Invacare Kite (Max Seating System) Retail Max User Weight 160Kg (25 stone)

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1 Power Wheelchair Retail Prescription Form KITEMAX Tel: Fax: OCTOBER Online Spares available at: Account No : Contact No : Delivery Address : Order Qty : Order Date : Invacare Kite (Max Seating System) Retail Max User Weight 160Kg (25 stone) Standard Features MAX Seating Tension Adjustable backrest upholstery Seat Widths from 560mm 600mm (22" 24") Seat Depths 510mm 580mm (20" 23") Detachable T Armrests, height, width and depth adjustable with extended armpad Manually settable seat tilt (0 12 ) and backrest recline ( ) Standard 80⁰ detachable legrest hangers with fixed footplate LiNX Control System with standard bracket 250mm (10") puncture proof PU foam sealed, Grey castors 350mm (14") puncture proof solid inlay Grey drive wheels Dual Swing Technology Black or Arctic White Frame colour with a choice of 7 Body Shroud colours, 7 side shroud colours and 3 Rim colours 6km/h (4mph) 4 Pole Motors and 60Ah gel Batteries Anti tippers 4 Point tie down system Lapbelt with autolock (adjustable both sides) Wheel lock / parking brake Toolkit and 8A ( V) Charger Standard Base Price 5,508 Configurations may vary from image shown X Please make your selection with a cross in the box Standard feature Free of Charge Customer weight = Kg Code Description RETAIL AVC0010 Kite Basic Model AVZ0010 Kite Special Basic Model PLEASE COMPLETE DETAILS AT THE END OF THE FORM POA Page 1 of 7

2 SEATING TYPE AVC1145 X Max Seat Unit 5,508 SEAT WIDTH mm AVC0383 X Width of Seat Frame 550 mm (adjustable by armrests mm) SEAT DEPTH AVC0317 X Seat depth mm SEAT CUSHION AVC1459 X Seat Cushion Max ( 550 mm x 635 mm/width x depth) PUSH HANDLES AVC1306 X Push handles BACKREST UPHOLSTERY / CUSHION (backrest height mm, Dartex) AVC1104 X Tension Adjustable UPHOLSTERY COLOUR AVC0278 X Dartex ARMREST AVC0606 X Detachable T-armrest, adjustable in height mm, without armpads (with depth and width adjustable receiver) ARMPADS for T- ARMREST (0606) AVC0649 X Armpad extended (375 mm) SEAT ACCESSORIES HEADREST / NECKREST (Dartex) - Adequate headrest option must be selected AVC1350 Neckrest: height and depth adjustable (Azalea type, dartex covered) 64 AVC1432 Headrest: height, depth and sideways adjustable (Azalea type, dartex covered) 158 AVC1427 Headrest with cheek support: height and depth adjustable (Azalea type, dartex covered) 179 AVC1495 Push bar dia. 22mm in conjunction with telescopic seat frame/backposts, No Headrest - no mounting hardware. Neckrest 1350 Headrest 1432 Headrest (with cheek support) 1427 SEAT ADJUSTMENTS SEAT LIFTER / SEAT TILT AVC1002 Manually settable Seat Tilt (0-12 ) AVC1001 Powered Tilt (0-12 ) 375 AVC1045 Powered Tilt (0-20 ) 397 AVC1014 Powered Tilt (0-28 ) ( min. SH 510 mm with Max Seat) 918 AVC1021 Seat lifter with powered tilt (300 mm, 28 ) ( min. SH 510 mm with Max Seat) Only with hard suspension option AVC1219 Only available with REM24SD, G90A and Linx controls 1,583 SEAT HEIGHT SETTING (only if option 1002,1001 or 1045 is chosen before) AVC0331 Seat height setting 460 mm Not available with Powered Tilt (0-20 ) AVC0339 Seat height setting 480 mm Not available with Powered Tilt (0-20 ) AVC0381 Seat height setting 500 mm Luggage rack not available with combination of BACKREST RECLINER AVC0959 Manual settable reclining angle crash-tested (-10 /0 /7,5 /15 /22,5 /30 ) Max Seat: by spindle Not available with Seat lifter with powered tilt AVC0947 Powered Recliner 375 Page 2 of 7

3 LEGREST PAIRS FOOTREST HANGER TYPE / PAIRS AVC0503 VARI F : Angle adjustable legrest hanger (swing away and detachable) (adjustable via tools 0-70 ) : knee to heel length mm VARI A : Manually angle adjustable legrest hanger (swing away and AVC0533 detachable) (adjustable via hand wheel / knob 0-70 ) - complete with calf Not available with Fixed footplates or footboard 185 pad support : knee to heel length mm ADE Powered : Electrically angle adjustable (0-80 ) legrest hanger AVC0531 (swing away and detachable) (powered via joystick) - complete with calf Not available with Fixed footplates or footboard 530 pad support : knee to heel length mm VARI F 0503 VARI A 0533 ADE 0531 FOOTPLATE TYPE / PAIRS AVC0512 Fixed Footplate pair AVC0504 Angle adjustable Footplate pair 25 AVC0513 Angle and depth adjustable Footplate pair (Adapt) 94 AVC0522 Angle adjustable Footboard 121 LiNX PRIMARY CONTROLS LiNX PRIMARY REMOTE & BRACKET AVC2201 Remote LiNX DLX-REM110 Drive only Not available with lights AVC2203 Remote LiNX DLX-REM211 Drive & Actuators Not available with lights AVC2204 Remote LiNX DLX REM216 Drive, Actuators & Lights 120 AVC1207 Standard Bracket RH AVC1208 Standard Bracket LH AVC1707 Swing Away RH 105 AVC1708 Swing Away LH 105 AVC2227 Bracket RH mounted for Attendant 50 AVC2228 Bracket LH mounted for Attendant 50 Drive Only Drive & Actuators Drive, Actuators & Lights REM110 REM211 REM216 LiNX DUAL CONTROL & BRACKET: CAN ONLY BE SELECTED IN ADDITION TO LiNX USER CONTROL AVC2220 Dual Control LiNX DLX-REM050 as secondary remote 313 AVC2219 Compact Dual Control LiNX (DLX-ACU200) NEW! 313 AVC1207 Standard Bracket RH AVC1208 Standard Bracket LH INVACARE LiNX IDC DUAL CONTROL & BRACKET AVZ2245 Invacare IDC Dual control (Available from End of October) NEW! TBC AVZ1221 IDC Detachable Bracket RH (Available from End of October) AVZ1222 IDC Detachable Bracket LH (Available from End of October) Page 3 of 7

4 LiNX 10-WAY SWITCH & BRACKET AVC Way Switch DLX-SW10-A for direct Powered Seating Access (includes loom to connect + additional jack for mode switch) 400 AVC2217 Bracket RH, mounted for user AVC2218 Bracket LH, mounted for user AVC2227 Bracket RH, mounted for attendant 50 AVC2228 Bracket LH, mounted for attendant 50 LiNX ACCESSORIES AVC2252 Loom providing jack sockets for 10 way switch and buddy button (Mode) 80 Dual Control NEW Compact Dual Control NEW LiNX IDC Dual Control 10 Way Switch REM050 ACU200 FURTHER LiNX COMPONENTS / ACCESSORIES AVC2300 X To be enclosed only - not mounted to the chair BUDDY BUTTONS to be enclosed only (Accessory loom 2252 required) AVC1685 Red Buddy Button 70 AVC1686 Yellow Buddy Button 70 AVC1687 Green Buddy Button 70 AVC1690 Blue Buddy Button 70 EGG SWITCH to be enclosed only (Accessory loom 2252 required) NEW! AVC2254 Egg Switch, black 70 PIKO BUTTONS to be enclosed only (Accessory loom 2252 required) AVC1711 Red Piko Button 125 AVC1712 Yellow Piko Button 125 AVC1713 Green Piko Button 125 AVC1714 Orange Piko Button 125 AVC1715 Blue Piko Button 125 AVC1716 Black Piko Button 125 TOGGLES / BUTTONS to be enclosed only NEW! AVZ2261 Stereo Toggle - direct control for tilt only 213 AVZ2262 Stereo Button - direct control for tilt only 204 AVZ2263 Four-Way Toggle - direct control for tilt & recline 266 AVZ2264 Four-Way Button - direct control for tilt & recline 284 AVZ2207 RH Mount AVZ2208 LH Mount AVZ2225 Without Mounting REMOTE STOP SWITCH to be enclosed only NEW! AVZ2258 Remote Stop Switch (ASL504) 832 Buddy Button NEW Egg Switch Piko Button Page 4 of 7

