Order Form and Price List: provider locator Invacare® Top ... · Handcycle design is used by...

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Invacare® Top End® Force™ K Handcycle Kneeling Cage Invacare Corporation Top End Division All rights reserved. Trademarks are identified by the symbols ™ and ®. All trademarks are owned by or licensed to Invacare Corporation unless otherwise noted. Specifications and prices are subject to change without notification. ©2015 Invacare Corporation 1181418 REV H KPIPARO 11-4-2019 Page of Order Form and Price List: All products must be ordered directly from TopEnd or through an Invacare provider. Our provider locator is available at www.topendwheelchair.com Product Description: Top End is excited to introduce a new way to order Top End products. Our new Smart Forms provide an easy and electronic way to fill out order forms, save copies, and submit them via e-mail. Please see below for the features and useful information. Please see below for the features and useful information. Please note that because of the many upgrades available on our Invacare® Top End® Force™ K Handcylce, the base price does not include wheels or components. The standard selections are set as the default for your convenience and the overall price will be adjusted accordingly. This will allow you to build your Invacare® Top End® Force™ K Handcycle exactly how you want it! The Invacare® Top End® Force™ K Handcycle is our kneeling position handcycle available with a choice of two custom, made-to- measure designs: one for athletes who are amputees and another for those who have lost their lower limbs. The Force K Kneeler Handcycle design is used by athletes with very low spinal cord injuries and the Force K Double Amp Handcycle defines the kneeling position for amputees. Both designs utilize a custom welded bucket to harness and maximize power. How to use: Use any Adobe Acrobat application to electronically fill out the order form Use the default selections to order a product with the most common configuration Use the "Reset" button located in the forms footer to reset selections to their defaults Use the "Clear All" button located in the forms footer to clear selections, including defaults. This feature allows for a blank order form to be printed and completed by hand Use the "E-mail to Top End order box" button located on the last page of the form to e-mail the completed form directly to the [email protected] e-mail inbox Forms can be completed electronically, printed, and e-mailed or faxed to [email protected] or 727-522-1007 if access to Acrobat Reader for Windows is unavailable (Acrobat Reader for Windows with java-script enabled is required to save and attach to e-mail) Features: Tabulated options for an organized and standardized work-flow New more specific option codes which will appear on confirmations to improve customer / manufacturing communication Common special requests have been given option codes Built in exclusions to help eliminate errors Ability to save the form after it is filled out Ability to e-mail the form inside Acrobat Reader rather than saving a copy and attaching to an e-mail Ability to clear the entire form so it can be printed and completed by hand in the field when a computer is not available Ability to reset form to default selections About New Smart Forms:

Transcript of Order Form and Price List: provider locator Invacare® Top ... · Handcycle design is used by...

Page 1: Order Form and Price List: provider locator Invacare® Top ... · Handcycle design is used by athletes with very low spinal cord injuries and the Force K Double Amp Handcycle defines

Invacare® Top End® Force™ K Handcycle Kneeling Cage

Invacare Corporation Top End Division All rights reserved. Trademarks are identified by the symbols ™ and ®. All trademarks are owned by or licensed to Invacare Corporation unless otherwise noted. Specifications and prices are subject to change without notification. ©2015 Invacare Corporation 1181418 REV H KPIPARO 11-4-2019 Page of

Order Form and Price List: All products must be ordered directly from TopEnd or through an Invacare provider. Our provider locator is available at www.topendwheelchair.com

Product Description:

Top End is excited to introduce a new way to order Top End products. Our new Smart Forms provide an easy and electronic way to fill out order forms, save copies, and submit them via e-mail. Please see below for the features and useful information. Please see below for the features and useful information. Please note that because of the many upgrades available on our Invacare® Top End® Force™ K Handcylce, the base price does not include wheels or components. The standard selections are set as the default for your convenience and the overall price will be adjusted accordingly. This will allow you to build your Invacare® Top End® Force™ K Handcycle exactly how you want it!

