Sunrise Medical Quickie Tango Prescription Form - The Mobility ...

Invoice to:Deliver to:Name:Name:Street:Street:Town: Postal code: Town: Postal code:Country:Country:Tel: Fax: Tel: Fax:Order date:Marked for:Purchase order:TANGO COMFORTStandard Features • PG VR2 controller with parallel s/a mount Comfort Package (included in base price)• Drive wheel suspension • Width adjustable armrests • Jay Comfort Seat (seat and backrest)• 40Ah twin batteries • Depth adjustable back (16.5" to 19.5") • Powered reclining backrest• 6kph (4mph) motors • Swing-in/out hangers & flip-up footplates • Powered tilt-in-space• 12" pneumatic or solid tyres • Transportation approved • Comfort headrestBase price £3395 / €5524Fax: +44 (0)845 605 66 89 Maximum user weight limit 140Kg (22 stone)E-mail: orders@sunmed.co.uk£FRAME WIDTH:TANW043 • 43cm (17") frame width (Adjusts out 43cm - 50cm via armrests / inwards 43cm - 38cm via side guard reduction pads)€SEAT DEPTHSeat depth setting (42.5cm to 50cm seat depth adjustment via backrest)◦ 42.5cm (16.5") ◦ 45cm (17.5") ◦ 47.5cm (18.5") ◦ 50cm (19.5")SEAT• Solid seat panJAY020002 JAY Basic 46JAY020003 JAY Soft Combi P 64JAY020006 JAY Easy Visco, Flat Base 10976104178CUSHION• Jay Comfort seat (cushion & back) 40cm width 44cm width 48cm width(Reduces effective seat depth by 1" - measured from centre of contoured backrest)SEAT TILTTAN020007 • Powered tilt (3° to 25°)BACKRESTTAN030003 • Powered recline back (-3° to 30°)(Fold down Backrest)TAN030005 Adjustable laterals 70114HEADRESTTAN030004 • HeadrestARMREST• Width, depth, height adjustable armrest (Rumba Modular type, moulded arm pad gives +7cm width adjustmentTAN040001 Side guard reduction pads (Reduces seat width by 5cm/ 2") 4980LEGRESTSTAN050000 ◦ 70° swing-away legrestTAN050001 Manual elevating legrest 158◦ Uni style hangers and footplates (B4Me Option Ref XL0020)Extension tubes for swing-away legrests:• Medium 34 cm - 48 cm (13" - 19") (measured from seat pan to footplate)• Composite, angle and depth adjustable footplates258OF_TANGO_COMFORT_RETAIL_01-10-2012_REV 3

• = Standard ◦ = No cost option = Cost option£ €VR2 60Ah CONTROLS (including parallel swing-away controller mount)TAN011008 ◦ VR2 Joystick (inc actuator buttons)TAN011001 ◦ VR2 Joystick for lights & Indicators (Includes 2 actuator and L&I buttons)TAN011003 ◦ RH TAN011004 ◦ LHTAN011009 VR2 Attendant only with actuator control (Lever drive / tiller style mount RH mount) 213 364TAN011010 VR2 Attendant only with lights and actuator control (Lever drive / tiller style mount RH mount) 250 427TAN011002 VR2 remote dual control (Dual Module always RH mount) 388 630KERB CLIMBERTAN090002 Kerb climber 142 231DRIVE WHEELS & CASTORSTAN070000 ◦ 12" Pneumatic drive wheels 8" Solid castorsTAN070001 ◦ 12" Solid drive wheels 8" Solid castorsTAN070002 14" Pneumatic drive wheels 9" Solid castors 104 168TAN070003 14" Solid drive wheels 9" Solid castors 104 168TAN070004 • Drive wheel mud guardsMOTOR SPEED• 6kphFRAME COLOURTAN090004 ◦ Brilliant silverTAN090005 ◦ Brilliant blueTAN090006 ◦ Brilliant redLIGHTS & INDICATORSTAN090000 ◦ Lights & Indicators 274 443BATTERIESTAN016000 ◦ 40Ah gel batteriesTAN016001 50Ah gel batteries 158 257CHARGERTAN016003 • 8A ChargerACCESSORIESTAN090007 • Transportation tie down pointsTAN090009 Swing-away tray table 148 239TAN090010 • Adjustable lap strapTAN090013 Rear view mirror 33 53Quickie Tango Comfort - Base Price£3395 / €5524Option PriceTotal PriceOF_TANGO_COMFORT_RETAIL_01-10-2012_REV 3