Quickie 2 Lite Order Form - Quickie-Wheelchairs.com

7. KEY OPTIONS & ACCESSORIESNo Gos may exist depending on wheel size and positiono 184A1 Quickie Backpack Black $55.00o 184WL1 o High Mount Push NC 184A2Quickie Kids Backpack Black$50.00ooo184WL2184WL27184WL30 oHigh Mount PullErgo ScissorCompactNC$100.00$125.00184A8Seat PouchQuickie Seat Pouch Black$45.00oo184WL10184WL12OmitDo Not MountNCNCAdditional Cover & Pack AccessoriesExtension Handleoo184A500184A994Gel Cover Hanger/FrameGel Cover Swing Away Arm$105.00$105.00Only available w/ high mount push or pull to lock wheel lockso 184EH7 E0961 Extension Handle (Pair)Only available w/ high mount push or pull to lock wheel locks on pneumatic orpneumatic w/ airless tire optionsoooo184AT1 oE0971 Rear Anti-Tip $135.00184SL6 o Omit Seat Sling -$15.00184CU1 oE2601 2" Cushion $95.00To order any JAY cushions on-chair, please see the JAY price list.Cushion name or part number must be filled out with desired width and depthJAY Bundled Cushiono184GA1184JC20E0974Width:Wheel LockGrade AidGrade Aid $150.00Anti-TipSeat SlingCushionJAY Cushions (Optional)Cushion Name or Part #Depth:Transit Option$60.00Price ListNA w/ padded swing away armso 184TO30 o Transit System $350.00ooooooooooooooooooo184A82184IG2184A54184A83184C36184C14184C35184C128184C6184C126184C116184C117184C103184C114Candy BlueCandy Purple184C127 Fuchsia NCMatte Green184C4 Midnight Purple NC184C5K0038CaddyGlowMiscellaneousMatte BlackPearl PinkRootbeerBackpackSparkle Silver$45.00Impact Guard Neoprene $85.00Extra Leg Strap BlackTool KitFrame Color$30.00$45.00184C2 Black NC184C10Black Opal184C38 Blue Opal NCCandy RedCopperForest Green184C113 Titanium Color Paint NC184C11 Toxic Green NC184C8 Yellow NCNCNCNCNCNCNCNCNCNCNCNCNCooooooSide Guard184SG33 oK0108 Plastic Standard (8.5" High) $125.00184SG29 oK0108 Plastic Low (6.5" High) $125.00Positioning Belts184A141 E0978 Belt 1.5" Auto Buckle w/Clamps $70.00 o 184C108184A117 E0978 Belt 2" Aircraft Buckle w/Clamps $110.00184A118 E0978 Belt 2" Aircraft Buckle Pad w/Clamp $120.00184A120 K0108 Positioning Belt Slide Clamps $50.00oCustom Frame Color184C112 Desert Camouflage $295.00184C43 Mossy Oak Camouflage $295.00184C42 Stars & Stripes $295.00Zebra (Choose above base color) Stdwith White unless above base paint ischosen NA w/ Black$295.00Spoke GuardsOnly available w/ Mag, Mountain, and Lite Spoke wheelsoo184A23184A302K0065K0065Black Spoke GuardsQuickie Clear Spoke Guards$115.00$115.00ORDERING INFORMATION PHONE: (800) 236-4215, FAX: (602) 279-0952, WEBSITE: www.southwestmedical.comPage 6