SPEEDY 4all "Classicline"

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Im Hofstätt 11 D- 72359 Dotternhausen Tel +49 (0)7427 9480-0 Fax +49 (0)7427 9480-7025 e-mail info@proactiv-gmbh.de www.proactiv-gmbh.de Quotation date: Order date: according to GTC PRO ACTIV GmbH SPEEDY 4all "Classicline" Active easy running rigid frame wheelchair Approved up to 120 kg user load capacity 9016100000 3,089.00 Medical suppliers / Company address: Cust. no.: Name: Street: Postcode, city: Phone: Fax: E-mail: Contact: Invoice address: same as company address Rechnungsadresse: other (see below) Cust. no.: Name: Street: Postcode, city: Phone: Fax: E-mail: Contact: Shipping address: same as company address other (see below) Name: Street: Postcode, city: Customer name / commission: Name: Street: Postcode, city: Phone.: Fax: E-mail: Date of birth: Paying organisation: Indication: - 1-2017-09-19 / The prices are plus statutory value-added tax and shipping costs = Included in the basic price = Position selected

Basic size Body size: Body size: Weight: cm kg Lower leg length: cm (anatomic dimension: hollow of the knee to the foot sole) Wheel chair dimensions: Seat width SB Seat depth ST Back height RH Lower leg length USL Seat height back SHh 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 The following dimensions are optionally available subject to surcharge: Short frame 36 37 38 39 40 41 42 43 51 52 Long frame 40 41 42 43 44 45 46 47 48 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 37 38 39 40 41 42 43 44 45 46 47 48 49 50 39 40 41 42 43 The following dimensions are optionally 44 45 46 47 available subject to surcharge: Seat height front SHv 44 45 46 47 48 49 50 51 52 Tipping point KP 1 2 3 4 5 6 7 8 9 10 Please cross on the appropriate dimension (all dimensions are specified in cm). Underlined values are standard settings. The values SHh and SHv may deviate from the specified values depending on the wheel size and wheel camber! Special dimensions possible upon request. - 2-2017-09-19 / The prices are plus statutory value-added tax and shipping costs = Included in the basic price = Position selected

Frame colour - One-colour design Information on current colour designs and example images under: www.proactiv-gmbh.de/farben.php White RAL 9016 gloss 9000100170-023 matt 9000100170-123 Brilliant Silver gloss 9000100170-011 Anthrazit RAL 7016 gloss 9000100170-001 matt 9000100170-101 Black RAL 9005 gloss 9000100170-003 matt 9000100170-019 Deep black, silver effect gloss 9000100170-007 Pure orange RAL 2004 gloss 9000100170-022 Fire Red gloss 9000100170-018 matt 9000100170-118 Pink magenta RAL 4010 gloss 9000100170-037 matt 9000100170-137 Sky blue gloss 9000100170-017 Pastel blue RAL 5024 gloss 9000100170-036 matt 9000100170-136 Navy blue gloss 9000100170-045 matt 9000100170-145 Apple green gloss 9000100170-014 matt 9000100170-114 Lemon green gloss 9000100170-005 matt 9000100170-105 Purple gloss 9000100170-044 Yellow RAL 1023 gloss 9000100170-046 matt 9000100170-146 Red RAL 3001 gloss 9000100170-047 matt 9000100170-147 Colour - Attachment parts Drive wheel Aluminium rim and hub Caster fork and bearing block silver 9000100171-011 9000100173-011 Rahmenfarbe Frame colour - - Einfarbdesign Two-colour design Information on current colour designs and example images under: www.proactiv-gmbh.de/farben.php Note: With two-colour design, according to both colours of the gloss level of the design colour. Two-colour design 205.90 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 9000100170-200 Silver 9000100170-201 Anthracite 9000100170-202 Black 9000100170-203 Pastel blue 9000100170-206 Lemon green 9000100170-207 Yellow 9000100170-208 Design colours (on the front frame) Yellow gloss 9000100170-261 matt 9000100170-262 Lemon green gloss 9000100170-250 matt 9000100170-251 Blue gloss 9000100170-252 matt 9000100170-263 Chili gloss 9000100170-253 matt 9000100170-254 Pure orange gloss 9000100170-255 matt 9000100170-256 Cappuccino gloss 9000100170-257 matt 9000100170-258 Black black 9000100171-003 9000100173-003 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 144.390 1 RAL 2004 9000100171-022 white RAL 9016 144.90 1 9000100171-023 in frame colour Selection from single colour design deviating from the frame colour 176.10 1 9000100171-999 206.20 1 9000100171-998 5" Aluminium rim 2 3 spoke design 30.70 2 9000100174-022 30.70 2 9000100174-023 51.50 2 9000100174-999 60.80 2 9000100174-998 Please enter the last 3 digits of the desired colour (single colour design): 9000100170-9000100170- gloss 9000100170-259 matt 9000100170-260 Special colour requests (frame or attachment parts) Frame colour single procurement Frame from RAL range of colours Surface coating: gloss matt - 3-2017-09-25 / The prices are plus statutory value-added tax and shipping costs = Included in the basic price = Position selected Colours Rev. 02 9000100170-100 317.20 Colour details with RAL number Note: Attachment parts not possible in design colours 1 Only in combination with aluminium rim drive wheel 9000203000-9000203300 2 Only in combination with caster wheel 5" Aluminium rim 3-spoke design smooth running 9000501200 or 5" Aluminium rim 3-spoke design good shock absorption 9000501210