The Invacare® Top End® Force™ K Handcycle is our kneeling position handcycle available with a choice of two custom, made-to-measure designs: one for athletes who are amputees and another for those who have lost their lower limbs. The Force K Kneeler Handcycle design is used by athletes with very low spinal cord injuries and the Force K Double Amp Handcycle defines the kneeling position for amputees. Both designs utilize a custom welded bucket to harness and maximize power.

How to use: ■ Use any Adobe Acrobat application to electronically fill out the order form ■ Use the default selections to order a product with the most common configuration ■ Use the "Reset" button located in the forms footer to reset selections to their defaults ■ Use the "Clear All" button located in the forms footer to clear selections, including defaults. This feature allows for a

blank order form to be printed and completed by hand ■ Use the "E-mail to Top End order box" button located on the last page of the form to e-mail the completed form directly

to the [email protected] e-mail inbox ■ Forms can be completed electronically, printed, and e-mailed or faxed to [email protected] or 727-522-1007 if

access to Acrobat Reader for Windows is unavailable (Acrobat Reader for Windows with java-script enabled is required to save and attach to e-mail)

Features: ■ Tabulated options for an organized and standardized work-flow ■ New more specific option codes which will appear on confirmations to improve customer / manufacturing communication ■ Common special requests have been given option codes ■ Built in exclusions to help eliminate errors ■ Ability to save the form after it is filled out ■ Ability to e-mail the form inside Acrobat Reader rather than saving a copy and attaching to an e-mail ■ Ability to clear the entire form so it can be printed and completed by hand in the field when a computer is not available ■ Ability to reset form to default selections

About New Smart Forms:

Page 2: Order Form and Price List: provider locator Invacare® Top ... · Handcycle design is used by athletes with very low spinal cord injuries and the Force K Double Amp Handcycle defines

Invacare® Top End® Force™ K Handcycle Kneeling Cage

Invacare Corporation Top End Division All rights reserved. Trademarks are identified by the symbols ™ and ®. All trademarks are owned by or licensed to Invacare Corporation unless otherwise noted. Specifications and prices are subject to change without notification. ©2015 Invacare Corporation 1181418 REV H KPIPARO 11-4-2019 Page of

Order Form and Price List: All products must be ordered directly from TopEnd or through an Invacare provider. Our provider locator is available at www.topendwheelchair.com

PROVIDER / CUSTOMER INFORMATION: Provider Information: End User Information:

Date: Name: Height:

IVC Acct #: Ship to Address: Weight (lbs.):

Contact: Address Line 2: Leg Length (in.):

Phone #: City: Hip Width (in.):

Fax/Email: State: Zip: Phone #:

Ship to Provider Ship to End User Email:

ORDER REQUEST TYPE:

Quote Quote and CAD Order and CAD PO #

BASE MODEL:10010 Force K Frame and Fork - Kneeling Cage

Note: Bike ordered without wheels, tires, axles or shifting starts at $10,010 $10,500

WHEELBASE: (Front to Rear Axle)75076 58" Wheebase $0

CAMBER ANGLE:45002450034500445005

3 Degree Camber $06 Degree Camber $09 Degree Camber $011 Degree Camber $0

CRANK OPTIONS: (See Diagram Below)CRANK LENGTH:

65040650426504365045650476505165052

180mm Long $0190mm Long $0200mm Long $0210mm Long $0220mm Long $0230mm Long $0240mm Long $0

CRANK WIDTH:6500965013650176502165025

14" Wide $016" Wide $018" Wide $020" Wide $022" Wide $0

HAND PEDALS: (See Diagram Below)

HAND PEDAL SIZE:6512765113

Medium (1-3/4") Ovalized Ergonomic $0Large (2-1/4") Ovalized Ergonomic $0

POWER PLATES:65138 Power Plates $0

Hand Pedal Size

Assembly: (see definitions) 10048 Assembled $0

Shipping: Shipping Fee (Continental US Only - See definitions) $150

Page 3: Order Form and Price List: provider locator Invacare® Top ... · Handcycle design is used by athletes with very low spinal cord injuries and the Force K Double Amp Handcycle defines

