Zippie TS Nvember 2015 EIZ1A Dte: Deler Acct #: Deler: Deler Cntct: Deler Address: Deler City: ST: Deler Phne: ( ) Fx: ( ) Cnfirm Vi: Mrk Fr: ZIP: Attentin: SUBMITTING FOR: Qute Order Fx Emil Ship T Phne: ( ) Fx: ( ) PO#: Ship T: Address: Address: Ship T City: The CODES prvided re bsed n cde verifictin thrugh PDAC r ur interprettin f the cde definitins. The use f CODES des nt ensure cverge r pyment. Fr cverge infrmtin, verify the pprprite pyer's cverge plicy. ST: ZIP: Optin # Definitin Optin # Definitin ZIPPIE TS 187WM63 187WM65 187WM64 187WM66 187F02 E1234 E1234 E1233 E1233 Bse Mdels Flding Grwing Zippie TS Trnsit Included (includes True Fit) Flding Grwing Zippie TS Trnsit Optinl (includes True Fit) Rigid Grwing Zippie TS Trnsit Included (includes True Fit) Rigid Grwing Zippie TS Trnsit Optinl (includes True Fit) Additinl Rigid Strut Tube 1. FRAME All Zippie TS mdels grw in width nd depth. $2,975.00 $2,825.00 $2,850.00 187TO11 Trnsit Optinl w/ Seting $2,700.00 187TO20 Trnsit Omit N/C Trnsit System (Fr use when Trnsit Optinl is selected) Tie Dwn Requires: Slid Set nd Slid Bck r Grwing Set Pn nd Jy Fit r Cnventinl Set nd Bck r Grwing Set Pn nd Slid Bck r Jy Fit nd/r Cnventinl Set & Bck 187TO12 187TT12 187VZ01 Trnsit Optinl Seting (Req. Selectin f Set & Bck) Tilt Optins Dul Trigger Cble Relese Criss Crss Cbles (cbles re lnger individully) 187VZ02 187TT8 Nn Criss Crss Cble Ft Relese (my limit flding width) Std 2. SIZE/SEATING 187W25 187S1 187S2 187S3 187W26 187S3 187S4 187S5 187W27 187S5 187S6 187S7 187W28 187S7 187S8 187S9 Frme Width Smll Crss Brce 10" 11" 12" Medium Crss Brce 12" 13" 14" Lrge Crss Brce 14" 15" 16" X-Lrge Crss Brce 16" 17" 18" 187FD4 187FD5 187FD6 187FD7 187FD8 187FD9 187FD10 187FD36 Frme Depth nd Bck Pst Lctin 13" Frme Depth 14" Frme Depth 15" Frme Depth 16" Frme Depth 17" Frme Depth 18" Frme Depth 19" Frme Depth (uses rer frme extensin plug) 20" Frme Depth (uses rer frme extensin plug) Figure 6.1 - Frme Depth Digrm ORDER INFORMATION: Custmer Service: 800-333-4000 Fx: 800-300-7502 www.sunrisemedicl.cm Specifictins re subject t chnge withut ntice. Cpyright 2013 Sunrise Medicl MK-100014 REV.C Pge 1
Mrk Fr: The CODES prvided re bsed n cde verifictin thrugh PDAC r ur interprettin f the cde definitins. The use f CODES des nt ensure cverge r pyment. Fr cverge infrmtin, verify the pprprite pyer's cverge plicy. Optin # Definitin Optin # Definitin 2. SIZE/SEATING CONT. Sets REFEREE ONLY 187ST55 187ST14 187ST5 E2231 Slid Set (Req. Slid Bck) Nt vil. w/10"13" W x 19" nd 20" Frme Depth r 17"-18" W x 13"-17" Frme Depth. E2231 Grwing Set Pn Depth (Fig. 7.1) Omit Set Std Set Depth Pn Size Medium 13"-14" Lng 15"-17" X-Lng 18"-20" Depth Rnge Minimum 11 3/4" 13 3/4" 15 3/4" Mximum 16 1/4" 18 1/4" 20 1/4" 187JC20 JAY Bundled Cushin Width: JAY Cushins (Optinl) T rder ny JAY cushins n-chir, plese see the JAY price list. Cushin nme r prt number must be filled ut with desired width nd depth. Nme / Prt # Depth: List Depth Figure 7.1 - Frme Depth Grwth Rnge Mtrix Rer Cster