Frames Note: Footrest area with V-shape x=sb (0,25 x USL + 6cm) Straight Front end 9016100010 Knee angle 105 Straight Front end 9016100012 Knee angle 95 Min. 4 cm seat slope and max. caster wheel size 5" Front end V-shape 9016100020 232.50 Knee angle 95 from SB 33 cm Front end V-shape 9016100023 232.50 Knee angle 105 from SB 33 cm Custom-made seat width dimension 47-52 cm 9016100060 234.00 with frame reinforcement dimensioned for 120 kg user load capacity Push handles Back tube with integrated handles 9016401051 99.90 straight tubes, also possible with lordosis bend: 1cm 2cm 3cm Aluminium push handles fixed in back tube 9016401050 99.90 from RH 23 cm Safety push handles with continuous height adjustment 9016401060 166.00 Mount in the back tube from RH 30 cm with belt cover from RH 43 cm with back shell Safety push handles backpositioned length 45 cm 9016401075 285.50 continuous height adjustment, Safety push handle holder mounted on the back cross bar Up to a SB of 42 cm or a body weight of 95 kg, not in combination with the armrest Push handles, horizontally screwed in back tube 9016401076 185.10 can be unscrewed Backrest Folding backrest 9016400011 7-way inclination adjustment with integrated plastic coated aluminium side parts Back tubes with lordosis bend 9000400005 88.00 1cm 2cm 3cm Back equipment Adaptable back with back padding 9016802010 Colour: black Equipment with back cross bar Raised back + 3-5 cm 9016802100 119.60 (for the nominal back height dimension) Only in combination with continuous height adjustable push handles Art no. 9016401060! Equipment without back upholstery and back padding or back system 9000802011-50.00 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 Body Contour 9016801025 Open belt system 9016801010 58.80-4 - 2017-09-19 / The prices are plus statutory value-added tax and shipping costs = Included in the basic price = Position selected

Equipment without seat upholstery 9000801050 Seat cushion Armrests 25 cm long arm padding mounted on the clothing guard 9016403151 126.90 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 fold up, removable 9000403141 274.60 with arm padding 25 cm long Positioning: upper arm padding edge approx. 25 to 31 cm above the seat tube, adjustable in 1.5 cm steps Not possible in combination with safety push handles back-positioned, Art. no.: 9016401075! Axle plate Standard equipment with 12 mm sockets / axles, further axle plates on request. Standard axle plate 9016201000 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" Clothing guard Aluminium clothing guard removable via lock function Adjustable following wheel arch Only in combination with folding backrest! anthracite, matt 9016403210 186.30 in frame colour (basic colour with two-colour design) 9016403211 in design colour (only possible with frames in twocolour design) 9016403212 238.20 264.20 Carbon clothing guard removable via lock function Adjustable following wheel arch Only in combination with folding backrest! 9000400012 431.60 Rear seat height approx. 39 to 43 cm (for 24" wheel) Long axle plate 9016201020 179.70 Rear seat height approx. 43 to 47cm (for 24" wheel) Removable wheelbase extension Speedy 4all / 4you 9016102001 445.10 Wheel position displacement approx. 14 cm 4 camber integrated, adjustable track Wheel camber Total width with tight mounted hand rim 1 drive wheel camber 9016202010 Total width = approx. SB + 20 cm* 4 drive wheel camber 9016202030 Total width = approx. SB + 26 cm* 6 drive wheel camber 9016202040 Total width = approx. SB + 30 cm* E-adaptions Preparation for "e-motion" mounting 9016201200 229.30 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. Under the selection "Adaptation", please select the equipment 9016300100-001 und 9016300100-002! - 5-2017-09-19 / The prices are plus statutory value-added tax and shipping costs = Included in the basic price = Position selected

