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1 Im Hofstätt 11 D Dotternhausen Tel +49 (0) Fax +49 (0) Quotation date: Order date: according to GTC PRO ACTIV GmbH TRAVELER Heavy Duty Active easy running folding wheelchair with individual reinforcements Approved up to 150kg/180kg user load capacity HMV Pos.Nr.: , Invoice address: same as company address Medical suppliers / Company address: Cust. no.: Name: Street: Postcode, city: Phone: Fax: Contact: Invoice address: other (see below) Cust. no.: Name: Street: Postcode, city: Phone: Fax: Contact: Shipping address:same as company address other (see below) Name: Street: Postcode, city: Customer name / commission: Name: Street: Postcode, city: Phone: Fax: Date of birth: Paying organisation: Indication: / The prices are plus statutory value-added tax and shipping costs = Included the basic price = Position selected

2 Basic size Body size: Wheel chair dimensions: Seat width SB Seat depth ST Back height RH Lower leg length USL Short frame Long frame Seat height back SHh Seat height front SHv Tipping point KP (front side rear tube to axis middle drive wheel; at frame angle 95 of 4-10 cm and at frame angle cm possible) Please cross on the appropriate dimension (all dimensions are specified in cm). Underlined values are standard settings. The values SHh and SHv may deviate a little from the specified values depending on the wheel size, wheel camber as well as the front and rear frame angle! Special dimensions possible upon request / The prices are plus statutory value-added tax and shipping costs = Included the basic price = Position selected

3 Frame colour - One-colour design Information on current colour designs and example images under: White RAL 9016 gloss matt Brilliant Silver gloss Anthrazit RAL 7016 gloss matt Black RAL 9005 gloss matt Deep black, silver effect gloss Pure orange RAL 2004 gloss Fire Red gloss matt Pink magenta RAL 4010 gloss matt Sky blue gloss Pastel blue RAL 5024 gloss matt Navy blue gloss matt Apple green gloss matt Lemon green gloss matt Purple gloss Yellow RAL 1023 gloss matt Red RAL 3001 gloss matt Colour - Attachment parts Drive wheel Aluminium rim and hub Caster fork and bearing block silver Rahmenfarbe Frame colour - - Einfarbdesign Two-colour design Information on current colour designs and example images under: Note: With two-colour design, according to both colours of the gloss level of the design colour. Two-colour design comprising one basic colour (on the back of the frame) and one design colour (on the front of the frame) Please select from the following colours: Base colours (on the back frame): White Silver Anthracite Black Pastel blue Lemon green Yellow Design colours (on the front frame) Yellow gloss matt Lemon green gloss matt Blue gloss matt Chili gloss matt Pure orange gloss matt Cappuccino gloss matt Black black If no details have been made, the attachment parts are mounted in black. Attachment parts colour design according to customer desires: Drive wheel 1 Aluminium rim and hub Orange RAL white RAL in frame colour Selection from single colour design deviating from the frame colour " Aluminium rim 2 3 spoke design Please enter the last 3 digits of the desired colour (single colour design): gloss matt Special colour requests (frame or attachment parts) Frame colour single procurement Frame from RAL range of colours Surface coating: gloss matt / The prices are plus statutory value-added tax and shipping costs = Included in the basic price = Position selected Colours Rev Colour details with RAL number Note: Attachment parts not possible in design colours 1 Only in combination with aluminium rim drive wheel Only in combination with caster wheel 5" Aluminium rim 3-spoke design smooth running or 5" Aluminium rim 3-spoke design good shock absorption

