITIONAL SEAT OVERS OV4100 Additinal Zippered ver, Flat, Std $132 OV4109 Additinal Zippered ver, ustm $180 OV4110 Additinal Slip Over ver, Flat, Std $132 OV4119 Additinal Slip Over ver, ustm $180 OV99XX Additinal Zippered ver Fam Frm $495 ustmer Service: Fax: rders@sunmed.cm Web: Page 5

6 BAK MODIFIATIONS BAK MODIFIATIONS STRUTURAL MOD1045 Adj Offset Hinge, Wide in Pkg $85 MOD1055 Adj Offset Hinge, Ped in Pkg $85 MOD Piece ush & Base Back (1/2" Wd) $170 MOD5125 Add Hk/Lp lsure Back $145 MOD5170 Sub 1/2" Plastitech Back $40 MOD5180 Fam Frm Back $495 MOD5194 en & Tp Edge Zip Hidn Back N MOD5200 I-Style Back $125 MOD5300 T-Style Back $125 MOD5425 Half-Rund Lumbar Rll - Internal $175 MOD5426 Half-Rund Lumbar Rll w/ Strap $175 MOD5450 Adj Angle Bi-Angular Back w/ 2 brkts $365 Nt Available with urved wd MOD5451 Adj Angle Bi-Angular Back w/ 1 brkt $240 MOD5452 Adj Bi-Ang Back 2 Piece cver $495 MOD5455 Sub 1/2" Plastitech Base & ush, Back $65 MOD5460 Adjustable Lumbar Back 5.5" Adj Range $395 MOD5462 Adjustable Lumbar Back 7.5" Adj Range $395 MOD5475 Revers Bi-Angular Back - Fixed $215 MOD5500 urved Back $175 MOD5501 urved Back, w/ 2 hinged L brkts $215 MOD5502 urved Back, w/ 4 Hinged L brkts $235 MOD5510 urved Lateral Thr Pad Md MOD5530 urved Fam Additin t Flat Back $140 MOD5550 ubed Back (2"x2"x2" HR fam) $405 MOD5575 ustm ubes, Back $495 MOD5600 Sewn Anterir Psitin Strap Slts (PR) $110 MOD5605 T-Nut Fr Strap Ps Hdw N MOD5610 Shulder Strap Mnt Thrugh Back $145 MOD5620 Attaching Tie W/Velcr Back $25 MOD5621 Attaching Tie W/ Snaps Back $24 MOD5622 Attaching Ties Lps Back $24 MOD5650 Substitute ABS (1/2") fr Multi-Ply in Back $180 MOD5700 Replace 3/4 Multi-Ply with 1/2 $70 MOD5705 Replace 1/2 Multi-Ply with 3/4 $70 MOD5800 ntur Back $305 MOD5801 Quick-Fit ntur/bi-angular Back $605 MOD5802 Quick-Fit ntur Back Only $495 MOD5804 ntur Fixed Lumbar Wedge $195 MOD5835 Harn's Strap Ntches, Tp Edge f Back $100 MOD5849 ABS back with side walls Back $275 MOD5850 Scapular ntur utut, Back $185 MOD5855 Tp Edge Angle ut, Back $110 MOD5860 Large Radius rners Fr Back N MOD8100 Omit T-Nuts, Back N/ MOD9150 Oversize, ver 20 up t 24 $85 MOD9175 Oversize, ver 24 up t 28 $120 BAK MODIFIATIONS FOAM MOD0055 Omit Fam in Back N/ HR FOAM MOD2005 1/2 HR Fam in Back N MOD2100 1" HR Fam in Back N MOD /2 HR Fam in Back N MOD HR Fam in Back $35 MOD HR Fam in Back $55 PUDGEE FOAM MOD Pudgee Fam in Back $255 MOD2405 Additinal 1/2 Pudgee Fam in Back $180 MOD Partial Pudgee Fam in Back 0 T FOAM MOD2605 1/2 T-Fam in Back $60 MOD T-Fam in