Preparation for "e-fix" mounting 9016201210 244.40 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. Under "Adaptation", please select the equipment e- fix Art.-Nr.: 9016300105! Please order anti-tipping support e-fix with "Standard fork" direct from Alber. Wheelchair delivery to Alber GmbH specialist dealer Brake system Brake system push to lock Standard brake handle 9016701010-001 Brake system push to lock Long brake handle 9016701010-002 Brake system push to lock Low brake handle 9016701010-003 Brake handle angle 20 9000700002 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 9016706008 121.50 Length: 9cm Drum brake 9016702010 362.90 Operating from the push handle Total wheelchair width (see selection "Wheel camber") + 3cm! Depending on the seat height, the long wheel plate 9016201020 is mounted in order to protect the drum brake anchors. 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 9016601010 with tubular resting bracket height adjustable +/- 3 cm for KW 95 from USL 34cm for KW 105 from USL 39 cm For equipment of the foot bracket with "Rubber coated footplate", please select under "Footrest accessories". Footrest folding up to one side 9016601300 133.10 with continuous tubular resting bracket, height adjustable +/- 3 cm, can be swung away, cannot be removed for KW 95 from USL 37cm for KW 105 from USL 42cm with V-shape from SB 40cm For equipment of the foot bracket with "Rubber coated footplate", please select under "Footrest accessories". Footrest folding back to the rear with locking mechanism 9000602005 220.00 with tubular resting bracket minimum USL 42cm For equipment of the foot bracket with "Rubber coated footplate", please select under "Footrest accessories". Footrest folding back to the rear 9016602010 235.80 with continuous tubular resting bracket and 20 mm operating lever for KW 95 from USL 38cm for KW 105 from USL 42cm with V-shape from SB 33 cm with V-shape from SB 38 cm For equipment of the foot bracket with "Rubber coated footplate", please select under "Footrest accessories". Divided Footrest 9016603200 257.90 with rubber coated footplate, height adjustable +/- 3cm, angle adjustment, can be pivoted outwards and folded up to the side, including frame reinforcement for KW 95 from USL 37cm for KW 105 from USL 42cm with V-shape from SB 40cm "Swing away" footrest 9016604100 309.90 with rubber coated footplate, separated in the middle, can be folded to the side, removable, can be folded up, height-adjustable, angleadjustable including frame reinforcement from USL 34 cm. - 6-2017-09-19 / The prices are plus statutory value-added tax and shipping costs = Included in the basic price = Position selected

Footrest accessories Rubber coated footplate 9016610000 96.30 bolted, angle-adjustable Depth: 14cm In combination with tubular bracket Art.-no. 9016601010, 9016601300 or 9016602010! Footplate side stop 9016610100 46.00 adjustable Only in combination with rubber coated footplate! Adaptations Anti-tipping support right side 9016300100-001 left side 9016300100-002 129.40 129.40 with tension spring and universal adapter pivotable (for optimum pivoting behaviour, the seat slope should be >3 cm) Universal adapter prepared for e-fix anti-tipping support equipment 9016300105 222.80 Universal adapter is prepared for the assembly of the e-fix jack-up anti-tipping support. Supplied completely mounted, without antitipping support and anti-tipping support mount. On the customer side, please order the antitipping support by Alber! Transit wheels 9016301100 253.90 with universal adapter, removable (not in combination with anti-tipping support) Tilting clamp right side 9016302100-001 108.40 left side 9016302100-002 108.40 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 puncture proof! 4" Caster wheel "Standard" black 9000501011-004 (82A), 5" Caster wheel "Standard" grey 9000501010-005 (82A), 5" Caster wheel "Standard" black 9000501011-005 (82A), 6" Caster wheel "Standard" 9000501010-006 (82A), 5" Lenkrad "2 components" 9000501030 43.00 6" Caster wheel "Pneumatic tyre" 9000501050 43.00 6" Caster wheel "Flexel System" 9000501070 43.00 3" Skate wheel (80 mm) 9000501110 54.20 4" Skate wheel (100mm) 9000501120 54.20 Safety light-up wheel 4" (100mm) 9000501220 92.10 Safety light-up wheel 5" (125mm) 9000501221 92.10 5" Aluminium rim 3-spoke design "easy running" with replaceable rubber race 3 mm, hard, silver, anodised 9000501200 103.80 black 9000501201 103.80 5" Aluminium rim 3-spoke design "good shock absorption" with replaceable rubber race 6 mm, medium hard, silver, anodised 9000501210 103.80 black 9000501211 103.80-7 - 2017-09-19 / The prices are plus statutory value-added tax and shipping costs = Included in the basic price = Position selected