4 Frames Note: Footrest area with V-shape x=sb-(0,25 x USL + 6cm) Straight Front end Front end V-shape Frame angle KP=Tipping point (distance inner edge RL joint to axle middle drive wheel) standard setting 8.5 cm Knee angle Rear frame angle KP from 6.5 cm to 13 cm Knee angle Rear frame angle KP from 4.5 cm to 11 cm Heavy Duty version Reinforced drive wheel plate, 2-slots, 12 mm thick, reinforced steering fork closed version, rear tube reinforcement inlet on the side plate bolted thread, stainless steel backrest locking bolts, reinforced push handles, 2 mm Stainless steel version, foamed side panel with aluminium inserts, 2 mm, footrest or footbar continuous, reinforced version, stainless steel braking bolt for brake system (with 5 easy-running aluminium rim / 210 the reinforced 5-spoke aluminium rim is mounted) Heavy Duty Reinforcement of the frame as well as of different options for loading capacity kg Welded gusset plates for a higher stiffness and stability of the frame. Plates are welded where the folding arms are attached on the frame.. Push handles Aluminium push handles fixed in back tube from RH 23 cm Safety push handles with continuous height adjustment Mount in the back tube from RH 30 cm with belt cover from RH 43 cm with back shell Push handles, horizontally screwed in back tube can be unscrewed Backrest Folding backrest way inclination adjustment with integrated aluminium side parts Back tubes with lordosis bend cm 2cm 3cm Back equipment Adaptable back with back padding Colour: black Equipment with back cross bar Adaptable back with back padding "light" Back padding extra thin for an easy and space-saving folding of the wheelchair Colour: black Padding thickness: 9mm Equipment with back cross bar Attention: Not recommended for users with a risk for decubitus on the back Raised back cm for nominal RH dimension Only in combination with height adjustable push handles! / The prices are plus statutory value-added tax and shipping costs = Included the basic price = Position selected

5 Equipment without back upholstery and without back padding or back system Equipment with back cross bar Further back systems e.g. ergonomic back shell see separate dimension sheet: "PRO ACTIV Seat and back systems" Seat upholstery Open belt system Closed belt system Clothing guard Aluminium clothing guard removable via lock function Adjustable following wheel arch Only in combination with folding backrest! anthracite, matt in frame colour (basic colour with two-colour design) in design colour (only possible with frames in twocolour design) Carbon clothing guard removable via lock function Adjustable following wheel arch Only in combination with folding backrest! Equipment without seat upholstery Seat cushion Armrests 25 cm long arm padding mounted on the clothing guard Upper arm padding edge depending on the clothing guard setting mounted approx. 20 cm to 24 cm above the seat tube. Only in combination with clothing guard! rectangluar contour radius contour Armrests folding up, removable with arm padding 25 cm long Positioning: upper arm padding edge approx. 25cm to 31 cm above the seat tube, adjustable in 1.5 cm steps Axle plate Standard equipment with 12 mm sockets / axles, further axle plates on request 2-slot axle plate Rear seat height = approx cm (for 24" wheel) 3-slot axle plate cover: black, breathable, open fabric surface black, closed fabric surface If no specification is given, the cover material "black breathable, open surface" will be delivered. Further seat cushions, e.g., "Anti-Decubitus" see separate dimension sheet: "PRO ACTIV "Seat and back systems" Rear seat height (with 24" wheel): short frame= approx cm longer frame= approx cm 2-slot extended axle plate Wheelbase extension by 7.5 cm Extended Bike plate camber integrated Bike track can be set separately Further axle plates on request / The prices are plus statutory value-added tax and shipping costs = Included the basic price = Position selected

