qqqqqqqqq q qqqqqqqqq q qqqqqqqqq q ... - Ki Mobility · Not available on Superlight wheel or 25”...

13
Phone (800) 981-1540 | Fax (715) 254-0996 [email protected] | www.kimobility.com Company: ________________________________________________ Account Number: __________________ Date: _________________ q Quote q PO Number: ___________________________________ RTS: _____________________________________________________ Marked For: _______________________________________________ Ship To: __________________________________________________ Address: _________________________________________________ City: ________________________________ State: _____________ Zip: ________________ Phone: _____________________________ Email/Fax: ________________________________________________ HCPCS codes provided are based on code verification by the PDAC or our interpretation of the code definitions. Proper use of HCPCS codes does not ensure coverage or payment. For coverage information, verify the appropriate payer’s coverage policy. Frame Seat Width / Seat Depth Select box corresponding to desired Seat Width and Depth. See references A and B on page 7. Seat Width 12” 13” 14” 15” 16” 17” 18” 19” 20” Price HCPCS N/C N/C N/C N/C N/C N/C N/C N/C $500 E2201 Seat Depth 14” N/C qq q q q q q qq 15” N/C qq q q q q q qq 16” N/C qq q q q q q qq 17” N/C qq q q q q q qq 18” N/C qq q q q q q qq 19” N/C qq q q q q q qq 20” $500 E2203 qq q q q q q qq Transit Option Sling Position In Performance Position (0”), sling is at front of frame. The 1” or 2” sling position extends the frame in front of the sling by that amount. See reference C on page 7. q 0” (Performance) ________________________________________________________________________________ N/C q 1” _____________________________________________________________________________________________________________ N/C q 2” (Classic) ___________________________________________________________________________________________ N/C Backrest Adjustable Depth Adds the capability to grow seat in depth q No Rear Adjustment _________________________________________________________________________ N/C q 1/2” _________________________________________________________________________________________________________ N/C q 1” _____________________________________________________________________________________________________________ $85 q 2” ___________________________________________________________________________________________________________ $165 Front Frame Bend Angle between front seat tube and ground. See reference D on page 7. q 90º ________________________________________________________________________________________________________ $150 q 85º __________________________________________________________________________________________________________ N/C q 80º __________________________________________________________________________________________________________ N/C q 75º __________________________________________________________________________________________________________ N/C q 70º __________________________________________________________________________________________________________ N/C Push Handle q Omit Push Handle _____________________________________________________________________________ N/C q Standard Push Handle _____________________________________________________________________ $95 q Low Profile Push Handle _______________________________________________________________ $135 2” shorter than standard push handles q Bolt-On Push Handle ______________________________________________________________________ $175 Handles will be 1” - 2” above back height q Fold Down Push Handle ________________________________________________________________ $100 Stroller Handle Stroller Handles are removable and height adjustable q Single Stroller Handle _____________________________________________________________________ $165 q Double Stroller Handle ___________________________________________________________________ $330 Not available with Push Handles Back Post / Height Range / Back Height Cannot be retrofitted q Transit System __________________________________________________________________________________ $320 Select Back Height in row corresponding to desired Back Post and Height Range. Back Post Price Height Range Back Height Height Adjustable N/C Short q 11 2 q 12 q 13 q 14 Medium q 13 q 14 q 15 q 16 q 17 Tall q 17 q 18 q 19 q 20 Fixed Height 1 N/C q 9 2 q 10 2 q 11 2 q 12 q 13 q 14 q 15 q 16 q 17 q 18 1 Not available with back upholstery 2 Not available with Fold Down Push Handle DCN0025.32 Pricing and specifications subject to change without notice Page 1 of 7 Rogue K0005, E1235 ____________________________________________________________________ $2495 Rogue Standard Frame. 275 lb weight capacity. This form must be opened in Adobe Acrobat. The Submit Form button will not work from most browser windows. Seat Pan q Solid Seat Pan E2231 ______________________________________________________________________ $265 Effective 02/17/2020 Select if chair quote has: q Additional Ki Products with Different Quote/Order Number Quote/Order Number: ____________________

Transcript of qqqqqqqqq q qqqqqqqqq q qqqqqqqqq q ... - Ki Mobility · Not available on Superlight wheel or 25”...

Page 1: qqqqqqqqq q qqqqqqqqq q qqqqqqqqq q ... - Ki Mobility · Not available on Superlight wheel or 25” or 26” wheel sizes q Pneumatic with Airless Insert 1 3/8” E2211, E2213 Poly

Phone (800) 981-1540 | Fax (715) [email protected] | www.kimobility.com

Company: ________________________________________________

Account Number: __________________ Date: _________________

q Quote q PO Number: ___________________________________

RTS: _____________________________________________________

Marked For: _______________________________________________

Ship To: __________________________________________________

Address: _________________________________________________

City: ________________________________ State: _____________

Zip: ________________ Phone: _____________________________

Email/Fax: ________________________________________________

HCPCS codes provided are based on code verification by the PDAC or our interpretation of the code definitions.

Proper use of HCPCS codes does not ensure coverage or payment. For coverage information, verify the appropriate payer’s coverage policy.

Frame

Seat Width / Seat DepthSelect box corresponding to desired Seat Width and Depth.See references A and B on page 7.

Seat Width

12” 13” 14” 15” 16” 17” 18” 19” 20”

PriceHCPCS

N/C N/C N/C N/C N/C N/C N/C N/C$500E2201

Sea

t D

epth

14” N/C q q q q q q q q q15” N/C q q q q q q q q q16” N/C q q q q q q q q q17” N/C q q q q q q q q q18” N/C q q q q q q q q q19” N/C q q q q q q q q q20” $500

E2203 q q q q q q q q q

Transit Option

Sling PositionIn Performance Position (0”), sling is at front of frame. The 1” or 2” sling position extends the frame in front of the sling by that amount. See reference C on page 7.

q 0” (Performance) ________________________________________________________________________________ N/Cq 1” _____________________________________________________________________________________________________________ N/Cq 2” (Classic) ___________________________________________________________________________________________ N/C

Backrest

Adjustable DepthAdds the capability to grow seat in depth

q No Rear Adjustment _________________________________________________________________________ N/Cq 1/2” _________________________________________________________________________________________________________ N/Cq 1” _____________________________________________________________________________________________________________ $85q 2” ___________________________________________________________________________________________________________ $165