Back $105 MOD /2 T-Fam in Back $120 MOD T-Fam in Back $145 SUNMATE FOAM MOD2805 1/2 SunMate in Back $45 MOD SunMate Fam in Back $95 MOD /2 SunMate in Back $105 MOD SunMate Fam in Back $130 MOD2801 1/2" SSM OVER 1/2" MSM, BAK $95 MOD2804 1" SSM OVER 1/2" HR FOAM, BAK $95 JAY FLOW FLUID MOD2505 SPINAL PRESSURE RELIEF PAD $370 GEL MOD2500 5/8" Gel & 1" HR Fam in Back $240 MOD2595 5/8" Gel Partial & 1" HR Fam in Back 0 STIMILITE HONEYOMB MOD2185 1/2 Stimulite in Back 0 MOD Stimulite in Back $285 MOD2195 Partial Stimulite in Back $190 FOAM-IN-PLAE MOD5180 Fam-in-Place BAK Sft $495 BAK MODIFIATIONS - INTERNAL FTK10XX E0956 Thrcic Supprt Kit Fam Frm 5"Hx5"D $330 FTK11XX E0956 Thrcic Supprt Kit Fam Frm 7"Hx5"D $395 FTK12XX E0956 Thrcic Supprt Kit Fam Frm 9"Hx6"D $300 FTK13XX E0956 Thrcic Supprt Kit Fam Frm 11"Hx7"D $330 FTK19XX Thrcic Supprt Kit, Fam Frm, ustm $420 BAK MODIFIATIONS UPHOLSTERY MOD5115 Add Faux Sheepskin t Back us $220 MOD5135 Add Synthetic Sheepskin ver, Beige $180 MOD5125 Add Velcr lsure, ustm $145 MOD5127 Privacy Flap 12" Lng $110 MOD5165 Remvable tp ver Zipper at enter $150 MOD5610 Shulder Strap Munting Grmmets $145 MOD5620 Attaching Ties fr Back, Velcr $25 MOD5621 Attaching Ties fr Back, Snaps $24 MOD5900 Mngram Back, Blck N/ MOD5901 Mngram Back, Script N/ MOD5902 Mngram Stck Design N/ MOD5909 Mngram Back, ustm Qute ADDITIONAL BAK OVERS OV5100 Additinal Zippered ver, Flat, Std $135 OV5109 Additinal Zippered ver, ustm $190 OV5110 Additinal Slip Over ver, Flat, Std $140 OV5119 Additinal Slip Over ver, ustm $195 OV99XX Add Zipper ver Fam-in-place $495 ustmer Service: Fax: rders@sunmed.cm Web: Page 6

7 LATERAL THORAI SUPPORTS LATERAL THORAI SUPPORT PAKAGES LATERAL THORAI SUPPORT MODIFIATIONS LTK22XX E0956 Std prfile bracket - Flat Pad - Each $135 MOD2550 1/4 Gel in Thracic Supprt $50 Left Right Pair MOD2650 1/2 T-Fam in Thracic Supprt $40 LTK23XX E0956 Std prfile bracket - urved Pad - Each $190 MOD2750 1/2 Pudgee in Thracic Supprt $50 Left Right Pair MOD2850 1/2 SunMate in Thracic Supprt $19 LTK24XX E0956 Med/High prfile brkt - Flat Pad - Each $175 MOD SunMate in Thracic Supprt $19 Left Right Pair MOD2950 Taper Frnt Edge f Thracic Supprt $19 LTK25XX E0956/E1028 E-Z Access SA brkt - Flat Pad - Each $360 MOD3000 Replace Multi-Ply with ABS $12 Left Right Pair MOD3001 Flat Metal Base up t 5x6" $25 LTK27XX E0956/E1028 E-Z Access SA brkt - rvd Pad - Each $370 MOD3011 urved Metal Base up t 5X6" $25 Left Right Pair MOD3100 Add Waterfall Fam t Thracic Supprt $50 LTK30XX E0956/E1028 E-Z Access SA