6 Wheel camber * Total width with tight-mounted hand rim 1 drive wheel camber Total width = approx. SB + 20 cm* 4 drive wheel camber Total width = approx. SB + 26cm * 6 drive wheel camber Brake handle angle Space-saving; recommended for users with slight motoric disabilities. Only compatible with brake system push to lock with standard brake handle, long brake handle or low brake handle. Brake handle to Flip-down Length: 9cm Total width = approx. SB + 30cm* E-adoptions Preparation for "e-motion" mounting Equipment: e-motion torque support, 1/2" axle and socket length 50.8 mm (2") Pro Activ and Alber recommend that antitipping supports are installed in pairs for wheelchair equipment with e-motion, please select the equipment and ! Preparation for "e-fix" mounting Equipment: 1/2" axle, socket length 50.8 mm (2") and e-fix torque support. Pro Activ and Alber recommend that antitipping supports are installed in pairs for wheelchair equipment with e-fix. Please order anti-tipping support e-fix with mount "Traveler" direct from Alber! Wheelchair delivery to Alber GmbH Specialist dealer Brake system Brake system push to lock Standard brake handle Brake system push to lock Long brake handle Brake system push to lock Low brake handle Drum brake Operating from the push handle, Only with 2-slot axle plates (Total width (see "Wheel camber" selection) + 3 cm wheel plate cannot be mounted on the inside) Only in combination with 36 spoke drive wheel aluminium rim and hub in silver. Not in combination with one arm drive, e-fix or e-motion! Footrest Continuous footrest with tubular resting bracket foldable, removable When folding the wheelchair, the footrest also folds completely from USL 37 cm. With footrest x < 22 cm the foot bracket is carried out parallel. For equipment of the footrest with "Rubber coated footplate", please select under "Footrest accessories". Footrest folding up to one side with continuous tubular resting bracket, height adjustable +/- 3 cm, can be swung away, removable (with V-shape from SB 40 cm) For equipment of the footrest with "Rubber coated footplate", please select under "Footrest accessories". Footrest folding back to the rear with locking mechanism with tubular resting bracket minimum USL 42cm For equipment of the foot bracket with "Rubber coated footplate", please select under "Footrest accessories" / The prices are plus statutory value-added tax and shipping costs = Included the basic price = Position selected

7 Divided footrest with rubber coated foot rest, angleadjustable, can be pivoted outwards and folded up to the side, removable (with V-shape from SB 40 cm) "Swing away" footrest with rubber coated foot rest, separated in the middle, pivoted to the side, can be folded up, height adjustable, removable, angle-adjustable Footrest accessories Rubber coated footplate bolted, angle-adjustable Depth: 14cm Only in combination with tubular bracket Art.-no or ! Footplate side stop adjustable Only in combination with rubber coated footplate! Adaptations 5" Caster wheel "Standard" grey (82A), 5" Caster wheel "Standard" black (82A), 6" Caster wheel "Standard" (82A), 5" Lenkrad "2 components" " Caster wheel "Pneumatic tyre" " Caster wheel "Flexel System" " Skate wheel (80 mm) Anti-tipping support right side left side adjustable, removable, can be pivoted, with tension spring and universal adapter Transit wheels detachable with universal adapter Not in combination with anti-tipping support! 4" Skate wheel (100mm) Safety light-up wheel 4" (100mm) Tilting clamp right side left side Safety light-up wheel 5" (125mm) with universal adapter and Quick pin Not in combination with anti-tipping support, right side or left side! Caster wheels All caster wheels (except pneumatic tyres) are 4" Caster wheel "Standard" black (82A), 5" Aluminium rim 3-spoke design "easy running" with replaceable rubber race 3 mm, hard, silver, anodised black / The prices are plus statutory value-added tax and shipping costs = Included the basic price = Position selected

8 5" Aluminium rim 3-spoke design "good shock absorption" with replaceable rubber race 6 mm, medium hard, silver, anodised black Frog Legs-Caster wheel 4" (ø100x32) " (ø125x32) with replaceable rubber race, black, puncture proof, 3-spokes, rim: silver Caster fork Caster fork colours, see "Component colours Caster fork "Heavy duty" for high loads Extra weight approx g with screwed axle with quick-release axle Suspension fork with screwed axle and 5" Aluminium rim "good shock absorption" with quick-release axle and 5" Aluminium rim " good shock absorption " Caster fork spare wheel with quick-release axle Article is without caster wheel. In case a caster wheel is requested, please put a cross on a second selection in the category Caster wheels. Track distance Caster wheel track extension 10mm per side mm per side mm per side Antriebsräder Information on further rim types, versions and avaiabilities under Drive wheel, 36 spoke aluminium rim 24 (ETRTO 540) with aluminium front hub, spoked radially Drive wheel double rim 36 spokes 24 (ETRTO 540) (ETRTO (ETRTO 590) with aluminium front hub, spoked radially Use with higher loads and body weight > 120 kg! Spinergy running wheel "Spox Sport" with 24 PBO spokes; rim, hub and spokes in black 24 (ETRTO 540) (ETRTO 559) (ETRTO 590) Handrims x = dimension handrim attachment Handrim attachment: x = 11mm x = 19mm Curve Handrim attachment: x = 10mm x = 18mm If no specification is given, the handrims will be mounted wide (19mm/18mm). Ø 20 mm stainless steel handrims Ø 19 mm aluminium handrims silver anodised / The prices are plus statutory value-added tax and shipping costs = Included the basic price = Position selected

9 Ø 19 mm aluminium handrims powder coated in the frame colour (Basic colour in two-colour design) = surface gloss = surface matt Please note: coating in matt is because of the minimal Grip not recommended Ø 19 mm aluminium handrims polished and hard-anodised Ø 19 mm titanium handrims Ultra-Grip handrims "very good grip" Ergo-Grip handrims Resting attachment to the rim! Dual-Grip handrims Silicone handrim covers for 24" hand rim for 26" hand rim Surface without structure, compatible with handrim Ø 19mm or Ø 20mm Curve handrim, black anodised, ergonomic handrim profile H 24mm H 31mm Größe L H 31mm Size L Curve handrim powder coated, ergonomic handrim profile = frame colour (surface gloss) = black (surface gloss) Please note: coating in matt is because of the minimal Grip not recommended. H 24mm H 31mm Größe L H 31mm Size L Curve Grip handrim, Tetra-Grip coated, ergonomic handrim profile H 31mm Size L Quadro handrims, Tetra-Grip "very good grip" for 24 and 25" wheel Gekko handrims for 24 and 25" wheel Black anodised with strong and exchangeable rubber completely integrated in the handrim profile Equipment without handrims / The prices are plus statutory value-added tax and shipping costs = Included the basic price = Position selected

10 Spoke guard Finger- and spoke guard "transparent" für 24 Rad für 26" Rad Design and spoke protection film "basket" Only in combination with finger and spoke protection! Design and spoke protection film "silly-bubble" Only in combination with finger and spoke protection! Design and spoke protection film "blue-sky" Only in combination with finger and spoke protection! Design and spoke protection film "colour-stones" Only in combination with finger and spoke protection! Tyres Schwalbe "RightRun" High-pressure tyre 7.5 bar 24x1 (540-25) x1 (559-25) x1 (590-25) Schwalbe "DownTown" Tread tyre 7.5 bar 24x1 (540-25) Schwalbe "MarathonPlus Evolution" with "smart guard" puncture protection 24x1 (540-25) x1 (559-25) x1 (590-25) Colour: black 10 bar Schwalbe "MarathonPlus" with "smart guard" puncture protection 24x1 (540-25) Colour: grey, black wall, 10 bar Schwalbe "Airborne" 24x1,2 (540-20) Colour: black Puncture-proof tyre "solid-rubber tyres" 24x1 (540-25) Not in combination with the 18 spoke drive wheel! Puncture protection belt for pneumatic tyres Accessories 24 MTB spare wheel set with double rim (ETRTO 507), aluminium front hub, quick-release axle and stainless steel hand rim Mountain bike tyres, selectively: x1.75" Continental "RIDE Tour Trekking" Brake setting compatible with 24x1" wheel x1.75" Continental "Explorer" Brake setting not compatible with 24x1" wheel x2.1" Schwalbe "SMART SAM Sport" Brake setting not compatible with 24x1" wheel ATTENTION: we charge a surcharge of for the use of drum brakes Lockable drive wheel axle clip "Tetra Clip" Not for Spinergy drive wheels! Hand air compressor with pressure gauge up to 14 bar / The prices are plus statutory value-added tax and shipping costs = Included the basic price = Position selected

11 Adjustable safety belt with belt buckle Your additional notes: Adjustable safety belt with hook and loop fastener Crutch holder with nylon cup flexibel Light set with battery and charger Transport bag for Traveler frame Transport bag for drive wheels for 24" wheel Ø76cmx2cm Ø83cmx2cm Accessory bag cm x 13cm x 5cm Locking strap for Traveler Further accessories, e.g. adaptive bikes, steering attachments, etc. see separate dimension sheet or I herewith confirm the details listed above Location, Date Signature (End customer) Location, Date Signature (Dealer) / The prices are plus statutory value-added tax and shipping costs = Included the basic price = Position selected

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