Wheel CASTER SIZE Wheel Sme interference my ccur when chsing 8" Cster W Z-finity 3 4 5 6 8x1 8x Size 8x2 1.5 187CW30 3" Micr Light Up $65.00 17.0 16.5 16.5 17.0 187CW31 4" Micr Light Up $70.00 12 17.5 17.0 17.0 17.5 187CW51 5" Micr Light Up $85.00 17.5 17.5 187CW5 5" Lw-Prfile Plyurethne 12 16.0 16.0 16.0 187CW7 5" x 1.5" Semi-Pneumtic $85.00 Lw Ply 16.5 16.5 16.5 16.5 N/A N/A N/A 187CW33 E2214 6" Pneumtic $75.00 E2215 15.5 15.5 15.5 16 187CW34 6" Plyurethne 187CW35 6" x 1.5" Semi-Pneumtic $85.00 15.5 15.5 15.5 187CW21 E2214 8" Pneumtic $75.00 16.0 16.0 16.0 E2215 18 16.5 16.5 16.5 16.5 N/A N/A Cster Optins 187CS3 K0073 Cster Pin Lcks (Nt vilble with 8" x 2" nd 8" x 1.5" csters) 3. CASTERS 187CW32 8" Plyurethne 17.0 187CW39 8" x 1.5" Semi-Pnuemtic $85.00 15.5 15.5 15.5 187CW36 E2214 8" x 2" Pneumtic $145.00 16.0 16.0 16.0 E2215 187CW37 E2214 K0108 8" x 2" Pneumtic w/airless Insert $225.00 $195.00 16.5 16.5 16.5 16.5 20 17.0 17.0 17.0 17.0 22 24 17.5 17.5 17.5 16.5 16.5 16.5 16.5 17.0 17.0 17.0 17.0 17.5 17.5 17.5 17.5 17.0 17.5 17.5 17.5 17.5 17.5 Chrt A - Set t Flr Height Mtrix Nte: Rer set-t-flr ht. my be up t 1.5" lwer thn frnt set-t-flr ht. N/A ORDER INFORMATION: Custmer Service: 800-333-4000 Fx: 800-300-7502 www.sunrisemedicl.cm Specifictins re subject t chnge withut ntice. Cpyright 2013 Sunrise Medicl MK-100014 REV.C Pge 2
Mrk Fr: The CODES prvided re bsed n cde verifictin thrugh PDAC r ur interprettin f the cde definitins. The use f CODES des nt ensure cverge r pyment. Fr cverge infrmtin, verify the pprprite pyer's cverge plicy. Optin # Definitin Optin # Definitin 4. REAR WHEELS / SEAT HEIGHT 187RW13 187RW14 187RW3 187RW8 187RW1 187RW12 187RW90 187RW91 187RW54 187RT1 187RT2 187RT3 187RT4 187RT6 E2211 E2212 E2211 E2213 E2218 E2211 E2212 Rer Wheel Size 12" Mg (Nt vilble with hndrims) 16" Mg (Nt vilble with hndrims) 20" Mg 22" Mg 24" Mg 18" Spke 20" Lite Spke 22" Lite Spke 24" Lite Spke Rer Wheel Tire Pneumtic Pneumtic Airless Insert Full Plyurethne (Nt vil.w/ 12", 16" nd 18" rer wheels) Lw Plyurethne (Only vilble with 12" r 24" wheels ) High Pressure Clincher (Only vilble with 24" spke wheels) $100.00 $100.00 $80.00 $95.00 187HR1 187HR4 187HR7 187HR8 187AX26 187AX1 187AX11 187AL18 187AL34 187AL35 187AL17 Prjectins (Nt Avilble n Plstic Cted) *Only vilble with 24" wheels & nt vilble with spke gurds. E0958 Hndrim Aluminum Andized Plstic Cted Omit (Nt vilble with wheel/xle credit) 8 Oblique Axle One Arm Drive Axle (Only vil. w/one Arm Drive Optin) Quick Relese Qud Quick Relese (nt vilble with Lite Spkes) Axle Plte 12" Rer Wheel Axle Plte (Only vil. w/12" r 16" rer wheels) Shrt Adjustble (Nt vilble with 12" rer wheels) Lng Adjustble (Nt vilble with 12" rer wheels) One Arm Drive (Avil. w/ 20", 22", 24" Mg Rer Wheels & 13"-18" width) $95.00 $325.00 $125.00 $850.00 187OA2 187HM1 187HM2 187OA1 187HM1 187HM2 Stndrd Hndrim Right Left Smll Hndrim (nt vil w/ 20" wheels) Right Left 5. WHEEL LOCK / HUB LOCK Wheel Lck Nt vilble with Hub Lck Hub Lck *Only vilble with 12" r 16" wheels. Nt vil. w/ ne rm drive. 187WL1 High Munt Push 187LK01 12" Hub Lck $100.00 187WL2 High Munt Pull 187LK02 16" Hub Lck $100.00 187WL25 Ft Lck (my limit flding width) 187WL10 Omit 187EH1 E0961 Extensin Hndle 6" Pir $75.00 ORDER INFORMATION: Custmer Service: 800-333-4000 Fx: 800-300-7502 www.sunrisemedicl.cm Specifictins re subject t chnge withut ntice. Cpyright 2013 Sunrise Medicl MK-100014 REV.C Pge 3
Mrk Fr: The CODES prvided re bsed n cde verifictin thrugh PDAC r ur interprettin f the cde definitins. The use f CODES des nt ensure cverge r pyment. Fr cverge infrmtin, verify the pprprite pyer's cverge plicy. Optin # Definitin Optin # 6. FOOTRESTS Definitin Hnger Munted Ftrest (Ftpltes Munt t Hnger Tubing) Extensins Shrt (11.5" - 14") Lng (17" - 19") High Munt Ftplte Cmpsite (nt vil. In 10", 11" r 12" width) Extensins (my interfere with sme set heights & csters) 187E23 2" (nt munted) 187E24 4" (nt munted) Ftplte 187F9 K0040 Kids Angle Adjustble (nt vil. w/17"-18" widths) 187H160 187H140 187H142 187H158 187H9 187H10 187H11 187H161 187F8 187F62 187H145 187H139 187H141 187H159 187E1 187E2 187E5 187E16 187F1 187F3 Hnger Type 70 Swing In/Out Frnt Munt 80 Swing In/Out Frnt Munt 90 Swing In/Out Frnt Munt 70 Hvy Dty Fnt Munt Lift-Off 80 Hvy Dty Fnt Munt Lift-Off 90 Hvy Dty Fnt Munt Lift-Off E0990 90 Elevting (nt vil w/ 10-11" Wide r Z-finity) K0040 K0040 K0053 E0990 K0037 K0040 Adult Angle Adj. (Avilble with 10"-18" widths) Ftbrd (Avilble with 10"-16" widths) Ext. Tube Munted Ftrests (Ftpltes Munt t Ext. Tube) Hnger Type 60 Swing In/Out 70 Swing In/Out 80 Swing In/Out Articulting (nt vil w/ 10"-13" cmpsite ftpltes.) Elevting (Nt vil. w/ cmpsite r pltfrm ftpltes, r <16" width) Med (14" - 17") Nt vil. w/ ELR Aluminum Angle Adjustble $350.00 Z-finity Hngers/Ftrest System Sme interference my exist in certin cnfigurtins. 187DI20 187DI21 Shrt 2" Lng 3 1/4" Z-finity Ftplte Sme interference my exist in certin cnfigurtins. 187F320 K0040 Multi Angle Adjustble (Pir) (nt vil. w/8"-9" widths) 187F321 K0040 Angle Adjustble Pltfrm Ftbrd 187H162 Z-finity Hnger Z-finity Ftrest Munt (Must Chse see Illustrtin in ppendix) 187DI22 187DI23 187DI24 $150.00 187F6 Omit Ftplte Z-finity ExtensinTube Length (When Chsing Ext. Tube Munt) 187E62 K0040 Hemi 187E1 K0040 Shrt 187E2 K0040 Medium 187E5 K0040 Lng Direct Hnger Munt Direct Hnger Mt/Fixed Frme - High Direct Hnger Mt/Fixed Frme - Lw Extensin Tube Munt Z-finity Ftrest Pivt Arm (Must Chse, use mtrix in ppendix fr leg length) Extensin Tube Munt 187F4 K0040 Kids Angle Adjustble (nt vil. w/17"-18" width) 187F5 Aluminum (Only vilble with elevting legrests 14"-18") 187F48 K0040 Pltfrm Flip-Up (Avil n 60 70 nd $190.00 80 ext. munt hngers nly) 187IG2 187HL1 E0951 Ftrest Hnger Optins Neprene Cvers (Avil. On 60 / 70 /80 ext. munt hngers nly nd Z- finity except in highest munted psitin). Heel Lps (NA w/ Z-finity widths belw 14") 187A110 E0952 Te Lp (Only vil. w/ dult ngle djust. Ftpltes NA w/ Z-finity) $85.00 $30.00 $40.00 187HL5 K0038 Leg Strp $35.00 187A55 K0038 Extr Leg Strp $35.00 187H32 Omit Hnger ($15.00) 187F7 Omit Ftplte & Ext. Tube ($15.00) 187HL4 Omit Heel Lp 187HL6 Omit Single Leg Strp ORDER INFORMATION: Custmer Service: 800-333-4000 Fx: 800-300-7502 www.sunrisemedicl.cm Specifictins re subject t chnge withut ntice. Cpyright 2013 Sunrise Medicl MK-100014 REV.C Pge 4
Mrk Fr: The CODES prvided re bsed n cde verifictin thrugh PDAC r ur interprettin f the cde definitins. The use f CODES des nt ensure cverge r pyment. Fr cverge infrmtin, verify the pprprite pyer's cverge plicy. Optin # Definitin Optin # Definitin 7. BACKREST / SEATING Bcks (Slid Bck Depth = 2" Less Thn Frme Depth) 187PU4 Shrt Slid Bck 12" (Requires slid set) 187PU5 187PU6 187BT13 Med. Slid Bck 14" Tll Slid Bck 16" Omit Bckrest Jy Bcks (Optinl) Ordering JAYbcks n-chir, See the JAY List. Requires Prt # JAY Bundled Bckrest 187JB02 Bckrest Nme r Prt # List Width: Height: Stller Hndle Bck Psts - Bckrests 187BP9 187BP10 187BP11 187BP13 187RG1 Fixed Height Lw (19" Ht) Medium (22" Ht) Tll (25" Ht) Remvble Extensin Flding Adjustble Rigidizer $85.00 $175.00 187B202 187PH8 187PH9 187B203 187PH8 187PH9 Height Adjustble Rigid Frme w/ Angle Adjust Push Hndle Std. (16"-22" Height.) Std. Angle Adj. Push Hndle Lgth Lng Angle Adj. Push Hndle Length Tll (19"-25" Height.) Std. Angle Adj. Push Hndle Lgth Lng Angle Adj. Push Hndle Length 187B204 187BP47 Flding Frme with Push Hndle Std. (17"-23" Height.) Swing Awy Hndle (nt vilble with dul triggers) Fixed Rigid FIGURE 9.1 - HANDLE HEIGHT DIAGRAMS Flding 187B205 187BP47 Tll (20"-26" Height.) Swing Awy Hndle (nt vilble with dul triggers) ORDER INFORMATION: Custmer Service: 800-333-4000 Fx: 800-300-7502 www.sunrisemedicl.cm Specifictins re subject t chnge withut ntice. Cpyright 2013 Sunrise Medicl MK-100014 REV.C Pge 5
Mrk Fr: The CODES prvided re bsed n cde verifictin thrugh PDAC r ur interprettin f the cde definitins. The use f CODES des nt ensure cverge r pyment. Fr cverge infrmtin, verify the pprprite pyer's cverge plicy. Optin # Definitin Optin # Definitin 8. ARMRESTS / SIDEGUARDS Armrest nd Armpd - Height Adjustble Armrest Receiver fr Height Adjustble Armrest 187AA12 T-Pst Regulr w/fm 187AR17 Lw (nt vil. w/lite Spkes) 187AA13 T-Pst Tll w/fm 187AR18 Std 187AA3 Flip-Up 187AA1 Adjustble Lcking Flip-Up $255.00 Side Gurd 187AA7 Length Adjust. Lcking Flip-Up $265.00 (Nt vilble with height djustble rmrests r T-Pst rmrests) 187AM23 187AM24 187AM9 Desk Length (10") Full Length (14") Fm Shrt (nt vil. w/t Pst) 187SG33 187SG29 K0108 Plstic Std $125.00 K0108 Plstic Lw $125.00 187AM10 Fm Lng (nt vil. w/t Pst) Armrest - Height Adjustble 187AA11 Single-Pst Height Adj. Std. $285.00 187AM23 Desk Clssic 187AM21 187AM24 187AM22 187AA29 Desk Cntur Full Clssic Full Cntur Single-Pst Height Adj. Lw $285.00 187AM23 187AM21 187AM24 187AM22 Desk Clssic Desk Cntur Full Clssic Full Cntur Armrest Size Trnsfer Tube Length D Receiver H Rnge CLASSIC PAD Pd Length L Desk Full 8" 5 1/4" 10 3/4" t 15 3/4" 8 3/4" t 13 3/4" 9" t 13" 7 1/4" t 11 1/4" 10 1/4" 14" CONTOUR PAD Armrest Size Trnsfer Tube Length D Receiver H Rnge Pd Length L Desk Full 8" 5 1/4" 10" t 15" 8 1/4" t 12 1/2" 8 1/2" t 12 1/2" 6 3/4" t 10 3/4" 10 1/2" 14 1/4" Armrest Mtrix fr Single Pst ORDER INFORMATION: Custmer Service: 800-333-4000 Fx: 800-300-7502 www.sunrisemedicl.cm Specifictins re subject t chnge withut ntice. Cpyright 2013 Sunrise Medicl MK-100014 REV.C Pge 6
Mrk Fr: The CODES prvided re bsed n cde verifictin thrugh PDAC r ur interprettin f the cde definitins. The use f CODES des nt ensure cverge r pyment. Fr cverge infrmtin, verify the pprprite pyer's cverge plicy. Optin # Definitin Optin # Definitin 9. KEY OPTIONS 187A1 187A2 187A8 Bck Pck (Kids Bckpck included) Utility Bckpck - Blck Additinl Kids Blck Bckpck $50.00 Set Puch Blck $45.00 Psitining Belt (w/clmps) 187A112 E0978 1" Dul Pull Side Squeeze Pdded $85.00 187A117 E0978 Belt 2" Aircrft Buckle $110.00 187A118 E0978 Belt 2" Aircrft Buckle Pdded $10 187A141 E0978 Belt 1.5" Aut Buckle w/clmps $70.00 187A814 E0978 1" Cmfrt Fit APB5116 $10 187A83 187AO1 Tl Kit $45.00 (Nt vilble with 12", 16" nd 18" rer wheels & Prjectins Hndrims) 187A23 K0065 Blck $115.00 187A303 K0065 Cler Zippie $115.00 187AT1 Miscellneus Anti Tips E0971 Frnt Anti-Tip (Nt vilble with cster pin lcks) (Nt vilble with trnsit ptin) E0971 Spke Gurd Rer Anti-Tip Cnpy (SunShde) (Need 2" bck pst clernce t munt cnpy hrdwre, my require next height bsed n seting; plese nte sme interference my ccur with sme hedrest cnfigurtins) 1878A06 1878A07 K0108 K0108 Cnpy (Sunshde) 10"-14" Width Cnpy (Sunshde) 15"-20" Width $275.00 $275.00 Upper Extremity Supprt Try When rdering try with full rmrest r desk rmrest pds, dd 1" t set width t determine best try size. $150.00 187A29 187A30 187A31 E0950 E0950 E0950 X-Sm (Suggested 10"-12" Width) Sm (Suggested 13"-14" Width) Med (Suggested 15"-17" Width) $140.00 187A32 E0950 Lrg (Suggested 18"-20" Width) 10. FRAME COLOR Stndrd Clrs 187C140 Aztec Gld 187C2 Blck (Nt vil s bse w/zebr) 187C141 Blck Cherry 187C10 Blck Opl 187C38 Blue Opl 187C36 Cndy Blue 187C14 Cndy Purple 187C35 Cndy Red 187C142 Electric Blue 187C143 Evergreen 187C126 Glw 187C144 Green Apple 187C147 Ht Sprkle Pink 187C148 Muve Pink 187C103 Rtbeer 187C114 Sprkle Silver 187C145 Sunrise Ornge 187C113 Titnium Clr Pint 187C8 Yellw 187C116 187C151 187C152 187C150 187C149 187C42 187C108 Cmmnly Requested Optins Include: Dynmic Bck Reclining Bckrest Custm Andizing Custm Pint O2 Hlder with Trnsit IV Ple with Trnsit Stndrd Mtte Clrs Mtte Blck Mtte Blck Cherry Mtte Purple Mtte Electric Blue Mtte Evergreen Custm Clrs 187C43 Mssy Ok Cmuflge Strs nd Stripes Zebr (Chse bse clr bve: White Std, n/ blck, blck pl, mtte blck r titnium) Additinl Optins Thrugh Built fr Me T inquire but ny unique custmiztin fr Quickie prducts, cntct: Phne: (800) 333-4000, Fx: (800) 333 9011 ORDER INFORMATION: Custmer Service: 800-333-4000 Fx: 800-300-7502 www.sunrisemedicl.cm Specifictins re subject t chnge withut ntice. Cpyright 2013 Sunrise Medicl MK-100014 REV.C Pge 7