w/ Frnt Adj - Flat - Each $405 MOD3150 ntur-fit Pad $65 Left Right Pair MOD3175 Hinged Pad $165 LTK34XX E0956 Lat Thr W/ Fixed MOD brkt -Flat-Each $270 MOD5510 urved Lateral Pad Left Right Pair MOD6803 urved Back Bracket N LTK35XX E0956/E1028 Rear Quick Adjust (RQA) brkt -Flat- Each $360 LATERAL THORAI ADDITIONAL HARDWARE AND OVERS Left Right Pair HDW2025 1/4 Bracket Spacer LTK37XX E0956/E1028 E-Z Access & RQA brkt -Flat- Each $410 HDW2050 1/2 Bracket Spacer Left Right Pair HDW Height Adapter Plate $32 LTK40XX E0956 Reverse Offset (1.5") brkt -Flat- Each $215 HDW Height Adapter Plate $32 Left Right Pair HDW Height Adapter Plate $32 LTK45XX E0956/E1028 Lat Thr w/ Remvable brkt -Flat- Each $330 OV2656 Lateral Bracket Fabric ver (Ped) $33 Left Right Pair OV2666 Lateral Bracket Fabric ver (Shrt) $33 LTK47XX E0956/E1028 Remvable & RQA brkt -Flat- Each $395 OV2657 Lateral Bracket Fabric ver (1" Offset) $33 Left Right Pair OV2667 Lateral Bracket Fabric ver (2" Offset) $33 LATERAL PELVI/THIGH SUPPORTS LATERAL PELVI/THIGH SUPPORT PAKAGES LATERAL PELVI/THIGH SUPPORT MODIFIATIONS Nte: Pads can be built up t 5" High and 18" Lng MOD3025 D Frward Pad Shape N LPK22XX E0956 Standard prfile brkt w/ Pad - Each $145 MOD3050 Replace Multi-Ply with ABS $12 Left Right Pair MOD3055 ntured Pelvic Supprts (Anti-Thrust) $55 LPK27XX E0956/E1028 Remvable brkt w/ Pad - Each $315 MOD3500 Waterfall Fam Pelvic Supprt $45 Left Right Pair MOD3550 1/4 Gel in Pelvic Supprt $50 LPK31XX E º Med/High Prfl brkt w/ Pad - Each $175 MOD3551 1/4 Gel in Lng Pelvic Supprt $60 Left Right Pair MOD3650 1/2 T-Fam in Pelvic Supprt $40 LPK32XX E0956 Med/High Prfile brkt w/ Pad - Each $135 MOD3750 1/2 Pudgee in Pelvic Supprt $55 Left Right Pair MOD3850 1/2 SunMate in Pelvic Supprt $40 LPK33XX E0956/E º Adj Rmvbl brkt w/ Pad - Each $360 MOD SunMate in Pelvic Supprt $19 Left Right Pair MOD3858 Distal Edge ntur $100 LPK34XX E0956 Mdular Bracket w/ Pad - Each $230 MOD3870 Munt LPK n Flat Back Surface N Left Right Pair MOD3899 us Fam Md Pelvic Thigh Sup $60 LPK55XX E Reverse Offset brkt w/ Pad - Each 0 MOD4750L Lng, urved Pad, Pelvic/Thigh left Left Right Pair MOD4750R Lng, urved Pad, Pelvic/Thigh, right LPK57XX E º Adj fixed brkt w/ Pad - Each $275 Left Right Pair LATERAL PELVI/THIGH/ARMREST SUPPORT PAKAGES - Each ADDITIONAL DISTAL HARDWARE Nte: Pads can be built up t 5" High and 18" Lng HDW Distal Ext Adapter Bar $35 LPK40XX Fixed brkt w/ Pad - Each $375 HDW Distal Ext Adapter Bar $35 Left Right Pair LPK41XX Remvable brkt w/ Pad - Each $495 Left Right