Front Frame BendAngle between front seat tube and ground. See reference D on page 7.

q 90º ________________________________________________________________________________________________________ $150q 85º __________________________________________________________________________________________________________ N/Cq 80º __________________________________________________________________________________________________________ N/Cq 75º __________________________________________________________________________________________________________ N/Cq 70º __________________________________________________________________________________________________________ N/C

Push Handle

q Omit Push Handle _____________________________________________________________________________ N/Cq Standard Push Handle _____________________________________________________________________ $95q Low Profile Push Handle _______________________________________________________________ $135

2” shorter than standard push handles

q Bolt-On Push Handle ______________________________________________________________________ $175Handles will be 1” - 2” above back height

q Fold Down Push Handle ________________________________________________________________ $100

Stroller HandleStroller Handles are removable and height adjustable

q Single Stroller Handle _____________________________________________________________________ $165q Double Stroller Handle ___________________________________________________________________ $330

Not available with Push Handles

Back Post / Height Range / Back Height

Cannot be retrofitted

q Transit System __________________________________________________________________________________ $320

Select Back Height in row corresponding to desired Back Post and Height Range.

BackPost

Price Height Range

Back Height

Height Adjustable

N/C

Short q 112 q 12 q 13 q 14

Medium q 13 q 14 q 15 q 16 q 17

Tall q 17 q 18 q 19 q 20

FixedHeight 1

N/Cq 92 q 102 q 112 q 12 q 13

q 14 q 15 q 16 q 17 q 181 Not available with back upholstery2 Not available with Fold Down Push Handle

DCN0025.32 Pricing and specifications subject to change without notice Page 1 of 7

Rogue K0005, E1235 ____________________________________________________________________ $2495Rogue Standard Frame. 275 lb weight capacity.

This form must be opened in Adobe Acrobat. The Submit Form button will not work from most browser windows.

Seat Pan

q Solid Seat Pan E2231 ______________________________________________________________________ $265

Effective 02/17/2020

Select if chair quote has: q Additional Ki Products with Different Quote/Order Number Quote/Order Number: ____________________

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Rigidizer Bar

q Adjustable Height Rigidizer Bar _____________________________________________________ $75

Seat Back AngleStandard is 90º (perpendicular to floor). Minus (-º) closes back angle. Plus (+º) opens back angle.

q Standard q +3º q +6º q +9ºq -3º q -6º q -9º q -12º

Backrest continued

Military Patch

Back Upholstery

US Military Service Patch _______________________________________________________________________ $90 q Army q Navy q Marines q Air Force q Coast Guard

q US Purple Heart Patch _____________________________________________________________________ $90

Purple Heart with Military Service Patch Combo __________________________ $145 q Army q Navy q Marines q Air Force q Coast Guard

Front Seat Height and Casters

Caster Type

Caster Size / Footrest Taper / Front Seat Height

Fork Options

q Standard Fork ______________________________________________________________________________________ Stdq Single Sided Fork _____________________________________________________________________________ $150q Frog Legs Ultra-Sport Fork - Black E1015 ________________________________ $425

Not included in Colored Anodizing Package

End User Weight Required: ____________ lbsq Frog Legs PHASE 2 Carbon Fork ______________________________________________ $425

Lightweight shock absorbing fork. Not included in Colored Anodizing Package.

Select Front Seat Height in row corresponding to Footrest Taper and Caster Size. 6” casters not available with 85º and 90º Front Frame Bend.

Footrest Taper indicates bend of front frame creating footrest width. Taper is measured from outside of seat frame to outside of front tube.2” Taper not available with 75º Front Frame Bend. Taper is not available with 70º Front Frame Bend. See reference E on page 7.

Front Seat Height is measured from floor to top of seat tube at front of seat sling. Adjustable up or down by 1/2”. See reference F on page 7.

Footrest Taper

Caster Size

Front Seat Height

Straight

3” q 13.5 q 14 q 14.5 q 15 q 15.5 q 16 q 16.5 q 17 q 17.5 q 18 q 18.5 q 19 q 19.5 q 20 q 20.5

4” q 14 q 14.5 q 15 q 15.5 q 16 q 16.5 q 17 q 17.5 q 18 q 18.5 q 19 q 19.5 q 20 q 20.5

5” q 14.5 q 15 q 15.5 q 16 q 16.5 q 17 q 17.5 q 18 q 18.5 q 19 q 19.5 q 20 q 20.5

6” q 15 q 15.5 q 16 q 16.5 q 17 q 17.5 q 18 q 18.5 q 19 q 19.5 q 20 q 20.5

1” Taper

3” q 16.5 q 17 q 17.5 q 18 q 18.5 q 19 q 19.5 q 20 q 20.5

4” q 17 q 17.5 q 18 q 18.5 q 19 q 19.5 q 20 q 20.5

5” q 17.5 q 18 q 18.5 q 19 q 19.5 q 20 q 20.5

6” q 18 q 18.5 q 19 q 19.5 q 20 q 20.5

2” Taper

3” q 16.5 q 17 q 17.5 q 18 q 18.5 q 19 q 19.5 q 20 q 20.5

4” q 17 q 17.5 q 18 q 18.5 q 19 q 19.5 q 20 q 20.5

5” q 17.5 q 18 q 18.5 q 19 q 19.5 q 20 q 20.5

6” q 18 q 18.5 q 19 q 19.5 q 20 q 20.5

Phone (800) 981-1540 | Fax (715) 254-0996

[email protected] | www.kimobility.com

DCN0025.32 Pricing and specifications subject to change without notice Page 2 of 7

q .75” Rollerblade __________________________________________________________________________________ N/CAvailable only with 3” and 4” Caster Sizes

q .75” Lighted Rollerblade __________________________________________________________________ $70Available only with 3” and 4” Caster Sizes

q 1” Poly ___________________________________________________________________________________________________ N/CNot available with 3” Caster Size

q 1” Poly Aluminum _____________________________________________________________________________ $110Available only with 4” and 5” Caster Sizes

q 1” Pneumatic _______________________________________________________________________________________ $80Available only with 6” Caster Size

q 1.5” Poly _______________________________________________________________________________________________ $50Not available with 3” Caster Size

q 1.5” Soft Roll Aluminum _________________________________________________________________ $175

Available only with Height Adjustable Back Posts. If selecting both upholstery and Axiom Back, the upholstery will be installed.