Invacare® Top End® Force™ K Handcycle Kneeling Cage

Invacare Corporation Top End Division All rights reserved. Trademarks are identified by the symbols ™ and ®. All trademarks are owned by or licensed to Invacare Corporation unless otherwise noted. Specifications and prices are subject to change without notification. ©2015 Invacare Corporation 1181418 REV H KPIPARO 11-4-2019 Page of

Order Form and Price List: All products must be ordered directly from TopEnd or through an Invacare provider. Our provider locator is available at www.topendwheelchair.com

SIZING:CRANK HEIGHT:

652026520365204

15" Crank Height $016" Crank Height $017" Crank Height $0

SEAT WIDTH: (See Diagram, Label E)

15011150121501315014150151501615017

13.0" Seat Width $013.5" Seat Width $014.0" Seat Width $014.5" Seat Width $015.0" Seat Width $015.5" Seat Width $016.0" Seat Width $0

BACK HEIGHT:15125 20" Back Height (Kneeler) $0

KNEE WIDTH: (See Diagram, Label F + 1.0" = Typical)

15317153191532115323

8" Knee Width $09" Knee Width $010" Knee Width $011" Knee Width $0

CAGE SIZING:FIXED BACK TO KNEE BLOCK: (See Diagrams Below, Label C + 2.0" = Typical)

1533415335153361533715338153391534015341153421534315344

15345153461534715348

18" Back to Knee Block $019" Back to Knee Block $020" Back to Knee Block $021" Back to Knee Block $022" Back to Knee Block $023" Back to Knee Block $024" Back to Knee Block $025" Back to Knee Block $026" Back to Knee Block $027" Back to Knee Block $028" Back to Knee Block $0

ADJUSTABLE BACK TO KNEE BLOCK:18.0" to 20.5" Back to Knee Block $020.5" to 23.0" Back to Knee Block $023.0" to 25.5" Back to Knee Block $025.5" to 28.0" Back to Knee Block $0

FOOTREST TO KNEE BLOCK: (See Diagram Below, Label D)

1534915350153511535215353153541535515356

23" Footrest to Knee Block $024" Footrest to Knee Block $025" Footrest to Knee Block $026" Footrest to Knee Block $027" Footrest to Knee Block $028" Footrest to Knee Block $029" Footrest to Knee Block $030" Footrest to Knee Block $0

Page 4: Order Form and Price List: provider locator Invacare® Top ... · Handcycle design is used by athletes with very low spinal cord injuries and the Force K Double Amp Handcycle defines

Invacare® Top End® Force™ K Handcycle Kneeling Cage

Invacare Corporation Top End Division All rights reserved. Trademarks are identified by the symbols ™ and ®. All trademarks are owned by or licensed to Invacare Corporation unless otherwise noted. Specifications and prices are subject to change without notification. ©2015 Invacare Corporation 1181418 REV H KPIPARO 11-4-2019 Page of

Order Form and Price List: All products must be ordered directly from TopEnd or through an Invacare provider. Our provider locator is available at www.topendwheelchair.com

DERAILLEUR:65075 Cable Driven Derailleur $0

SHIFTING PACKAGES:

65224

65228

65229

Omit All Shifting Components (see definitions)

-$240 (credit)

10 SPEED: Shifting and Brake Mounted on Right Hand Pedal Only

SRAM GX Trigger Shifting Package $0SRAM GX ShifterSRAM GX DerailleurAvid Brake LeverTektro Brake CaliperTektro Flip Lever Parking BrakeSRAM GS/GX Grip/Twist Shifter PackageLeft Hand Pedal Mount Available as a Special

$200

SRAM GS ShifterSRAM GX DerrailuerAvid Brake LeverTorq Lite Brake CaliperTorq Lite Flip Lever Parking Brake

CHAINRING AND CASSETTES:CHAINRINGS:

651056510165104

53-39 Chainring Combination $048-39-24 Chainring Combination $048-36-26 Chainring Combination $0

CASSETTES: 65161 11-36 Cassette $0

UPHOLSTERY: (see definitions)

MATERIAL & COLOR:30001 Nylon, Black Upholstery $0

SEAT UPHOLSTERY:25063 Seat Cushion $0

BACK UPHOLSTERY STYLE:25064 Back Cushion $0

TRAINING SYSTEMS:6505865151

Omit SRM Training System $0SRM Training System - Compact $2,500

WHEEL SETS: Wheel sets cannot be mixed and matched.