Frog Legs-Caster wheel 4" (ø100x32) 9000501230 137.30 5" (ø125x32) 9000501232 137.30 with replaceable rubber race, black, puncture proof, 3-spokes, rim: silver Caster fork Caster fork colours, see "Component colours" Drive wheels Information on further rim types, versions and avaiabilities under www.proactivgmbh.de Drive wheel, 18 spoke aluminium rim 9000203122 with aluminium front hub, spoked radially Only up to a body weight of 70 kg, not with tyres, not suitable for bike mode. Caster fork Standard 9000500100-001 with screwed axle 9000500100-002 130.40 with quick-release axle Caster fork "Heavy duty" for high loads Extra weight approx. 100-150g 9000510111-001 43.40 with screwed axle 9000510111-002 176.00 with quick-release axle Suspension fork 9000500160-001 334.90 with screwed axle and 5" Aluminium rim "good shock absorption" 9000500160-002 446.20 with quick-release axle and 5" Aluminium rim " good shock absorption" Caster fork spare wheel 9000500300 228.30 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 9000500400 15mm per side 9000500401 45.80 45.80 20mm per side 9000500410 45.80 Drive wheel, 36 spoke aluminium rim 9000203000 with aluminium front hub, spoked radially Drive wheel double rim 36 spokes 9000203100 126.90 25 (ETRTO 559) 9000203200 126.90 26 (ETRTO 590) 9000203300 with aluminium front hub, spoked radially Use with higher loads and body weight > 120 kg! 126.90 Spinergy running wheel "Spox Sport" with 24 PBO spokes; rim, hub and spokes in black 9000203550 561.40 25 (ETRTO 559) 9000201559 561.40 26 (ETRTO 590) 9000203555 561.40 Spinergy "Everyday Light Extreme" with 12 PBO spokes; rim and hub in black, spokes white 9000203554 652.30 Spinergy "Everyday Light Extreme" with 12 PBO spokes; rim, hub and spokes in black 9000203552 652.30-8 - 2017-09-19 / The prices are plus statutory value-added tax and shipping costs = Included in the basic price = Position selected

Handrims x = dimension handrim attachment! Handrim : Curve Handrim attachment: attachment: x = 11mm x = 10mm x = 19mm x = 18mm If no specification is given, the handrims will be mounted wide (19mm/18mm). Ø 20 mm stainless steel handrims 9000205010-004 9000205010-006 Ø 19 mm aluminium handrims silver anodised 9000205019-004 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. 9000205020-004 51.90 9000205020-006 Ø 19 mm aluminium handrims polished and hard-anodised 9000205030-004 9000205030-006 Ø 19 mm titanium handrims 9000205040-004 9000205040-006 Ultra-Grip handrims "very good grip" 9000205070-004 51.90 124.80 124.80 257.90 257.90 316.40 9000205070-006 316.40 Ergo-Grip handrims 9000205080-004 316.40 9000205080-006 Resting attachment to the rim! 316.40 Dual-Grip handrims 9000205110-004 9000205110-006 Silicone handrim covers for 24" hand rim 9000205100-004 for 26" hand rim 9000205100-006 Surface without structure, compatible with handrim Ø 19mm or Ø 20mm. Curve handrim, black anodised, ergonomic handrim profile H 24mm 9000205130-004 H 31mm Size L 9000205140-004 H 31mm Size L 9000205140-006 Curve handrim powder coated, ergonomic handrim profile 178.90 178.90 187.10 187.10 309.90 309.90 309.90 = frame colour (surface gloss) = black (surface gloss) Please note: coating in matt is because of the minimal Grip not recommended. H 24mm 9000205135-004 H 31mm Size L 9000205145-004 H 31mm Size L 9000205145-006 Curve Grip handrim, Tetra-Grip coated, ergonomic handrim profile H 31mm Size L 9000205150-004 Quadro handrims, Tetra-Grip "very good grip" for 24 and 25" wheel 9000205170-004 359.90 359.90 359.90 395.20 395.20 9000205170-006 395.20-9 - 2017-09-19 / The prices are plus statutory value-added tax and shipping costs = Included in the basic price = Position selected