Pair LPK42XX Remvable brkt & Hgt Adj w/ Pad - Each $575 Left Right Pair MEDIAL THIGH SUPPORTS MEDIAL THIGH SUPPORT PAKAGES MEDIAL THIGH SUPPORT MODIFIATIONS MTK10XX E0957/E1028 MTS w/ Swing-Away brkt, 5 r 7 arm $470 MOD3855 1/2 SunMate Fam in Medial Supprt STD MTK50XX E0957/E1028 Adj height Swing-Away brkt, 2-3 $520 MOD SunMate Fam in Medial Supprt $45 MTK60XX E0957/E1028 Adj height Swing-Away brkt, $520 MOD3555 1/4 Gel in Medial Supprt $130 MTK70XX E0957/E1028 Adj Hideaway L Munt, $635 MOD3655 1/2 T-Fam in Medial Supprt $40 MTK72XX E0957/E1028 Adj Hideaway T Munt, $635 MOD3755 1/2 Pudgee Fam in Medial Supprt $130 MTK74XX MTK76XX MTK93XX MTK95XX MTK97XX E0957/E1028 Adj Hideaway L Munt, Shrt E0957/E1028 Adj Hideaway L Munt, Tall E0957/E1028 Pull-Away brkt, 1.5 t 2 adj E0957/E1028 Pull-Away brkt, 2 t 3.5 adj E0957/E1028 Pull-Away brkt, 3.5 t 5.5 adj $660 $660 $550 $550 $550 ustmer Service: Fax: rders@sunmed.cm Web: Page 7

8 PELVI POSITIONING BELTS ANTERIOR PELVI POSITIONING BELTS SINGLE PULL ANTERIOR PELVI POSITIONING BELTS DUAL PULL APB6212 E Side Release buckle, 7.5" Pads $56 APB6222 E Side Release buckle, Small Pads $56 APB6213 E Side Release buckle, 9.5" Pads $56 APB6223 E Side Release buckle, Med Pads $56 APB6210 E Side Release buckle, Nn-Padded $35 APB7221 E Push-Buttn buckle, 5.5" Pads $86 APB7212 E Push-Buttn buckle, Small Pads $86 APB7222 E Push-Buttn buckle, 7.5" Pads $86 APB7213 E Push-Buttn buckle, Med Pads $86 APB7223 E Push-Buttn buckle, 9.5" Pads $86 APB7210 E Push-Buttn buckle, Nn-Padded $40 APB5125 E0978 Li l Kidds 1 Push Buttn, 4.5 Pads $91 APB5115 E0978 Li l Kidds 1 Push Buttn, 4.5 Pads $91 APB5126 E0978 Li l Kidds 1 Push Buttn, 5.5 Pads $91 APB5116 E0978 Li l Kidds 1 Push Buttn, 5.5 Pads $91 APB5127 E0978 Li l Kidds 1 Push Buttn, 7.5 Pads $91 APB5117 E0978 Li l Kidds 1 Push Buttn, 7.5 Pads $91 APB6121 E0978 Li l Kidds 1 Release buckle, 5.5 Pads $56 APB5110 E0978 Li l Kidds 1 Push Buttn, Nn-Padded $40 APB6122 E0978 Li l Kidds 1 Release buckle, 7.5 Pads $56 APB6111 E0978 Li l Kidds 1 Release buckle, 5.5 Pads $56 APB6112 E0978 Li l Kidds 1 Release buckle, 7.5 Pads $56 ANTERIOR PELVI POSITIONING BELTS 4-POINT V-ntur APB6110 E0978 Li l Kidds 1 Release buckle, Nn-Pad $35 ANTERIOR PELVI POSITIONING BELTS MEDIAL 4-POINT APB7242 E Push-Buttn buckle, 4.5" Pads $111 APB7243 E Push-Buttn buckle, 5.5" Pads $111 APB7244 E Push-Buttn buckle, 6.5" Pads $111 APB5145 E0978 Li l Kidds 1 PB buckle, 3.5 Pads $111 APB5146 E0978 Li l Kidds 1 PB buckle, 4.5 Pads $111 APB3716 APB3727 APB3738 E0978 