26" FRONT AND REAR:

50183

50173

50174

50185

50181

Omit Wheels & Axles, Build for 26" Front and 26" Rear

-$250 (credit)

Clincher Wheels:High Performance, 26" Front High Performance, 26" Rear $0

Tubular Wheels: Corima Aero Carbon , 26" Front Corima Aero Carbon , 26" Rear $2,600

700C FRONT AND REAR: Omit Wheels & Axles, Build for 700C Front and 700C Rear

-$250 (credit)

Tubular Wheels: Corima Aero Carbon, 700C Front Corima Aero Carbon, 700C Rear $2,700

Page 5: Order Form and Price List: provider locator Invacare® Top ... · Handcycle design is used by athletes with very low spinal cord injuries and the Force K Double Amp Handcycle defines

Invacare® Top End® Force™ K Handcycle Kneeling Cage

Invacare Corporation Top End Division All rights reserved. Trademarks are identified by the symbols ™ and ®. All trademarks are owned by or licensed to Invacare Corporation unless otherwise noted. Specifications and prices are subject to change without notification. ©2015 Invacare Corporation 1181418 REV H KPIPARO 11-4-2019 Page of

Order Form and Price List: All products must be ordered directly from TopEnd or through an Invacare provider. Our provider locator is available at www.topendwheelchair.com

FRAME COLOR:5500255003 550015505055005550065505155052550075505355054550085501055011550125505555056550155505755016550175501855019550205502355066

Red Tangerine Red $0 Red Raspberry Red $0 Red Simple Red $0 Red Neon Red $0 Orange Simple Orange $0 Orange Sunkissed Orange $0 Orange Neon Orange $0 Yellow Neon Yellow $0 Yellow Safety Yellow $0 Green Agriculture Green $0 Green Neon Green $0 Green Grasshopper Green $0 Blue Midnight Blue $0 Blue Royal Blue $0 Blue Electric Blueberry $0 Purple Lilac Purple $0 Purple Purple Death $0 Pink Bubble-Gum Pink $0 Pink Neon Pink $0 White White Snow $0 Black Stealth Black $0 Black Wet Black $0 Black Black Prism $0 Silver Silver Metallic $0 Grey Stealth Grey $0Raw Buffed Aluminum $350

FORK COLOR:

5506755041550425504055033550345503555046550615503155062550295502855059550385506555063550245502555026550585504355039550305506055044

N/A

Same as Frame Color (Not applicable with 55066, must select 55044) $0

Black Wet Black $100Black Black Prism $100Black Stealth Black $100Blue Midnight Blue $100Blue Royal Blue $100Blue Electric Blueberry $100Gray Stealth Grey $100Green Agriculture Green $100Green Grasshopper Green $100Green Neon Green $100Orange Sunkissed Orange $100Orange Simple Orange $100Orange Neon Orange $100Pink Bubblegum Pink $100Pink Neon Pink $100Purple Lilac Purple $100Red Simple Red $100Red Tangerine Red $100Red Raspberry Red $100Red Neon Red $100Silver Silver Metallic $100White White Snow $100Yellow Safety Yellow $100Yellow Neon Yellow $100Raw Buffed Aluminum $200

Page 6: Order Form and Price List: provider locator Invacare® Top ... · Handcycle design is used by athletes with very low spinal cord injuries and the Force K Double Amp Handcycle defines

