Quickie 2HP July 2018 EIHP Mark Fr: Submitting fr: Qute Order Date: PO#: Dealer Acct #: Dealer: ADDITIONAL SHIPPING INFORMATION Dealer Cntact: Ship T: Dealer Address: Attentin: Dealer City: PV: PC: Address: Dealer Phne: ( ) Fax: ( ) Address: Cnfirmatin Email: Ship T City: PV: PC: Cnfirm Via: Fax Email Ship T Phne: ( ) Fax: ( ) a Optin # Definitin Price a Optin # Definitin Price 1. FRAME 018WM33 018WM33 Base mdels 60 Fixed Frnt Frame 70 Fixed Frnt Frame N/A w/ Kids Frame r 8" Casters $3,020.00 $3,020.00 018RS2 018RS1 Rear Frame Type (250 lbs. Weight Capacity) Rear Side Frame Runded Lwest tw axle plate psitins N/A w/ 20" rear wheels and 8" caster Rear Side Frame Straight 018TO1 Transit System Transit System N/A w/ Padded SA Armrests, Strller Handles r Xtender Pwer Assist; Includes Stabilizer Bar Heavy-Duty - 350 lbs. Maximum Weight Limit N/A w/ Xtender Pwer Assist. Package includes: Tri-Crss Brace, Reinfrced Back Uphlstery, Stabilizer Bar 018HV1 Heavy Duty $1,165.00 018W2 018W3 018W4 018W5 018W6 018W7 018W8 018W9 018W10 018W11 018W12 018W13 2. SIZE / SEATING Frame Width Seat Depth 11" (by uphlstery) - 20" Available nly n lng frame r extra lng frame fr 19"-20" deep. 12" and sling depths N/A w/70 shrt frame r 60 kids frame 19" -20" Extra lng frame steel reinfrced. 14" 018SD3 10" 018SD4 11" 16" 018SD5 12" 018SD6 018SD7 14" 19" $284.00 018SD67 20" $284.00 018SD9 16" 21" (Only Avail. w/ Heavy Duty) $284.00 018SD10 22" (Only Avail. w/ Heavy Duty) $284.00 018SD11 018SD72 19" $284.00 Frame Length 018SD13 20" $284.00 Kids / Shrt 60 & 70 N/A w/ HD Package, 26" rear wheels r and sling depths 018FL2 018FL7 Kids 60 Shrt 60 (10"-14" nly) (10"-11", - nly) 018CU1 Cushin 2" Cushin 018FL12 Regular 60 (- nly) 018CU2 Omit Cushin 018FL22 Lng 60 (- nly) 018CU4 Omit Sling ($21.00) 018FL27 X-Lng 60 (-20" nly) 018FL8 Shrt 70 (10"-11", -16" nly) JAY Bundled Cushins - Optinal 018FL13 Regular 70 (- nly) T rder any JAY cushins n-chair, please see JAY Price List. Cushin name 018FL23 Lng 70 (- nly) r part number must be filled ut with desired width & depth. 018FL28 X-Lng 70 (-20" nly) JAY Bundled Cushin 018JC20 Cushin Name r Part #: Price List Width: Depth: Custmer Service: (800) 263-3390 Fax: (800) 561-5834 E-Mail: cscanada@sunmed.cm www.sunrisemedical.ca Specificatins are subject t change withut ntice. 2018 SMC. MK-100061 REV (G), MK-100061-CAN REV (4). Page 1 f 5
3. CASTERS 018CW1 018CW3 018CW31 018CW5 018CW7 018CW6 018CW33 018CW34 018CW35 018CW21 018CW32 018CW36 018CW37 018CW12 Caster Wheels 3" Micr N/A w HD package 4" Lw Prfile Plyurethane N/A w/ HD package 6" Plyurethane 6" x 1.5" Semi-Pneumatic nly avail. fr use in bttm frk hles 8" Pneumatic 8" x 2" Pneumatic 4" Micr Lighted N/A w/ HD package 5" Lw Prfile Plyurethane 5" x 1.5" Semi-Pneumatic nly avail. fr use in bttm frk hles 5" Sft Rll (Grey) N/A w/ Frg Legs 6" Pneumatic 8" Plyurethane 8" x 2" Pneumatic w/airless Insert Omit Casters $116.00 $228.00 $363.00 018CF46 018CF44 018CF29 018CS5 018CS9 018CS3 Caster Frk Multi Psitin Frk Frg Legs N/A w/ 8" casters. N/A w/ Xtenders Pwer Assist 8"x2" Frk Caster Frk Optins 3/4" Lnger Frk Stem Blt 1-1/2" Lnger Frk Stem Blt Caster Pin Lcks N/A w/8"x2" NA w/ Xtender r Frg Legs $530.00 $140.00 4. REAR WHEELS / SEAT HEIGHT Xtender Pwer Assist RSH f 14.5"-20" fr 22" rear wheels and RSH 15.5"-21" fr 24" wheels. N/A w/ Transit r HD Optins. 22" & 24" wheels nly. Dual Drive mde available with B4ME. Higher seat heights may be available thrugh Built 4 Me. 018XT6 22" Xtender Pwer Assist JWX-2 NICKEL $9,225.00 018XT7 22" Xtender Pwer Assist JWX-2 LITHIUM $10,710.00 018XT4 24" Xtender Pwer Assist JWX-2 NICKEL $9,225.00 018XT5 24" Xtender Pwer Assist JWX-2 LITHIUM $10,710.00 Please select ne f the fllwing handrim ptins 018XH5 Plastic Cated 018XH6 Stainless Steel Xtender - Other Optins 018XA10 Spare NiMH Pwer Pack - NICKEL $1,777.00 018XA11 Spare Li-in Pwer Pack - LITHIUM $2,287.00 018XA8 Xtender Wheel Optins SPARE 22" Lite Spke Pneu Alum Rear Wheel Type Ultra Lightweights nly available w/ silver andized aluminum handrim and HP clincher tire. 018RW3 018RW4 018RW8 018RW9 018RW1 018RW2 018RW11 018RR25 018RW77 018RW78 20" Mag Wheel 20" Spke Wheel $295.00 22" Mag Wheel 22" Spke Wheel $295.00 24" Mag Wheel 24" Spke Wheel 26" Spke Wheel $83.00 Omit Rear Wheel and Axle (Intended Size fr Set Up ) ($74.00) 22" Ultra Lightweight Spke Wheel $329.00 24" Ultra Lightweight Spke Wheel $329.00 Perfrmance Wheel Type Cntact Built 4 Me fr Spinergy Clr Optins 018RW42 24" Spinergy (540) SPOX Black 018RW43 24" Spinergy (559) SPOX Black 018RW88 24" Spinergy (540) LX Black 018RW89 24" Spinergy (559) LX Black Rear Wheel Tire $797.00 $1,082.00 $1,025.00 $1,082.00 018XA9 SPARE 22" Lite Spke Pneu Plastic $133.00 018RT1 Pneumatic 018XA2 SPARE 24" Lite Spke Pneu Alum 018RT2 Pneumatic Airless Insert $228.00 018XA4 SPARE 24" Lite Spke Pneu Plastic $133.00 018RT3 018RT6 Full Ply Available in 20",22" & 24" High-Pressure Clincher N/A w/ Perfrmance $96.00 018RT21 Schwalbe Marathn Plus Evlutin 018RT38 SHOX Perfrmance Ply Custmer Service: (800) 263-3390 Fax: (800) 561-5834 E-Mail: cscanada@sunmed.cm www.sunrisemedical.ca Specificatins are subject t change withut ntice. 2018 SMC. MK-100061 REV (G), MK-100061-CAN REV (4). Page 2 f 5
4. REAR WHEELS / SEAT HEIGHT (Cnt.) Hand Rim Natural Fits available in 22" and 24". Handrim selectin N/A w/ Xtender. Ultra lightweight wheels nly available w/ alum andized handrim 018HR1 018HR4 018HR7 Aluminum Andized Plastic Cated Omit Hand Rim ($12.00) 018HR22 Natural Fit - Standard Grip $345.00 018HR23 Natural Fit - Super Grip $401.00 Prjectin Hand Rim Only available with MAGs r Spke wheels. 018HR8 8 Oblique 018AL2 018AL6 018AL5 018AL29 Axle Plate Standard Adjustable Amputee Adjustable Lwest 2 axle plate psitins NA w/ runded rear frame, 20" rear wheels with 8" casters Curved Adjustable Offset Adjustable NA w/ swing-away r flip-back armrests; height adjustable armrests available at swing-away price 018AX1 018AX11 018AX30 Axle Quick Release Steel Quad Quick Release Omit $168.00 One Arm Drive N/A with amputee axle plate,26" rear wheels, r 21" r 22" seat widths, Xtender Pwer Assist, 11" r 12" frame width, HD package, padded SA armrests, and anti-tip. Only available fr use in bttm frk hles and mag wheel. Rear seat height will adjust in 1/2" increments. Rear seat height will be 1/4" lwer than std 018AL16 018OA1 018HM2 018HM1 018OA2 018HM2 018HM1 One Arm Drive Adj. Axle Plate $1,276.00 Small Handrim (N/A w/ 20" wheels) Left Hand Munt Right Hand Munt Standard Handrim Left Hand Munt Right Hand Munt 5. WHEEL LOCKS 018WL1 018WL2 018WL14 018WL5 Wheel Lck High Munt Push High Munt Pull High Munt Right Push/Left Pull High Munt Scissr N/A w/ extensin handles, grade aides, kids frame, shrt frame, r highest axle plate psitin n rear frame 018EH1 018GA1 Extensin Handle 6" Pair Grade Aid Grade Aid N/A w/ ply, high-pressure clincher tires, r kids length frames $67.00 018WL10 018WL12 Omit D Nt Munt 6. FOOTREST Ftplates Heel lp r leg strap nt included, See Ftplate Optins Sectin 018F1 Cmpsite Available n 14"-22" widths 018F3 Aluminum Angle Adj Available n 14"- 22" widths 018F48 018F7 Platfrm Flip Up N/A w/ shrt extensin tubes Omit Ftplate & Ext Tube $162.00 $212.00 ($16.00) 018HL1 018HL5 018HL4 018HL6 018IG2 Ftplate Optins Heel Lp Leg Strap Omit Heel Lp Omit Leg Strap Impact Guard Impact Guard Neprene Ftrest Extensin Tubes 018E1 Shrt (14"-16 1/2") 018E2 Medium (16 1/2"-19") 018E5 Lng (19"-21 1/2") High Munt Only avail. w/ angle 018E16 adj ftplates $90.00 Custmer Service: (800) 263-3390 Fax: (800) 561-5834 E-Mail: cscanada@sunmed.cm www.sunrisemedical.ca Specificatins are subject t change withut ntice. 2018 SMC. MK-100061 REV (G), MK-100061-CAN REV (4). Page 3 f 5
Back Type - Chse Optin 1 r Optin 2 7. BACKREST / SEATING OPTION 2 - Angle Adjustable Backrest (+3 t -15 ) Select pivt pint, back height and back tube - see chart fr ptins OPTION 1 - Standard Backrest N/A w/ flip-back r flip-back height adjustable armrests. 018B1 Lw (8.5"-12") 018BT20 Angle Adjustable Regular Pivt $329.00 018B5 Medium (12"-15.5") 018AH1 Angle Adjustable Pivt 3 018B9 Tall (15.5"-19") 018AH2 018AH3 Angle Adjustable Pivt 4 Angle Adjustable Pivt 5 Backrest Optins (Available w/ Optin 1 r 2) 018BT22 Angle Adjustable Tall Pivt $329.00 018BP3 Push Handle 8 018AH3 Angle Adjustable Pivt 5 Med.r Tall nly, N/A pt. 2 018AH4 Angle Adjustable Pivt 6 018BP2 Omit Push Handle Straight N/A w/hd ($12.00) 018AH5 Angle Adjustable Pivt 7 018BP4 Omit Push Handle 8 N/A w/hd Optinal Pre-Set Angle Backrest Uphlstery 018BD5 018BD4 Back Angle - 15 Back Angle - 12 018BU1 Standard Uphlstery 018BD3 Back Angle - 6 018BU8 Adjustable Uphlstery $188.00 018BD2 Back Angle - 0 018BU16 Reinfrced Included w/hd ptin $49.00 018BD1 Back Angle +3 018BU14 Omit Back Uphlstery ($21.00) Back Tube Height (See Chart) Strller Handles N/A w/ push handles when angle adjustable back is selected. N/A w/ amputee axle plate, 018B1 018B5 018B9 Lw Medium Tall flip back r flip back height adj arms Optinal Back Height (See Chart fr Desired Height) 018SR2 Regular Strller Handles $178.00 018B56 12" 018SR3 Tall Strller Handles $178.00 018B57 018B58 018B59 018B60 018B61 018B62 018B63 018B64 018B65 14" 16" 19" 20" 21" 018JB01 JAY Back (Optinal) J3 Back (See J3 Order Frm) Price List ANGLE ADJUSTABLE BACKREST CHART Back Tube Height LOW MEDIUM TALL Pivt Regular set at 3" 12" 14" 16" 19" Pivt Regular set at 4" 14" 16" 19" 20" Pivt Regular set at 5" 14" 16" 19" 19" 20" 21" Pivt Tall set at 5" 14" 16" 19" 19" 20" 21" Pivt Tall set at 6" 16" 19" 20" N/A Pivt Tall set at 7" 16" 19" 20" 21" N/A Adjustable Pivt Pint Preset Measurement frm Seat Sling 8. ARMREST / SIDE GUARDS Armrest N/A w/ kids frame, amputee axle plate, ext. handles, grade aids, highest axle plate psitin n runded rear frame. N/A w/ angle adjustable back rest 018AA6 Flip Back Height Adj (Classic) $351.00 018AM1 018AM2 Desk Length - Classic (10") Full Length - Cntur (14") 018AA9 Height Adjustable Kids $313.00 018AM1 Desk Length - Classic (10") 018AM2 Full Length - Cntur (14") 018AA8 Height Adjustable Adult $313.00 018AM1 Desk Length - Classic (10") 018AM2 Full Length - Cntur (14") 018AA5 018AA16 018AA14 018SG3 018SG4 Armrest (Cnt) Flip Back N/A w/ kids frame, amputee axle plate, ext. handles, grade aids, highest axle plate psitin n runded rear frame. N/A w/ angle adjustable back rest Padded Swing-Away Adult N/A w/ amputee axle plate. Omit Armrest Omit Armrest Side Guard Plastic side guards N/A w/ height adj. arms. Side guard interference w/ Padded SA arms at sme heights may exist. Plastic Regular Plastic Kids $289.00 Custmer Service: (800) 263-3390 Fax: (800) 561-5834 E-Mail: cscanada@sunmed.cm www.sunrisemedical.ca Specificatins are subject t change withut ntice. 2018 SMC. MK-100061 REV (G), MK-100061-CAN REV (4). Page 4 f 5
9. KEY OPTIONS & ACCESSORIES 018AT1 018A1 018A2 018A8 018A49 Rear Anti-Tip Rear Anti-Tip $111.00 Backpack Quickie Backpack Black $103.00 Quickie Kids Backpack Black $96.00 Seat Puch Quickie Seat Puch Black Crutch Hlder Crutch Hlder $77.00 $106.00 N/A w/ Xtender Pwer Assist; Only available w/ Mag and Lite Spke wheels 018A23 Black Spke Guards 018A24 Clear Spke Guards 018A141 018A117 018A118 018A120 018A31 Psitining Belts Belt 1.5" Aut Buckle w/clamps Belt 2" Aircraft Buckle w/clamps Belt 2" Aircraft Buckle Pad w/clamp Psitining Belt Slide Clamps Spke Guards Wheelchair Tray Table Tray Table $90.00 $129.00 $188.00 $351.00 018A54 Extra Leg Strap Extra Leg Strap Black 018A82 018A83 Caddy Tl Kit Miscellaneus $83.00 $39.00 10. COLOR Standard Frame Clrs 018C140 Aztec Gld 018C116 Matte Black 018C2 Black (Nt avail as base w/zebra) 018C151 Matte Black Cherry 018C141 Black Cherry 018C150 Matte Electric Blue 018C10 Black Opal 018C149 Matte Evergreen 018C38 Blue Opal 018C152 Matte Purple 018C36 Candy Blue 018C14 Candy Purple Custm Frame Clr 018C35 Candy Red 018C112 Desert Camuflage 018C142 Electric Blue 018C43 Mssy Oak Camuflage 018C143 Evergreen 018C42 Stars & Stripes 018C126 Glw Zebra (Chse abve base clr) Std 018C144 Green Apple with White unless abve base paint is 018C108 chsen N/A w/ Blk, Matte Black, Blk Opal 018C147 Ht Sparkle Pink r Titanium) 018C148 Mauve Pink 018C103 Rtbeer 018C114 Sparkle Silver 018C145 Sunrise Orange 018C113 Titanium Clr Paint 018C8 Yellw Matte Frame Clrs BUILT FOR ME T inquire abut any unique custmizatin fr Quickie prducts, cntact: Phne: (800) 263-3390, Fax: (800) 561-5834 Custmer Service: (800) 263-3390 Fax: (800) 561-5834 E-Mail: cscanada@sunmed.cm www.sunrisemedical.ca Specificatins are subject t change withut ntice. 2018 SMC. MK-100061 REV (G), MK-100061-CAN REV (4). Page 5 f 5