Padded Velcro Adjustable q Standard Cover ______________________________ Std q Air Mesh Breathable Cover _____________________ $75

Tension Adjustable E2611

q Standard Cover _____________________________ $315 q Air Mesh Breathable Cover ____________________ $390

q Omit Back Upholstery ___________________________________________________________________ - $10

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Footrest

Seat to Footrest LengthFootplate

q Tubular “Open” Footplate _________________________________________________________________ Stdq Tubular Footplate with ABS Cover _______________________________________________ $30

Not available w/footrest widths greater than 15.5”. See Reference G on page 7.

q Aluminum Angle Adjustable K0040 _______________________________________________ $95q Aluminum Angle Adjustable with Riser K0040, K0037 _____________ $165q High Mount Aluminum Angle Adjustable K0040, K0037 _________ $165q Angle Adjustable Flip Under K0040, K0037 _________________________________ $185

Not available with footrest widths less than 9.5”. See Reference G on page 7.

q High Mount Angle Adjustable Flip Under K0040, K0037 _________ $270Not available w/footrest widths greater than 15.5”. See Reference G on page 7.

Measured from front edge of seat sling to top, rear of footrest. Footrest length at least 2.5” shorter than Front Seat Height recommended. See reference H on page 7.

q 8” q 8.5” q 9” q 9.5” q 10” q 10.5”

q 11” q 11.5” q 12” q 12.5” q 13” q 13.5”

q 14” q 14.5” q 15” q 15.5” q 16” q 16.5”

q 17” q 17.5” q 18” q 18.5” q 19” q 19.5”

Rear Seat Height and Wheels

Wheel Size / Rear Seat Height

Rear Wheel Type

q MAXX Performance Spoke _____________________________________________________________ N/Cq Mag ________________________________________________________________________________________________________ N/C

Not available in 25” or 26” wheel sizes

q Superlight Spoke _____________________________________________________________________________ $315Available only in 24” and 25” wheel sizes. 25” wheel size available only with Superlight and Plastic Coated Handrims.

Spinergy Spox _________________________________________________________________________________________ $835Not available in 20” wheel size

Color: q Black q Red q White q Blue q Yellow

Handrim: q Short Tab $25 q Long TabAvailable only with Aluminum Anodized and Plastic Coated Handrims

Spinergy LX ___________________________________________________________________________________________ $1040Not available in 20” wheel size

Color: q Black q Red q White q Blue q Yellow

q Pink q Green q Orange q Purple

Handrim: q Short Tab $25 q Long TabAvailable only with Aluminum Anodized and Plastic Coated Handrims

Select Rear Seat Height in row corresponding to desired Wheel Size. For proper setup, selection is required when omitting rear wheels.Measured from floor to top of seat tube at front of back post. Rear Seat Height is custom to needs. See reference I on page 7.

Wheel Size

Rear Seat Height

20” q12.51 q 13 q 13.5 q 14 q 14.5 q 15 q 15.5 q 16 q 16.5 q 17 q 17.5 q 18 q 18.5 q 19 q 19.5 q 20

22” q13.51 q 14 q 14.5 q 15 q 15.5 q 16 q 16.5 q 17 q 17.5 q 18 q 18.5 q 19 q 19.5 q 20

24” q14.51 q 15 q 15.5 q 16 q 16.5 q 17 q 17.5 q 18 q 18.5 q 19 q 19.5 q 20

25” q 151 q 15.5 q 16 q 16.5 q 17 q 17.5 q 18 q 18.5 q 19 q 19.5 q 20

26” q15.51 q 16 q 16.5 q 17 q 17.5 q 18 q 18.5 q 19 q 19.5 q 201 Available only with Low Profile tires

Rear Tire Type

q Street Pneumatic 1 3/8” E2211, E2212 ___________________________________________ StdNot available on 25” wheel size

q Full Poly 1 3/8” E2218 _______________________________________________________________________ N/CNot available on Superlight wheel or 25” or 26” wheel sizes

q Pneumatic with Airless Insert 1 3/8” E2211, E2213 ____________________ $80Not available on Superlight wheel or 25” wheel size

q Schwalbe HS-127 1 3/8” E2211, E2212 ______________________________________ $125Available only on 24” wheel size. Not available on Mag wheel.

q Euro Trek Knobby 1 3/8” E2211, E2212 _________________________________________ $95Available only on 24” wheel size

q Mountain 2” Black E2211, E2212 _____________________________________________________ $95Available only on 22”, 24” and 25” MAXX Performance and Spinergy wheels

q Low Poly 1” E2218 _____________________________________________________________________________ $75Not available on Superlight wheel, 25” or 26” wheel sizes

q Sentinel Solid Tire 1” E2218 ____________________________________________________________ $95Not available on Superlight wheel or 20” and 22” Mag wheels

q High Pressure 1” E2211, E2212 ________________________________________________________ $95Not available on Mag wheel

q Schwalbe One 1” E2211, E2212 ____________________________________________________ $125Available only on 24” and 25” wheel sizes. Not available on Mag wheel.

q Schwalbe Marathon Plus Evolution 1” E2211, E2212 ______________ $135Not available on Mag wheel, 20” or 22” wheel sizes

Full Profile

Low Profile

Phone (800) 981-1540 | Fax (715) 254-0996

[email protected] | www.kimobility.com

q Footrest Protector _____________________________________________________________________________ N/CNot available with Angle Adjustable Flip Under, High Mount Angle Adjustable Flip Under or High Mount Aluminum Angle Adjustable Footplates

Footrest Protector

One Arm Drive E0958 __________________________________________________________________________ $1495Available only with Mag wheel. Axle not quick release. Standard Handrim will be Aluminum Anodized.

Drive Handrim Side: q Left q Right

Drive Handrim Type: q Aluminum _______________________________________ N/C q Poly Coated _________________________________ $200

One Arm Drive

DCN0025.32 Pricing and specifications subject to change without notice Page 3 of 7

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Handrim

Axle

q Quick Release ______________________________________________________________________________________ Stdq Quad Quick Release _______________________________________________________________________ $185

Not available with Mag or Spinergy wheels

Rear Wheel SpacingMeasured from outside of back to inside of rear tire. Adjustable out 1/2” from setting. 1.5” minimum Rear Wheel Spacing with Height Adjustable Armrests. 1” minimum Rear Wheel Spacing with 0º Rear Wheel Camber. 1.25” minimum Rear Wheel Spacing in combination with One Arm Drive and 12” Seat Width. See reference K on page 7. No selection needed with Wheelchair Drive Ready options.

q .75” q 1” q 1.25” q 1.5” q 1.75”

Rear Wheel Camber

Center of Gravity Preset

Handrim Option

q 3M Micro Grip _____________________________________________________________________________________ $65Not available on Plastic Coated or Projection Handrims

Rear Seat Height and Wheels continued

Measured from front of back post to center of rear axle. 0” indicates axle will be directly under back post. See reference J on page 7.

Wheel Locks

Wheel Lock Wheel Lock Options

q Push to Lock ________________________________________________________________________________________ Stdq Push to Lock Flush Mount ______________________________________________________________ N/Cq Pull to Lock __________________________________________________________________________________________ N/Cq Under Seat Scissor Lock _________________________________________________________________ $35q Low Profile Scissor Lock _________________________________________________________________ $65

Not available with Low Poly, Full Poly or Sentinel Solid tires

q Short Thro Scissor Lock ________________________________________________________________ $125q Omit Wheel Locks _____________________________________________________________________________ N/C

Amputee Positions

q -1.5” q -1.25” q -1” q -.75”

q -.5” q -.25” q 0” q .25”

q .5” q .75” q 1” q 1.25”

q 1.5” q 1.75” q 2” q 2.25”

q 2.5” q 2.75” q 3” q 3.25”

q 3.5” q 3.75” q 4” q 4.25”

Standard Positions

q Aluminum Anodized ___________________________________________________________________________ Stdq Superlight Aluminum Anodized _____________________________________________________ $50

Available only on 24” and 25” wheel sizes. Available only on MAXX Performance, Superlight or Spinergy wheels.

q Plastic Coated ___________________________________________________________________________________ $100q Projection (8 Vertical Projections) ________________________________________________ $315

Available only with full profile tires in combination with 22”-26” MAXX Performance or 24” Mag wheel

q Spinergy Flex Rim ____________________________________________________________________________ $650Available only on 24” and 25” Spinergy LX Wheels

q Omit Handrim ______________________________________________________________________________________ N/C

Not available on 20” wheel size or 22” Mag wheel. Not recommended with Mag wheel.

q Natural Fit LT Regular Grip ____________________________________________________________ $465q Natural Fit Standard Regular Grip _______________________________________________ $445q Natural Fit LT Super Grip _______________________________________________________________ $515q Natural Fit Standard Super Grip __________________________________________________ $495q Natural Fit LT Omit Grip _________________________________________________________________ $395q Natural Fit Standard Omit Grip ____________________________________________________ $375

Natural Fit Handrims

Phone (800) 981-1540 | Fax (715) 254-0996

[email protected] | www.kimobility.com

DCN0025.32 Pricing and specifications subject to change without notice Page 4 of 7

q Extension Handles E0961 ________________________________________________________________ $70Available only with Push to Lock or Pull to Lock Wheel Locks

q Grade Aids E0974 _____________________________________________________________________________ $150Available only with Push to Lock Wheel Locks and Pneumatic or Pneumatic with Airless Insert tires

Wheelchair Drive ReadyChair will ship from Ki Mobility with adaption kit installed for selected Alber system. Order system separately from Alber USA. Select Rear Seat Height (full profile selections only) in drive wheel size on Rear Seat Height chart (page 3). Requires Rear Anti-Tips. Not available with Spinergy wheels.

q e-motion Ready __________________________________________________________________________________ N/Cq twion Ready _________________________________________________________________________________________ N/C

Camber Selection: q 0º q 3º

No selection needed with One Arm Drive Standard Handrims

No selection needed with One Arm Drive

q 0º q 2º q 4º q 6º q 8º

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Accessories

Anti-Tip

q Rear Anti-Tips E0971 _______________________________________________________________________ $145

Positioning Belt

q 1 1/2” Auto Buckle E0978 ________________________________________________________________ $70q 1 1/2” Padded Auto Buckle E0978 _____________________________________________ $155q 1” Auto Buckle E0978 _______________________________________________________________________ $70q 1” Padded Auto Buckle E0978 _____________________________________________________ $155q 2” Airline Buckle E0978 ___________________________________________________________________ $110

Bodypoint Evoflex - Pelvic Stabilizer E0978 ____________________________________ $183 Size: q Small (16-24”) q Medium (19-29”) q Large (25-37”)

Other Accessories

q Tool Kit ___________________________________________________________________________________________________ $45q Removable Underseat Pouch ________________________________________________________ $50q Ki Mobility Backpack ________________________________________________________________________ $65q Luggage Carrier _________________________________________________________________________________ $85q Black Neoprene Impact Guards ____________________________________________________ $90q Under Chair Carrier and Removable Bag ___________________________________ $85

Not available with Seat Widths less than 14”

q Clear Spoke Guards K0065 ___________________________________________________________ $115Not available with Mag wheel

q Black Spoke Guards K0065 __________________________________________________________ $115Not available with 20” wheel size or Mag wheel

q Cane and Crutch Holder _______________________________________________________________ $195

Calf Strap

q Velcro Adjustable K0038 ___________________________________________________________________ $40q Padded Velcro Adjustable K0038 __________________________________________________ $68q Bodypoint Padded AeroMesh K0038 _________________________________________ $102

Phone (800) 981-1540 | Fax (715) 254-0996

[email protected] | www.kimobility.com

Side Guards

Fabric Side GuardNot available when omitting Back Upholstery

q Fabric Side Guards K0108 _______________________________________________________________ $95

Belt Mounting Kit

q Ki Mobility Belt Mounting Clamp ___________________________________________________ $35q Bodypoint Belt Mounting Bracket Kit ________________________________________ $105

q Composite Side Guards K0108 ____________________________________________________ $145

Aluminum Straight K0108 New! q Black Matte _________________________________ $195q Match Frame Color __________________________ $245

Not available with Hydrographics

Aluminum Adjustable Fender with Foam Pad K0108Not available with Adjustable Depth greater than 1/2”

q Black Matte _________________________________ $275 q Match Frame Color __________________________ $325

Not available with Hydrographics

q Carbon Fiber Adjustable Fender K0108 _____________________________________ $485Not available with Adjustable Depth greater than 1/2”

Direct Mount

q Composite Side Guards K0108 ____________________________________________________ $175

Aluminum Straight K0108 New! q Black Matte _________________________________ $225 q Match Frame Color __________________________ $275

Not available with Hydrographics

Aluminum Adjustable Fender with Foam Pad K0108

q Black Matte _________________________________ $305 q Match Frame Color __________________________ $355

Not available with Hydrographics

q Carbon Fiber Adjustable Fender K0108 _____________________________________ $515

Clamp-On Mount

DCN0025.32 Pricing and specifications subject to change without notice Page 5 of 7

Armrests

Armrest Please select Arm Pad option

q Height Adjustable T-Arm (8.5” - 13.5”) E0973 ________________________________ $340q Height Adjustable T-Arm Low (7.5” - 11.5”) E0973 ______________________ $340

q Swing Away (8.5” - 12.5”) E0973 _______________________________________________________ $210Not available with Arm Pads

q Swing Away with Side Guard (8.5” - 12.5”) E0973 _______________________ $285Includes direct mount receiver. Not available with Arm Pads.

q Omit Armrests _____________________________________________________________________________________ N/CArm Pad

Armrest continued

Not available with Swing Away Armrests

q Desk q Full

Not available with T-Arms or Swing Away with Side Guard Armrests

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Phone (800) 981-1540 | Fax (715) 254-0996

[email protected] | www.kimobility.com

DCN0025.32 Pricing and specifications subject to change without notice Page 6 of 7

Color

HydrographicsVisit www.kimobility.com for current Hydrographic options. Note selection below

q _________________________________________________ $595Not available with Transit Option

Colored Anodizing Package

q Black ______________________________________________________________________________________________________ N/Cq Blue Skies ____________________________________________________________________________________________ N/Cq Bubblegum Pink _________________________________________________________________________________ N/Cq Candy Blue __________________________________________________________________________________________ N/Cq Candy Purple ______________________________________________________________________________________ N/Cq Candy Red ___________________________________________________________________________________________ N/Cq Copper __________________________________________________________________________________________________ N/Cq Granny Smith ______________________________________________________________________________________ N/Cq Metallic Fuchsia __________________________________________________________________________________ N/Cq Metallic Orange __________________________________________________________________________________ N/Cq Silver ______________________________________________________________________________________________________ N/Cq Yellow ____________________________________________________________________________________________________ N/C

q Charcoal Gray _____________________________________________________________________________________ N/Cq Emerald Green ____________________________________________________________________________________ N/Cq Iridescent Burgundy __________________________________________________________________________ N/C q Iridescent Navy ___________________________________________________________________________________ N/Cq Military Green ______________________________________________________________________________________ N/Cq Retro Red _____________________________________________________________________________________________ N/Cq Royal Blue ____________________________________________________________________________________________ N/Cq Shadow Black _____________________________________________________________________________________ N/Cq Smooth White _____________________________________________________________________________________ N/C

Matte Frame FinishGloss Frame Finish

Select desired color. If no selection is made, black will be used.

Option Back Plates 2 Camber Tube 3 Towers CG Clamps 3,5 Side GuardReceivers

RP TuningHousing

Front Caster 4

ForksRetail $25 $25 $25 $25 $25 $25 $25

Co

lor

Black 1 q q q q q q qBlue q q q q q q qBright Green q q q q q q qGold q q q q q q qOrange q q q q q q qPewter q q q q q q qPink q q q q q q qPurple q q q q q q qRed q q q q q q q

1 Black is no charge2 Not available with Transit Option3 Not available with Wheelchair Drive Ready4 Available only with Standard or Single Sided5 Not available with negative Center of Gravity

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References A. Seat Width See Diagram 1

Measured from outside of frame tube on one side to outside of frame tube on other side.

B. Seat Depth See Diagram 3

Measured from front of back posts to front edge of seat sling. Seat sling starts at beginning of bend at front of frame.

C. Sling Position See Diagram 2

In Performance Position (0”), sling is at front of frame to keep chair shorter and more maneuverable. The 1” or 2” seat sling position extends the frame in front of the sling by that amount. Adding more frame can improve stability and provide support to aid in transfers.

D. Front Frame Bend See Diagram 3

Angle between front seat tube and ground.

Seat Width Straight 1” Taper 2” TaperOutside

Measurement2” Narrower than

Seat Width4” Narrower than

Seat Width6” Narrower than

Seat Width

12” 9.5” 7.5”

13” 10.5” 8.5”

14” 11.5” 9.5”

15” 12.5” 10.5”

16” 13.5” 11.5” 9.5”

17” 14.5” 12.5” 10.5”

18” 15.5” 13.5” 11.5”

19” 16.5” 14.5” 12.5”

20” 17.5” 15.5” 13.5”

F. Front Seat Height See Diagram 1

Measured from floor to top of seat tube at front of seat sling.

Phone (800) 981-1540 | Fax (715) 254-0996

[email protected] | www.kimobility.com

C

Diagram 2

Diagram 1

A

GF

K

E

G. Footrest Width See Diagram 1

Measured from inside of front tube to inside of front tube on other side. Footrest width is listed below for each seat width and taper.

E. Footrest Taper See Diagram 1

Indicates bend of front frame creating footrest. Taper is measured from outside of seat frame to outside of front tube.

H. Seat to Footrest Length See Diagram 3

Measured from front edge of seat sling to top rear of footrest. Footrest length of at least 2.5” shorter than front seat height recommended.

I. Rear Seat Height See Diagram 3

Measured from floor to top of seat tube at front of back post. Rear seat height is custom to needs.

J. Center of Gravity Preset See Diagram 3

Measured from front of back post to center of rear axle. 0” indicates axle will be directly under back post.

K. Rear Wheel Spacing See Diagram 1

Measured from outside of seat back to inside of rear tire. Adjustable out .5” from setting.

DCN0025.32 Pricing and specifications subject to change without notice Page 7 of 7

Diagram 3

B

H

JI

D

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DCN0537.0 Pricing and specifications subject to change without notice Page 1 of 1

Width

14” 15” 16” 17” 18” 19” 20” 21” 22”

Dep

th

14” q15” q q q16” q q q q q q q17” q q q q q q q18” q q q q q q q q19” q q q q q q q20” q q q q q q q21” q q q q q22” q q q q q

Width

14” 15” 16” 17” 18” 19” 20” 21” 22”D

epth

14” q q q15” q q q q q16” q q q q q q q q17” q q q q q q q q18” q q q q q q q q q19” q q q q q q q q q20” q q q q q q q q q21” q q q q q q q q22” q q q q q q q q

Width

14” 15” 16” 17” 18” 19” 20” 21” 22”

Dep

th

14” q q q15” q q q q16” q q q q q q q q17” q q q q q q q q18” q q q q q q q q q19” q q q q q q q q q20” q q q q q q q q q21” q q q q q q q q22” q q q q q q q q

q Axiom G E2601 __________________________________________________________________________________ $120q Axiom S E2603 __________________________________________________________________________________ $210q Axiom P E2605 __________________________________________________________________________________ $355

q Axiom G E2602 __________________________________________________________________________________ $199q Axiom S E2604 __________________________________________________________________________________ $315q Axiom P E2606 __________________________________________________________________________________ $460

q Axiom SP - Visco E2607 _________________________________________________________________ $430q Axiom SP - Fluid E2607 __________________________________________________________________ $470

q Axiom SP - Visco E2608 _________________________________________________________________ $525q Axiom SP - Fluid E2608 __________________________________________________________________ $575

q Axiom G Extra Outer Cover ____________________________________________________________ $75q Axiom S Extra Outer Cover _____________________________________________________________ $85q Axiom P Extra Outer Cover _____________________________________________________________ $95q Axiom SP Extra Visco Outer Cover ____________________________________________ $105q Axiom SP Extra Fluid Outer Cover _____________________________________________ $105

q Axiom SP Extra Visco Inner Cover _____________________________________________ $105q Axiom SP Extra Fluid Inner Cover _______________________________________________ $105

Select size in chart below. Weight capacity: 350 lbs.

Solid Seat Insert ________________________________________________________________________________________ $60

Inner Cover Quantity: q 1 q 2If no selection is made, quantity 1 will be selected

Outer Cover Quantity: q 1 q 2If no selection is made, quantity 1 will be selected

Solid Seat Insert Quantity: q 1 q 2If no selection is made, quantity 1 will be selected

Axiom SP Cushion Quantity: q 1 q 2If no selection is made, quantity 1 will be selected

Axiom G, S or P Cushion Quantity: q 1 q 2If no selection is made, quantity 1 will be selected

Axiom G, S and P Cushions

Cushions Under 22” Wide

Outer Covers

22” Wide Cushions

Axiom SP Cushions

Cushions Under 22” Wide

22” Wide Cushions

Axiom Cushion Accessories

Solid Seat Insert

Inner Covers

Select size in chart at right. Weight capacity: 350 lbs.

Select size in chart at right. Weight capacity: 350 lbs.

Phone (800) 981-1540 | Fax (715) 254-0996

[email protected] | www.kimobility.com

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DCN0538.0 Pricing and specifications subject to change without notice Page 1 of 5

Phone (800) 981-1540 | Fax (715) 254-0996

[email protected] | www.kimobility.com

Axiom Back Select back that is the same or up to 2” narrower than the width of the frame. Hardware is included with back. Low Back selections are not available with headrests, modifications, or posture supports. Weight capacity: 300 lbs.

Width

12” 14” 16” 18” 20” 22”Retail $555 $555 $555 $555 $555 $791

HCPC E2613 E2613 E2613 E2613 E2613 E2614

Hei

gh

t Lo

w

8” q AXPB1208 q AXPB1408 q AXPB1608 q AXPB1808 q AXPB2008

10” q AXPB1410 q AXPB1610 q AXPB1810 q AXPB2010 q AXPB2210

12” q AXPB1212 q AXPB1412 q AXPB1612 q AXPB1812 q AXPB2012

Mid

14” q AXPB1414 q AXPB1614 q AXPB1814 q AXPB2014 q AXPB2214

16” q AXPB1216 q AXPB1416 q AXPB1616 q AXPB1816 q AXPB2016

18” q AXPB1418 q AXPB1618 q AXPB1818 q AXPB2018 q AXPB2218

Axiom Posterior Back (PB)

Width

12” 14” 16” 18” 20” 22”Retail $636 $636 $636 $636 $636 $862

HCPC E2615 E2615 E2615 E2615 E2615 E2616

Hei

gh

t

Lo

w

8” q AXPL1208 q AXPL1408 q AXPL1608 q AXPL1808 q AXPL2008

10” q AXPL1410 q AXPL1610 q AXPL1810 q AXPL2010 q AXPL2210

12” q AXPL1212 q AXPL1412 q AXPL1612 q AXPL1812 q AXPL2012

Mid

14” q AXPL1414 q AXPL1614 q AXPL1814 q AXPL2014 q AXPL2214

16” q AXPL1216 q AXPL1416 q AXPL1616 q AXPL1816 q AXPL2016

18” q AXPL1418 q AXPL1618 q AXPL1818 q AXPL2018 q AXPL2218

Tall 20” q AXPL1220 q AXPL1420 q AXPL1620 q AXPL1820 q AXPL2020

22” q AXPL1422 q AXPL1622 q AXPL1822 q AXPL2022 q AXPL2222

Axiom Posterior Lateral Back (PL)

Axiom Posterior Back - Low Axiom Posterior Back - Mid

Axiom Posterior Back Measurement Reference

Back Height A B Shell Contour Depth

Hei

gh

t Lo

w

8” 10” 6.5”

2.25”

10” 12” 8.5”

12” 14” 10.5”

Mid

14” 16” 8.5”

16” 18” 9.5”

18” 20” 10.5”

A

4.1

BA

4.1

B

Axiom Posterior Lateral Back Measurement Reference

Back Height A B Shell Contour Depth

Hei

gh

t

Lo

w

8” 10” 6.5”

3.65”

10” 12” 8.5”

12” 14” 10.5”

Mid

14” 16” 8.5”

16” 18” 9.5”

18” 20” 10.5”

Tall 20” 22” 11.5”

22” 24” 12.5”Axiom Posterior Lateral

Back - LowAxiom Posterior Lateral

Back - MidAxiom Posterior Lateral

Back - Tall

A

5.5

B

5.5

AB

A

5.5

B

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DCN0538.0 Pricing and specifications subject to change without notice Page 2 of 5

Width

12” 14” 16” 18” 20” 22”Retail $735 $735 $735 $735 $735 $813

HCPC E2620 E2620 E2620 E2620 E2620 E2621

Hei

gh

t

Lo

w

8” q AXLB1208 q AXLB1408 q AXLB1608 q AXLB1808 q AXLB2008

10” q AXLB1410 q AXLB1610 q AXLB1810 q AXLB2010 q AXLB2210

12” q AXLB1212 q AXLB1412 q AXLB1612 q AXLB1812 q AXLB2012

Mid

14” q AXLB1414 q AXLB1614 q AXLB1814 q AXLB2014 q AXLB2214

16” q AXLB1216 q AXLB1416 q AXLB1616 q AXLB1816 q AXLB2016

18” q AXLB1418 q AXLB1618 q AXLB1818 q AXLB2018 q AXLB2218

Tall 20” q AXLB1220 q AXLB1420 q AXLB1620 q AXLB1820 q AXLB2020

22” q AXLB1422 q AXLB1622 q AXLB1822 q AXLB2022 q AXLB2222

Axiom Lateral Back (LB)

Axiom Back continued Select back that is the same or up to 2” narrower than the width of the frame. Hardware is included with back. Low Back selections are not available with headrests, modifications, or posture supports. Weight capacity: 300 lbs.

Axiom Lateral Back Measurement Reference

Back Height A B Shell Contour Depth

Hei

gh

t

Lo

w

8” 10” 6.5”

3.65”

10” 12” 8.5”

12” 14” 10.5”

Mid

14” 16” 8.5”

16” 18” 9.5”

18” 20” 10.5”

Tall 20” 22” 11.5”

22” 24” 12.5”Axiom Lateral

Back - LowAxiom Lateral

Back - MidAxiom Lateral

Back - Tall

A

5.5

B

5.5

AB

A

5.5

B

Axiom Deep Lateral Back (DL)

Width

12” 14” 16” 18” 20” 22”Retail $735 $735 $735 $735 $735 $813

HCPC E2620 E2620 E2620 E2620 E2620 E2621

Hei

gh

t

Mid

14” q AXDL1214 q AXDL1414 q AXDL1614 q AXDL1814 q AXDL2014 q AXDL2214

16” q AXDL1416 q AXDL1616 q AXDL1816 q AXDL2016

18” q AXDL1218 q AXDL1418 q AXDL1618 q AXDL1818 q AXDL2018 q AXDL2218

Tall 20” q AXDL1220 q AXDL1420 q AXDL1620 q AXDL1820 q AXDL2020

22” q AXDL1422 q AXDL1622 q AXDL1822 q AXDL2022 q AXDL2222

Axiom Deep Lateral Back Measurement Reference

Back Height A

B1 Shell Contour Depth12” 14” 16” 18” 20” 22”

Hei

gh

t

Mid

14” 16” 8.25” 8.25” 8.25” 8.25” 8.25” 8.25”

6”

16” 18” 9.25” 9.25” 9.25” 9.25” 9.25” 9.25”

18” 20” 10.25” 10.25” 10.25” 10.25” 10.25” 10.25”

Tall 20” 22” 9.5” 9.75” 10” 10.25” 10.25” 10.5”

22” 24” 10.75” 11” 11.25” 11.5” 11.5” 11.75”1 Measurement based on back width

Axiom Deep Lateral Back - Mid Axiom Deep Lateral Back - Tall

AB

7.75

AB

7.75

Phone (800) 981-1540 | Fax (715) 254-0996

[email protected] | www.kimobility.com

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Description Item Code HCPC Retail (Each)

q Headrest Flip Down MountOnly available with HEDHMD401/HEDHMD417

HDR100 E1028 $170

q Universal Mounting PlateFor use with other manufacturer headrests

UMP K0108 $40

DCN0538.0 Pricing and specifications subject to change without notice Page 3 of 5

Axiom Back Accessories

Headrest and HardwareChoose headrest and hardware combination in chart below. Not available with Low Backs.

Phone (800) 981-1540 | Fax (715) 254-0996

[email protected] | www.kimobility.com

HEDHDW101/HEDHDW117 HEDHDW201/HEDHDW217 HEDHDW401/HEDHDW417

HEDPAD408

HEDPAD410

HEDPAD414

HEDPAD201

HEDPAD202

HEDPAD203

HEDPAD502

HEDPAD503

Hardware

Standard Straight Back Mount Hardware with Ball

Multi Axis Removable Hardware with Horizontal Bar

Headrest Hardware with Ball

HEDHDW101 / HEDHDW117 HEDHDW201 / HEDHDW217 HEDHDW401 / HEDHDW417

Description Item Code HCPC Kio Code Retail Kio Code Retail Kio Code Retail

Hea

dre

st P

ad

Comfort Plus Headrest 8” HEDPAD408 E0955E1028 q HDR001 $277 q HDR009 $313 q HDR017 $388

Comfort Plus Headrest 10” HEDPAD410 E0955E1028 q HDR002 $277 q HDR010 $313 q HDR018 $388

Comfort Plus Headrest 14” HEDPAD414 E0955E1028 q HDR003 $277 q HDR011 $313 q HDR019 $388

Small All Positioning Headrest Pad and Ring Only HEDPAD201 E0955

E1028 q HDR004 $277 q HDR012 $313 q HDR020 $388

Medium All Positioning Headrest Pad and Ring Only

HEDPAD202 E0955E1028 q HDR005 $277 q HDR013 $313 q HDR021 $388

Large All Positioning Headrest Pad and Ring Only HEDPAD203 E0955

E1028 q HDR006 $277 q HDR014 $313 q HDR022 $388

Tri-Comfort Plus Headrest 14”