Invacare® Top End® Force™ K Handcycle Kneeling Cage

Invacare Corporation Top End Division All rights reserved. Trademarks are identified by the symbols ™ and ®. All trademarks are owned by or licensed to Invacare Corporation unless otherwise noted. Specifications and prices are subject to change without notification. ©2015 Invacare Corporation 1181418 REV H KPIPARO 11-4-2019 Page of

Order Form and Price List: All products must be ordered directly from TopEnd or through an Invacare provider. Our provider locator is available at www.topendwheelchair.com

Special Request 1)Special Request 2)Special Request 3)Special Request 4)Special Request 5)

Note: All Special requests are subject to approval, additional charges, and additional lead time

HANDCYCLE SPECIFICATIONS:Weight: 30 pounds

Turning Radius: 18 feet for 360 degree turn, 12 feet with 3 point turn. Transfer Height: 12" from ground

Frame Style: Custom, 6061 Ovalized T6 aircraft aluminum

Fork: Super stiff with fixed crank height. 6061 Ovalized T6 aircraft aluminum

Shifting: 30 speeds with choice of components

Cranks: Fixed crank heightBack: Welded or adjustable

Footrest: Fixed, weldedHand Pedals: Ovalized ergonomic with frictionless bearings

Brake: Caliper brakes standardWheelbase: 58"

Camber: 3, 6, 9, 11 degrees available Wheels: 26" or 700c wheels with optional upgrades

Axles: Threaded Tires / Tubes: 26" or 700c clincher or tubular options

Cushions: Seat and back cushion includedSafety / Visibility: Flag and reflectors included

Chain Guard: Carbon Fiber chain guard included

ACCESSORIES: STANDARD:

25061 Safety Flag $025067 Drafting Bumper $025070 Carbon Fiber Chainguard $025099 Mirror, Lower Fork Mounted $0

UPGRADABLE: SAFETY:

25030 Extra Steering Dampener $1525015 Light, Front (White) $1525016 Light, Rear (Red) $1525018 Helmet, Small/Medium $3025019 Helmet, Medium/Large $3025029 Tool and Tire Repair Kit $95

POSITIONING: 25001 Click Strap, 8" Small $7525002 Click Strap, 10" Medium $8025003 Click Strap, 12" Large $90

HYDRATION:25021 Water Bottle and Cage $5025020 Backpack Hydration System $130

PERFORMANCE ENHANCEMENT:

25023Crank Width Adaptor Set Not installed - (Gain +1.5" of crank width per set)

$20

25024 Cordless Computer $10025022 Wheel Alignment Gauge $215

TRANSPORTATION:25007 Bike Rack, Hitch 1-1/4" $55025008 Bike Rack, Hitch 2" $600

BAGS:25031 Wheel Bag $21525032 Travel Bag $350

TRAINING:25033 Heartrate Monitor $9525036 Indoor Stationary Roller $25025037 Sportscrafter Mini Roller $350

APPAREL: 25084 Lemon Yellow Top End T-Shirt $2025085 Grey Top End T-Shirt $2025086 Grey Top End Racer Back Tank Top $20

Please select a size for your shirt selection:25087 25088 25089 25090 25091 25092 25093

Extra Small Small Medium Large Extra LargeXX LargeXXX Large

EXCLUSIONS:

Wheels/Tires:Must choose the same size tires as wheels. Clincher wheels must have clincher tires and tubular wheels must have tubular tires.

Invacare warrants the frames and forks when purchased new and unused to be free from defects in materials and workmanship for a period of three (3) years from the date of purchase from Invacare or a dealer, with a copy of the seller’s

invoice required for coverage under this warranty. Invacare warrants the upholstered materials (seat and back) and remaining components of this product

when purchased new and unused to be free from defects in materials and workmanship for a period of thirteen (13) months from date of purchase from Invacare or a dealer, with a copy of the seller’s invoice required for coverage

under this warranty

Warranty Info:

DEFINITIONS:DEFINITIONS:Arrives factory assembled, rear wheels and some accessories will need to be installed. Shipping rate is $150 for all shipments in the continental US. Freight quotes for shipments outside the continental US are available upon request.

Assembly and Shipping: