RXS Invoice to: Ship to: Name: Name: Street: Street: Town: Post Code: Town: Post Code: Telephone: Fax: Telephone: Fax: Order Date: Marked for: Purchase Order Base Price £1,325.00 Fax number: +44 (0)845 605 66 89 Email: [email protected] Maximum user weight limit 113kg Standard features u Foldable modular aluminium frame u u Swing-away footrests 24" quick-release rear wheels, pneumatic tyres, cross-spoked u Standard front seat height 49.5cm (19 5/8") u u Standard rear seat height 47cm (18 1/4") Infinite centre point of gravity adjustment achieved with slotted vertical axle plate u Low rider hemi-frame available, front seat u 8" front castors with pneumatic tyres u Wide choice of frame colours u Backrest height 37.5cm-42.5cm (15"-17") u Weight 14kg u Minimum seat height 38cm (15") u Black anodised frame parts u Tension adjustable nylon seat upholstery and u This Quickie model is ideal in combination with a height 44cm (17 5/8") 5cm (2") seat cushion JAY seating system u Swing-away armrests u Maximum user weight limit 113kg u Height adjustable backrest with padded nylon upholstery u Crash tested and passed How to measure: Seat Depth Seat Width From front of seat sling to back of seat sling From outside seat rail tube to outside seat rail tube OF-QUICKIE-RXS-RETAIL-01-10-2013-REV1 Frame Length Back Height From outside rear frame to outside front frame From seat sling to top of backrest sling RXS Invoice to: Ship to: Name: Name: Street: Street: Town: Post Code: Town: Post Code: Telephone: Fax: Telephone: Fax: Order Date: Marked for: Purchase Order (Repeat on all pages): £ £ MODEL (Mark one box) m m Quickie RXS (swing-away front frame) Quickie RXS (hemi front frame) FRAME COLOUR (Mark one box) Gloss Finish: Matt/Frost Finish: m 1 White Ral 9010 m 15 Brilliant Marine q 3 Matt Silver q 16 Matt Marine 72 m 2 Brilliant Silver m 19 Brilliant Purple q 8 Matt Lime q 20 Matt Purple 72 m 4 Silver m 21 Red Ruby q 10 Matt Candy Teal q 23 Matt Red 72 m 5 Silver Moon m 22 Brilliant Red m 6 Sun Yellow m 24 Tutti Fruitti Orange m 7 Brilliant Lime m 26 Silver Texture m 9 Candy Teal m 27 Graphite Metallic m 14 Blue m 28 Platinum Metallic m 29 Black COLOURED CHAIR PARTS m q Coloured crossbrace (Same colour as frame) Chair colour set (Castor fork, housing, crossbrace, 64 handrim, seat rails & axle plate) Colour (Mark one box): q 3 Matt Silver q 16 Matt Marine 141 q 8 Matt Lime q 20 Matt Purple 141 q 10 Matt Candy Teal q 23 Matt Red 141 FRAME WIDTH (Mark one box) m Frame width 14"/ 35 cm m Frame width 18"/ 45 cm m Frame width 15"/ 37.5 cm m Frame width 19"/ 47.5 cm m Frame width 16"/ 40 cm m Frame width 20"/ 50 cm m Frame width 17"/ 42.5 cm m Frame length kids (1, 11) FRAME LENGTH (Mark one combination of frame length and seat depth) m m m Seat Depth 14"/35cm Frame length reg q Seat depth 15"/37.5 cm m Seat depth 16"/40 cm Frame length long q Seat depth 17"/42.5 cm m Seat depth 18"/45 cm 47.00 47 SEAT TYPE (Mark one cushion and sling choice) Cushion: m Cushion 2"/ 5 cm q Omit cushion m 8º Bend backrest with push handles Sling: m Upholstery (Mark one box): m Padded upholstery q Optima back upholstery (tension adjustable) q Omit back upholstery Back Height (Mark one box): m 12-15"/30-38 cm (Factory setting 14"/35 cm) m 15-18"/38-46 cm (Factory setting 17"/43cm) m 17-20"/43-50 cm (Factory setting 19"/50cm) Sling upholstery, tension adjustable q Omit sling upholstery -26 BACKREST (Mark one type and choices underneath) OF-QUICKIE-RXS-RETAIL-01-10-2013-REV1 103 -25 -21 TOTAL £ £ BACKREST (Mark one type and choices underneath) (Continued) q Half folding backrest with push handles 48 m 8º back tubes Upholstery (Mark one box): m Padded upholstery q Omit back upholstery q 8º Backrest with integrated height adj. push handles 93 Upholstery (Mark one box): Backrest Angle (Mark one box): m Straight back tubes m Padded upholstery q Optima back uphol. (tension adj, with back stabilizer bar) 103 q Omit back upholstery -25 Back Height (Standard): -25 l 14"-20"/35-50cm (Factory setting 16"/38 cm) Back Height (Mark one box): m 15-18"/38-46cm (Factory setting 17"/43cm) m 17-20"/43-51cm (Factory setting 19"/48cm) m Padded swing-away armrest (pair) q Tool height adj. w/10" std pad armrest (pair) (8) (Not with amputee axle plate or optima back) q Tool height adj. w/14" full length pad a/rest (pair) (8) 48 ARMRESTS (Mark one box) 48 q Adult composite height. adj. w/10" std pad (pair) (8) 118 q Kids height adjustable w/10" std pad armrest (pair) 118 q Adult composite height. adj. w/14" full length pad (pair) (8) 118 q Kids height adjustable w/14" full length pad armrest (pair) 118 q Adult aluminium height. adj. w/10" std pad (pair) (8) 118 q Kids tool height adjustable armrests 10" (pair) 48 q Adult aluminium height. adj. w/14" full length pad (pair) (8) 118 q Omit armrest (pair) -46 q Plastic side guards (pair) 137 SIDE GUARDS (Optional) q (Not in combination with height adj armrests) Fender guards (pair) 178 (Not with height adjustable armrests or Kids frame) q Fabric side guards 48 HANGERS/FOOTPLATES/EXTENSION TUBES (Mark one type or omit) m 60º Hangers (pair) Footplates (Mark one box): q One piece flip-up angle adj. f/plate w/legstrap (pair) (2) m Composite Footplates w/heel loops (pair) q Angle adjustable Footplates w/heel loops (pair) m Foam Footplates w/legstrap (pair) (2) q Omit Footplate (pair) m 70º Hangers (pair) Footplates (Mark one box): 118 73 -25 Legstrap (optional): q Additional Legstrap q One piece flip-up angle adj. footplate w/legstrap (pair) (2) m Composite Footplates w/heel loops (pair) q Angle adjustable Footplates w/heel loops (pair) m Foam Footplates w/legstrap (pair) (2) q Omit Footplate (pair) 118 73 -25 Legstrap (optional): 25 Extension Tubes (Mark one box): q Additional Legstrap 25 Extension Tubes (Mark one box): m Ext. Tubes short/med (pair) m Ext. Tubes short/med (pair) m Ext. Tubes long (pair) m Ext. Tubes long (pair) Amputee support pad (is fitted to hanger and Amputee support pad (is fitted to hanger and replaces footplate and ext. tube) (optional): replaces footplate and ext. tube) (optional): q Amputee support pad left 16 q Amputee support pad left 16 q Amputee support pad right 16 q Amputee support pad right 16 q Articulating legrest (pair) (not on hemi frame) 297 m 70º V-Hangers (9) (not on hemi model) Footplates: (not available with hemi frame) Calf Pad: l Straight calf pad Footplates (Mark one box): m Composite flip-up Footplates w/heel loop (pair) q Angle adjustable Footplates w/ heel loops (pair) 73 q Omit Footplate (pair) -25 Ext. Tubes med (pair) m Ext. Tubes long (pair) q Elevating legrest (pair) (not available on hemi frame) One piece flip-up angle adj. f/plate w/legstrap (pair) (2) Composite Footplates w/heel loops (pair) q Angle adjustable Footplates w/heel loops (pair) m Foam Footplates w/legstrap (pair) (2) q Omit Footplate (pair) Additional Legstrap 163 m Ext. Tubes short (pair) m Ext. Tubes med (pair) m Ext. Tubes long (pair) m 90º Hangers (pair) (Not available with 26" wheels Composite flip-up Footplates w/heel loop (pair) q Angle adjustable Footplates w/heel loops (pair) 73 q Angle adjustable Footplates w/heel loops (pair) q Omit Footplates (pair) -25 m 90º Adj. flip-up footplates w/legstrap (pair) (2) q Omit Footplate (pair) m Ext. Tubes short/med (pair) m Ext. Tubes long (pair) OF-QUICKIE-RXS-RETAIL-01-10-2013-REV1 -25 25 or 8" castors, not available. on hemi frame) m m Curved calf pad Extension Tubes (Mark one box): 73 Extension Tubes: Footplates (Mark one box): Calf Pad: m Straight calf pad 118 Legstrap (optional): q Extension Tubes (Mark one box): m q m Footplates (Mark one box): 73 -25 Legstrap (optional): q Additional Legstrap 25 q Omit Hangers and Footplate (pair) -25 TOTAL £ £ CASTORS (Mark one box) m 5" Solid (pair) m 8" Pneumatic castors (pair) (4) m 5" Low-profile polyurethane castors (pair) m 8" Solid castors (pair) (4) m 6" Pneumatic castors (pair) m 8" x 2" Solid castors (pair) m 6" Solid castors (pair) (Not available with any castor stem options, 26" wheels, only with 60º hangers, not on Kids frame) CASTOR FORKS (Mark one box) m 5 1/4" castor fork (pair) m 7" castor fork (pair) m 6" castor fork (pair) m 8" castor fork (pair) (Only avl. w/8" x 2" castors & not w/castor stem opt.) CASTOR STEM (Option) m 3/4" Longer fork stem bolt (pair) m 1 1/2" Longer fork stem bolt (pair) AXLE PLATES (Mark one box) m Slotted indexed vertical axle plate (pair) q Amputee axle bracket (pair), mounted behind rear frame -39 q Amputee axle bracket (pair), mounted in front rear frame -39 AXLES (Standard) l Quick release axles (pair) REAR WHEEL SIZE/TYPE/TYRE/HANDRIM (Mark one combination of wheel, tyre type, handrim and tab) m Rear wheel size 22" m Rear wheel size 24" (not on Kids frame) Rear Wheel Type: Rear Wheel Type: m Mag (pair) m Mag (pair) m X-spoke (pair) m X-spoke (pair) Tyre Type: Tyre Type: m Pneumatic tyre (pair) q Solid tyre (pair) m Pneumatic tyre (pair) 32 Handrims: m Aluminium handrim (pair) q Solid tyre" (pair) 32 q High pressure clincher (pair) (5) 48 Handrims: q Plastic coated handrim (pair) 73 m Aluminium handrim (pair) q Omit handrims (pair) -28 q Plastic coated handrim (pair) Tabs: m Short screw tabs (pair) q Long screw tabs (pair) 47 73 q Stainless steel handrim (pair) (5) 84 q Omit handrims (pair) -28 Tabs: m Short screw tabs (pair) q Rear wheel size 26" (Not on Kids frame) 53 Rear Wheel Type: 47 q Rear wheel size 12" 114 Rear Wheel Type: m X-spoke (pair) m Mag (pair) Tyre Type: Tyre Type: m Pneumatic tyre (pair) q High pressure clincher (pair) q Long screw tabs (pair) m Pneumatic tyre (pair) 48 q Solid tyre (pair) 32 Handrims: m Aluminium handrim (pair) q Plastic coated handrim (pair) 73 q Stainless steel handrim (pair) 84 q Omit handrims (pair) -29 Tabs: m Short screw tabs (pair) q Long screw tabs (pair) 47 WHEEL LOCKS (Mark one box) m High push knee lever wheel locks (pair) m Active wheel lock q Drum brakes (pair) (Not available with Mag wheels or 26" wheels) m High scissor wheel locks (pair) 310 (Not on children's frame, ext. handles) WHEEL LOCK OPTION q 6" Wheel lock extension (pair) 33 ACCESSORIES (Optional) q Caddy (pair) (Not available with ELR/ALR or 90° hangers) 48 q Step tube left q Crutch holder 54 q Step tube right 8 q Spoke guards Space Alien 22", 24" (pair) (5) 100 q Backpack 48 q Spoke guards Purple Turtle 22", 24" (pair) (5) 100 q Seat pouch 41 q Spoke guards Get Out There 22", 24" (pair) (5) 100 q Positioning belt buckle 64" 34 q Spoke guards Leopard 22", 24" (pair) (5) 100 q Positioning belt buckle 54" 34 q Spoke guards clear 22", 24" (pair) 93 q Swing-away tray table (6) 155 q Spoke guards black 22", 24" (pair) 93 q Anti-tip tubes (pair) 61 q Neoprene impact guards (pair) (7) 29 q F16 power unit (please fill out F16 order form as well. q Tool kit 21 See F16 order form for restrictions that apply on RXS 8 specification when ordering F16) £1,325.00 Base Price OF-QUICKIE-RXS-RETAIL-01-10-2013-REV1 Options: £ Total Price: £ TOTAL Front Seat Height 5 1/4" Fork Fork Size Fork Position 6" Fork 7" Fork Bottom Top* Bottom Top Bottom Top 5" Polys / Solid Tyre 18 1/16" 17 1/16" 18 7/8" 17 7/8" 19 7/8" 18 7/8" 6" Solid Tyre 18 5/8" 17 5/8" 19 7/16" 18 7/16" 20 7/16" 19 7/16" 6" Pneumatic 18 5/8" 17 5/8" 19 7/16" 18 7/16" 20 7/16" 19 7/16" 8" Solid Tyre 19 7/16" - 20 1/4" 19 1/4" 21 1/4" 20 1/4" 8" Pneumatic 19 5/8" - 20 7/16" 19 7/16" 21 7/16" 20 7/16" Castor Type * When using a 5 1/4" fork, the top hole position on the fork becomes the second hole down. Rear Seat Height Std Spec. Overall Chair Width Highest Position Lowest Position 14" width 22" (55cm) 22" Pneumatic 19 3/4" 15 1/4" 15" width 23" (57.5") 22" Solid Tyre 19 3/4" 15 1/4" 16" width 24" (60cm) 24" Pneumatic 20 1/2" 16" 17" width (25" (62.5cm) 24" Solid Tyre 20 1/2" 16" 18" width 26" (65cm) 24" High pressure clincher 20 3/8" 15 7/8" 19" width 27" (67.5cm) 26" Pneumatic 21 5/8" 17 1/8" 20" width 28" (70cm) 26" High pressure clincher 21 1/4" 16 3/4" Axle Plate Position Actual measurements may vary up to 3/8" Based upon standard stem. Folded Width 14 1/2" (37cm) Maximum seat angle 2" (5 cm) Add ¾" for ¾" stem Add 1½" for 1½" stem Add 1/8" for quick release stems. Hemi front frame: Subtract 2" FOOTNOTES: (1) Not available with 24" or 26" wheels or 8" castors (2) Not available with heel loops (4) Not available on Kids frame, 90º hanger or 26" rear wheel (5) Not available on Mag wheels (6) Only available on height adjustable armrests (7) Not available with ELR/ALR or 90° hangers (8) Not on Kids frame (9) Only on seat width 16"/40 cm and above (10) Not available with padded swing-away armrests (11) Not available with hemi front frame OF-QUICKIE-RXS-RETAIL-01-10-2013-REV1
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