Gekko handrims for 24 and 25" wheel 9000205175-004 395.20 9000205175-006 395.20 Black anodised with strong and exchangeable rubber completely integrated in the handrim profile Equipment without handrims 9000205990 Spoke guard Finger- and spoke guard "transparent" for 24" wheel 9000206300-004 158.60 9000206300-006 158.6 Design and spoke protection film "basket" 9000206310-001 110.80 Only in combination with finger and spoke protection! Design and spoke protection film "silly-bubble" 9000206310-002 110.80 Only in combination with finger and spoke protection! Design and spoke protection film "blue-sky" 9000206310-003 110.80 Only in combination with finger and spoke protection! Design and spoke protection film "colour-stones" 9000206310-004 110.80 Only in combination with finger and spoke protection! Tyres Schwalbe "RightRun" High-pressure tyre 7.5 bar 24x1 (540-25) 9000204000-004 25x1 (559-25) 9000204000-005 26x1 (590-25) 9000204000-006 Schwalbe "DownTown" Tread tyre 7.5 bar 24x1 (540-25) 9000204010-004 Schwalbe "MarathonPlus Evolution" with "smart guard" puncture protection 24x1 (540-25) 9000204030-014 35.50 25x1 (559-25) 9000204030-015 35.50 26x1 (590-25) 9000204030-016 Colour: black 10 bar Schwalbe "MarathonPlus" with "smart guard" puncture protection 24x1 (540-25) 9000204030-004 Colour: grey, black wall, 10 bar Schwalbe "Airborne" 35.50 35.50 24x1,2 (540-20) 9000204122-004 70.70 Colour: black Puncture-proof tyre "solid-rubber tyres" 24x1 (540-25) 126.70 9000204201-004 Colour: black Not in combination with the 18 spoke drive wheel! Puncture protection belt for pneumatic tyres 9000206100 42.80 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: 9000203410 538.70 24x1.75" Continental "RIDE Tour Trekking" Brake setting compatible with 24x1" wheel 9000203411 538.70 518.00 24x1.75" Continental "Explorer" Brake setting not compatible with 24x1" wheel 9000203413 538.70 24x2.1" Schwalbe "SMART SAM Sport" Brake setting not compatible with 24x1" wheel ATTENTION: we charge a surcharge of 150.00 for the use of drum brakes - 10-2017-09-19 / The prices are plus statutory value-added tax and shipping costs = Included in the basic price = Position selected

Lockable drive wheel axle clip "Tetra Clip" Your additional notes: 9000206400 127.40 Not for Spinergy drive wheels! Hand air compressor with pressure gauge up to 14 bar 9000901100 85.50 Adjustable safety belt with belt buckle 9000902100 61.90 Adjustable safety belt with hook and loop fastener 9000902110 46.30 Crutch holder with nylon cup 9000902310 110.40 flexibel Light set 9000903270 82.70 with battery and charger Transport bag for drive wheels for 24" wheel 9000903530-004 Ø76cmx2cm 9000903530-006 Ø83cmx2cm Accessory bag 59.50 59.50 9000903600 58.20 17cm x 13cm x 5cm Further accessories, e.g. adaptive bikes, steering attachments, etc. see separate dimension sheet or www.proactiv-gmbh.de I herewith confirm the details listed above Location, Date Signature (End customer) Location, Date Signature (Dealer) - 11-2017-09-19 / The prices are plus statutory value-added tax and shipping costs = Included in the basic price = Position selected

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