HEDPAD502 E0955E1028 q HDR007 $288 q HDR015 $324 q HDR023 $399

Tri-Comfort Plus Headrest 19”

HEDPAD503 E0955E1028 q HDR008 $288 q HDR016 $324 q HDR024 $399

Headrest Hardware Options

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DCN0538.0 Pricing and specifications subject to change without notice Page 4 of 5

Axiom Back Accessories continued

Available only with Axiom Lateral Back and Axiom Deep Lateral back

Description Item Code HCPC Retail

q Lumbar Pad 12” L12 K0108 $48

q Lumbar Pad 14” L14 K0108 $48

q Lumbar Pad 16” L16 K0108 $48

q Lumbar Pad 18” L18 K0108 $48

q Lumbar Pad 20” L20 K0108 $48

q Lumbar Pad 22” L22 K0108 $48

Lumbar Pads

Description Item Code HCPC Retail

q Privacy Flap 12” PF12 K0108 $45

q Privacy Flap 14” PF14 K0108 $45

q Privacy Flap 16” PF16 K0108 $45

q Privacy Flap 18” PF18 K0108 $45

q Privacy Flap 20” PF20 K0108 $45

q Privacy Flap 22” PF22 K0108 $45

Privacy Flap

Phone (800) 981-1540 | Fax (715) 254-0996

[email protected] | www.kimobility.com

Lateral Support

Laterals for Posterior BackPair Left Right Description Item Code HCPC Pair Each

q q q 3 x 4 Lateral Pads with Fixed Mounting Hardware for Axiom Posterior Back LF3x4P E0956 $305 $153

q q q 4 x 5 Lateral Pads with Fixed Mounting Hardware for Axiom Posterior Back LF4x5P E0956 $305 $153

q q q 3 x 4 Lateral Pads with Swing Away Mounting Hardware for Axiom Posterior Back LS3x4P E0956, E1028 $650 $325

q q q 4 x 5 Lateral Pads with Swing Away Mounting Hardware for Axiom Posterior Back LS4x5P E0956, E1028 $650 $325Laterals for Posterior Lateral BackPair Left Right Description Item Code HCPC Pair Each

q q q 3 x 4 Lateral Pads with Fixed Mounting Hardware for Axiom Posterior Lateral Back LF3x4L E0956 $305 $153

q q q 4 x 5 Lateral Pads with Fixed Mounting Hardware for Axiom Posterior Lateral Back LF4x5L E0956 $305 $153

q q q3 x 4 Lateral Pads with Swing Away Mounting Hardware for Axiom Posterior Lateral Back

LS3x4L E0956, E1028 $650 $325

q q q4 x 5 Lateral Pads with Swing Away Mounting Hardware for Axiom Posterior Lateral Back

LS4x5L E0956, E1028 $650 $325

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DCN0538.0 Pricing and specifications subject to change without notice Page 5 of 5

Axiom Back Accessories continued

Selection of a modification from the Axiom Back Modifications section required in order to mount posture supports. Not available with Low Backs.

Description Item Code HCPC Retail

q Small Static Therafit 2-Piece Chest Strap with H & L Adj and 1” Safety Strap 60153T E0960 $144

q Medium Static Therafit 2-Piece Chest Strap with H & L Adj and 1” Safety Strap 60154T E0960 $144

q Large Static Therafit 2-Piece Chest Strap with H & L Adj and 1” Safety Strap 60155T E0960 $144

q Small Dynamic Therafit Chest Strap with Dual D-Ring Adjustment 60110T E0960 $113

q Medium Dynamic Therafit Chest Strap with Dual D-Ring Adjustment 60111T E0960 $113

q Large Dynamic Therafit Chest Strap with Dual D-Ring Adjustment 60112T E0960 $113

q Small Dynamic Therafit Comfortfit Full Vest 30589T E0960 $167

q Medum Dynamic Therafit Comfortfit Full Vest 30590T E0960 $167

q Large Dynamic Therafit Comfortfit Full Vest 30591T E0960 $167

q XLarge Dynamic Therafit Comfortfit Full Vest 30592T E0960 $167

q XXLarge Dynamic Therafit Comfortfit Full Vest 30593T E0960 $167

q Small Dynamic Therafit Comfortfit Trim Vest 30618T E0960 $169

q Medum Dynamic Therafit Comfortfit Trim Vest 30619T E0960 $169

q Large Dynamic Therafit Comfortfit Trim Vest 30620T E0960 $169

q XLarge Dynamic Therafit Comfortfit Trim Vest 30621T E0960 $169

q XXLarge Dynamic Therafit Comfortfit Trim Vest 30622T E0960 $169

Therafin Posture Support

Choose modification to add holes to the back shell in order to mount posture supports. Not available with Low Backs.

Description Item Code HCPC Retail

q Modification for 4 Point Harness AXM4PT K0108 N/C

q Modification for 2 Point Chest Strap AXM2PT K0108 N/C

q Modification for Shoulder GuidesIncludes shoulder guides

AXMSG K0108 $50

Axiom Back Modifications

Gloss Finish Item Code Retail

q Black AXMBLK N/C

q Blue Skies AXMSKY N/C

q Bubblegum Pink AXMPNK N/C

q Candy Blue AXMCBL N/C

q Candy Purple AXMPUR N/C

q Candy Red AXMRED N/C

q Copper AXMCOP N/C

q Granny Smith AXMGSM N/C

q Metallic Fuchsia AXMMTF N/C

q Metallic Orange AXMMOR N/C

q Silver AXMSIL N/C

q Teal AXMTEA N/C

q Yellow AXMYLW N/C

Painted Back Shell ModificationIf no selection is made, standard Shadow Black will be used with no additional lead time

Axiom Back Modifications Extended lead times will apply for all modifications

Phone (800) 981-1540 | Fax (715) 254-0996

[email protected] | www.kimobility.com

Matte Finish Item Code Retail

q Charcoal Gray AXMCGM N/C

q Emerald Green AXMEGM N/C

q Iridescent Burgundy AXMIBM N/C

q Iridescent Navy AXMINM N/C

q Military Green AXMAGM N/C

q Retro Red AXMRRM N/C

q Royal Blue AXMRBM N/C

q Smooth White AXMSWM N/C