E0978 E Push-Buttn buckle 1.5 Push-Buttn buckle 2 Push-Buttn buckle $170 $170 $170 APB3616 E Release buckle $170 APB3627 E Release buckle $170 APB3638 E Release buckle $170 ANTERIOR TRUNK SUPPORTS ANTERIOR TRUNK SUPPORTS LASSI STYLE ANTERIOR TRUNK SUPPORTS ONTOUR STYLE ATS8100 Dynamic, X-Small $152 ATS9100 Dynamic, X-Small $152 ATS8101 Dynamic, Small $152 ATS9101 Dynamic, Small $152 ATS8102 Dynamic, Medium $152 ATS9102 Dynamic, Medium $152 ATS8103 Dynamic, Large $152 ATS9103 Dynamic, Large $152 ATS8104 Dynamic, X-Large $152 ATS9104 Dynamic, X-Large $152 ATS8107 Dynamic, Early Interventin $152 ATS9107 Dynamic, Early Interventin $152 ATS8300 Structured, X-Small $152 ATS9300 Structured, X-Small $152 ATS8301 Structured, Small $152 ATS9301 Structured, Small $152 ATS8302 Structured, Medium $152 ATS9302 Structured, Medium $152 ATS8303 Structured, Large $152 ATS9303 Structured, Large $152 ATS8304 Structured, X-Large $152 ATS9304 Structured, X-Large $152 ANTERIOR TRUNK SUPPORTS ENTER OPENING STYLE ANTERIOR TRUNK SUPPORTS Y STYLE ATS8807 Dynamic, Early Int - Side Rel Buckle $141 ATS9167 Dynamic, Early Interventin $136 ATS8800 Dynamic, X-Small - Side Rel Buckle $141 ATS9161 Dynamic, Small $136 ATS8801 Dynamic, Small - Side Rel Buckle $141 ATS9162 Dynamic, Medium $136 ATS8802 Dynamic, Medium - Side Rel Buckle $141 ATS9163 Dynamic, Large $136 ATS8803 Dynamic, Large - Side Rel Buckle $141 ATS9169 Dynamic, ustm $250 ATS8804 Dynamic, X-Large - Side Rel Buckle $141 ATS9367 Structured, Early Interventin $136 ATS8809 Dynamic, ustm - Side Rel Buckle $250 ATS9361 Structured, Small $136 ATS9407 Structured, Early Int - Side Rel Buckle $152 ATS9362 Structured, Medium $136 ATS9400 Structured, X-Small - Side Rel Buckle $152 ATS9363 Structured, Large $136 ATS9401 Structured, Small - Side Rel Buckle $152 ATS9369 Structured, ustm $250 ATS9402 Structured, Medium - Side Rel Buckle $152 ATS9403 Structured, Large - Side Rel Buckle $152 ANTERIOR TRUNK SUPPORTS BAK PAK STYLE ATS9404 Structured, X-Large - Side Rel Buckle $152 ATS9601 Dynamic, 12" $136 ATS9409 Structured, ustm - Side Rel Buckle $250 ATS9603 Dynamic, 18" $136 ATS8701 Dynamic, Small - Zipper $152 ATS9609 Dynamic, ustm $250 ATS8702 Dynamic, Medium - Zipper $152 ATS9701 Structured, 12" $136 ATS8703 Dynamic, Large - Zipper $152 ATS9703 Structured, 18" $136 ATS8704 Dynamic, X-Large - Zipper $152 ATS9709 Structured, ustm $250 ATS8709 Dynamic, ustm - Zipper $250 ANTERIOR TRUNK SUPPORTS STRAP GUIDES ANTERIOR TRUNK SUPPORTS TRUNK STRAP HDW6900 STRAP POSITIONER - EAH $35 ATS4050 ATS4000 ATS4100 ATS4200 ATS4300 ATS4900 X-Small Small Medium Large X-Large ustm $141 $141 $141 $141 $141 $250 ustmer Service: Fax: rders@sunmed.cm Web: Page 8