5 REMOTE DX2 SYSTEM USER CONTROL & BRACKET AVC1601 ACS REM 24SD Remote 165 AVC1638 REM Type A, w/o light function (enables operation up to 4 electr. adjustments) Not available with lights AVC1639 REM Type B, (enables operation up to 4 electr. adjustments and lights) 125 AVC1614 G90A 190 AVC1207 Standard Bracket RH AVC1208 Standard Bracket LH AVC1707 Swing Away + height adjust. RH high end 105 AVC1708 Swing Away + height adjust. LH high end 105 ATTENDANT REMOTE & BRACKET AVC1602 ACS REM 24SD Remote 171 AVC1616 G90A 171 AVC1643 REM Type A (Up to 4 electric actuators) Not available with Lights 15 AVC1207 Standard Bracket RH AVC1208 Standard Bracket LH DUAL CONTROL & BRACKET: (can only be selected as an addition to user remote) AVC1720 Compact Dual Control 445 AVC1207 Standard Bracket RH Only available with LH user bracket AVC1208 Standard Bracket LH Only available with RH user bracket INVACARE IDC DUAL CONTROL & BRACKET AVC1645 Invacare IDC Dual control 585 AVC1221 Detachable Bracket RH AVC1222 Detachable Bracket LH REM 24SD REM Type A G90A Chin control Dual control IDC Dual Control DRIVE UNIT OPTIONS FRAME COLOUR AVC0228 Black AVC0252 Frame colour Arctic White BODY SHROUD COLURS AVC0242 Body shroud colour Pearl Night Blue AVC0243 Body shroud colour Metalic Silver AVC0224 Body shroud colour Black AVC0204 Body shroud colour Transparent Cherry Red AVC0222 Body shroud colour Artic White AVC0248 Body shroud colour Grasshopper Green AVC0279 Body shroud Sunshine Yellow SIDE SHROUD COLOURS AVC0284 Side shroud colour Pearl Night Blue AVC0285 Side shroud colour Metalic Silver AVC0265 Side shroud colour Black AVC0261 Side shroud colour Transparent Cherry Red AVC0253 Side shroud colour Artic White AVC0250 Side shroud colour Grasshopper Green AVC0254 Side shroud colour Sunshine Yellow RIM COLOUR AVC0290 Rim colour White Not available with grey front wheels AVC0292 Rim colour Silver AVC0291 Rim colour Black Not available with grey front wheels Page 5 of 7

6 FRONT WHEEL AVC mm (10") Castor pneumatic, black (non-marking) AVC mm (10") Castor puncture proof solid inlay, black (non-marking) AVC mm (10") Castor puncture proof (sealed), black (non-marking) AVC mm (10") pneumatic, grey AVC mm (10") puncture proof solid inlay, grey AVC mm (10") puncture proof (sealed) grey DRIVE WHEELS AVC mm (14") DW pneumatic, black (non-marking) Not available with grey front wheels AVC mm (14") DW puncture proof solid inlay, black (non-marking) Not available with grey front wheels AVC mm (14") DW puncture proof (sealed), black (non-marking) Not available with grey front wheels AVC mm (14") pneumatic grey Not available with black front wheels AVC mm (14") puncture proof solid inlay grey Not available with black front wheels AVC mm (14") puncture proof (sealed) grey Not available with black front wheels PERFORMANCE OPTIONS DUAL SWING TECHNOLOGY AVC1200 X Dual-swing technology suspension system REAR SUSPENSION AVC1217 Rear suspension with soft shock absorbers, recommended for user weight Not available with seat lifter with electrical tilt up to 90 kg AVC1218 Rear suspension with medium shock absorbers, recommended for user weight kg Not available with seat lifter with electrical tilt AVC1219 Rear suspension with hard shock absorbers, recommended for user weight kg; mandatory for lifter version option AVC1021 MOTOR TYPE AVC km/h (4mph) AVC km/h (6mph) (Please select correct joystick and lights) 57 BATTERY AVC Ah (Gel) AVC Ah (Gel) 73 PERFORMANCE ACCESSORIES G-TRAC AVC1215 G-trac ensures the powerchair takes the intended direction as indicated by the user control, without the need for continual correction by the client on uneven or sloping terrain. CHARGER AVC1343 OptiCharge Charger 8A ( V) AVC1313 OptiCharge Charger 10A ( V) Charging time will be 20% faster 120 SAFETY OPTIONS ANTI-TIPPERS AVC1205 X Standard anti-tipper LIGHT AVC1437 LED light system with Indicators 360 AVC1254 Without Light system SAFETY ACCESSORIES KERB RIDER AVC1244 Kerb Rider Not available with a footboard 168 TRANSPORTATION KIT AVC1494 X 4-Point tie-down (Tested version for using wheelchair as a vehicle seat according to ISO :2001) (Adequate headrest is compulsory) LAP BELT AVC1329 X Lap belt with Auto Lock (standard mount on backrest) REAR VIEW MIRROR AVC1415 Rear View Mirror RH 33 AVC1339 Rear View Mirror LH 33 WHEEL LOCK / PARKINGBRAKE AVC1206 X Wheel lock / parking brake, pair 653 Page 6 of 7

7 ACCESSORIES LUGGAGE RACK AVC1438 Luggage rack Not available with combination of seat height 500mm with powered tilt (0-20 ) with powered recliner 261 CANE HOLDER (in combination with attendant or dual control it has to be mounted on the opposite side of the remote) AVC1312 Cane Holder RH 33 AVC1363 Cane Holder LH 33 FENDER AVC1416 Fender for castors 83 AVC1417 Fender for rear wheels 83 TOOLKIT AVC1333 X Toolkit (incl.bit holder, bits and fork spanners) Total Price : Need a different option not on the form? Take a look at our Powerchair Alternative Options form, available as standard. Powerchair Alternative Option required: Please refer to our Invacare Unique special order form, for more complex custom requirements. Available at Special Instructions - Please supply the following information: Name: Phone: Fax: Description of special request (please include relevant option code or part number): Page 7 of 7