9 LOWER BODY POSITIONING KNEE POSITIONING SHOE HOLDERS KPG10XX E0953 Knee Ps Blcks, + Pullaway Hardware $495 TST6001 E0951/E0952 She Hlder padded buckles Small $71 KPG19XX E0953 Knee Ps Blcks, ustm + Hardware $550 TST6101 E0951/E0952 She Hlder padded buckles Medium $71 KAK31XXL E0953/E1028 Knee Add PKG Swing Away Lng L $355 TST6201 E0951/E0952 She Hlder padded buckles Large $71 KAK31XXR E0953/E1028 Knee Add PKG Swing Away Lng R $355 TST6301 E0951/E0952 She Hlder padded buckles X-Large $71 KAK21XXL E0953/E1028 Knee Add PKG Swing Away Shrt L $355 TST6000 E0951/E0952 She Hlder nn-padded buckles Small $64 KAK21XXR E0953/E1028 Knee Add PKG Swing Away Shrt R $355 TST6100 E0951/E0952 She Hlder nn-padded buckles Med $64 KAD10XX E0953 Knee Adductr Pad 3" Rund $55 TST6200 E0951/E0952 She Hlder nn-padded buckles Large $64 KAD11XX E0953 Knee Adductr Pad 4" Rund $55 TST6300 E0951/E0952 She Hlder nn-padded buckles XL $64 KAD19XX E0953 Knee Adductr Pad ustm $110 SHOE HOLDERS with TENDON RELIEF HDW4851 E1028 Knee Add brkt Swing Away Lng L $385 TST6061 E0951/E0952 She Hlder padded buckles Small $72 HDW4852 E1028 Knee Add brkt Swing Away Lng R $385 TST6161 E0951/E0952 She Hlder padded buckles Medium $72 HDW4853 E1028 Knee Add brkt Swing Away Shrt L $385 TST6261 E0951/E0952 She Hlder padded buckles Large $72 HDW4854 E1028 Knee Add brkt Swing Away Shrt R $385 TST6361 E0951/E0952 She Hlder padded buckles X-Large $72 FOOT BOXES FOOT and ANKLE POSTIONING TST7014L E0954 Single Ft Bx, Std, 14 W/ (left leg) $320 TST6510L E0951/E0952 Ft & Ankle Psitiner Small Left $91 TST7014R E0954 Single Ft Bx, Std, 14 W/ (right leg) $320 TST6510R E0951/E0952 Ft & Ankle Psitiner Small Right $91 TST7016L E0954 Single Ft Bx, Std, 16 W/ (left leg) $320 TST6520L E0951/E0952 Ft & Ankle Psitiner Medium Left $91 TST7016R E0954 Single Ft Bx, Std, 16 W/ (right leg) $320 TST6520R E0951/E0952 Ft & Ankle Psitiner Medium Right $91 TST7018L E0954 Single Ft Bx, Std, 18 W/ (left leg) $320 TST6540L E0951/E0952 Ft & Ankle Psitiner Large Left $91 TST7018R E0954 Single Ft Bx, Std, 18 W/ (right leg) $320 TST6540R E0951/E0952 Ft & Ankle Psitiner Large Right $91 TST7114 E0954 Full Width Ft Bx, Std, 14 W/ (1 pc) $520 TST6560L E0951/E0952 Ft & Ankle Psitiner X-Large Left $91 TST7116 E0954 Full Width Ft Bx, Std, 16 W/ (1 pc) $520 TST6560R E0951/E0952 Ft & Ankle Psitiner X-Large Right $91 TST7118 E0954 Full Width Ft Bx, Std, 18 W/ (1 pc) $520 ANKLE POSTIONING FLEXI FEET 32600XS-RT E0951/E0952 Flexi-Feet System Xtra Small - Pair $ S-RT E0951/E0952 Flexi-Feet System Small - Pair $ M-RT E0951/E0952 Flexi-Feet System Medium - Pair $ L-RT E0951/E0952 Flexi-Feet System Large - Pair $215 TST6501L E0951 Ankle Psitiner Xtra Small Left $71 TST6501R E0951 Ankle Psitiner Xtra Small Right $71 TST6511L E0951 Ankle Psitiner Small Left $71 TST6511R E0951 Ankle Psitiner Small Right $71 TST6521L E0951 Ankle Psitiner Medium Left $71 TST6521R E0951 Ankle Psitiner Medium Right $71 TST6541L E0951 Ankle Psitiner Large Left $71 TST6541R E0951 Ankle Psitiner Large Right $71 TST6561L E0951 TST6561R E0951 Ankle Psitiner Extra-Large Left $71 Ankle Psitiner Extra-Large Right $71 TRAYS WT1005 E0950 Wden Supprt Platfrm, X-Small $240 WT1000 E0950 Wden Supprt Platfrm, Small $240 WT2000 E0950 Wden Supprt Platfrm, Medium $240 WT3000 E0950 Wden Supprt Platfrm, Large $275 WT4000 E0950 Wden Supprt Platfrm, X-Large $275 WT5005 E0950 Lexan Supprt Platfrm, X-Small $275 WT5000 E0950 Lexan Supprt Platfrm, Small $275 WT6000 E0950 Lexan Supprt Platfrm, Medium $275 WT7000 E0950 Lexan Supprt Platfrm, Large $285 WT8000 E0950 Lexan Supprt Platfrm, X-Large $285 WT9000 E0950 ustm Supprt Platfrm $520 UPPER BODY POSITIONING TRAY MOUNTING HARDWARE NOTES THW1000 Tggle Hardware $60 THW2000 Slide Tube Hardware $180 THW3000 Birch Runners $40 THW3100 S-Style Runners, ABS $40 THW3210 Sltted hannel Runners, ABS $45 THW3700 Tp Drp Platfrm $120 THW4000 am Style Hardware $45 THW4500 Angle-am Hardware $60 PLATFORM AESSORIES TA11XX TA4100L TA4100R TA4150 TA4175 THW6000 Platfrm Padding, Remvable ver Jystick utut, Left Jystick utut, Right Jystick Midline utut Platfrm utut, ustm Strap with Release Buckle $320 $65 $65 $130 $70 $50 ustmer Service: Fax: rders@sunmed.cm Web: Page 9

10 SEAT DIMENSIONS Specificatins SOLID SEAT INSERT I STYLE SEAT INSERT T STYLE SEAT INSERT A B A E A B F B D G D OFFSET SEAT INSERT ANTI-THRUST SEAT INSERT ADJUSTABLE SPLIT SEAT INSERT Lng Left Side A D A D Lng Right Side B E B E F A B D BUILT-IN MEDIAL THIGH SUPPORT ONTOUR SEAT INSERT A B D E A B D E F G H I J K L ustmer Service: Fax: rders@sunmed.cm Web: Page 10

11 BAK DIMENSIONS Specificatins SOLID BAK INSERT I STYLE BAK INSERT T STYLE BAK INSERT A B A D A B E B D F BI-ANGULAR BAK INSERT URVED BAK INSERT ADJ LUMBAR SUPPORT BK INSERT A A B A B B D ONTOUR BAK INSERT A B D E Sunrise Medical (US) LL 2842 Business Park Ave. Fresn, A USA ustmer Service: Fax: rders@sunmed.cm Web: Page 11