Match Point Order Form - Quickie-Wheelchairs.com

Quickie Match Point, November 2012Front Seat HeightHandrim156SH14 16" Front Seat Height NC 156HR1 Anodized Aluminum NC156SH16 17" Front Seat Height NC 156HR4 Plastic Coat Handrim $95.00156SH18 18" Front Seat Height NC 156HR7 Omit Handrim NC156SH21 19" Front Seat Height NC156SH24 20" Front Seat Height NC Handrim Tab156SH27 21" Front Seat Height NC 156TB1 Handrim Regular Tab NCRear Anti-TipBack Type 156AT39 Rear Anti Tip Integral NCBack HeightBACKRESTS156BT1 Folding Backrest NC 156AT40 Rear Anti Tip Quick Release $90.00156BT3 Non Folding Backrest NCACCESSORIESSpoke Guard156B128 Back Height 9" NC 156A24 Spoke Guard - Clear $115.00156B133 Back Height Fixed 10 - 13" NC 156A23 Spoke Guard - Black $115.00156B83 Back Height Fixed 12 - 16" NC 156A25 Spoke Guard Sport Hi-Profile $120.00156B134 Back Height Fixed 15 - 18" NC 156A26 Spoke Guard Sport Low-Profile $120.00156B135 Back Height Fixed 17 - 20" NCSide GuardBack Upholstery 156SG4 Plastic Side Guard Kids $125.00156BU1 Back Upholstery Std NC 156SG3 Plastic Side Guard Reg $125.00156BU13 Back Upholstery Adj Sports $150.00 156SG5 Alum Side Guard Reg $175.00156BU14 Back Upholstery -- Omit -$15.00 Required for the 1/2" seat width optionCASTERSBackpackCaster Wheel 156A1 Black Utility Backpack $55.00156CW1 3" Micro NC 156A2 Back Pack Blk/Charcoal Kids $50.00FOOTRESTSSeat PouchFootrest 156A8 Seat Pouch Black/Charcoal $45.00156F234 Platform NC156F39 High Mount Platform NC Positioning Belt156IG20 Impact Guard Neoprene NC 156A17 Hook & Loop Closure $60.00156A18 Nylon Buckle Closure $60.00Adaptive Platform Spacer 156A190 Ratchet Pos Belt Lrg $90.00NA w/ High Mount Platform Footrest 156A191 Ratchet Pos Belt X-Lrg $90.00156AD1 Adaptive Platform 2" Spacer $95.00156AD2 Adaptive Platform 4" Spacer $95.00 Miscellaneous156AD3 Adaptive Platform 6" Spacer $95.00 156A103 Chest Strap 2" (48" Length) $30.00156A106 Chest Strap 4" (48" Length) $40.00WHEELS156A90 Pad For Backrest Crossbar $30.00Camber Tube 156A98 Tire Pump $80.00156CI10 16 Degree Camber NC 156A180 Toe Clips $50.00156CI11 20 Degree Camber NC 156A181 5th Wheel Support $110.00Axle156AX4 QR Steel NC156AX11 Quad QR Axles $90.00Rear Wheel Rim/Size156RW53 24" X/S Spoke Wheel (540) NC156RW69 24" X/S QP HT Tnns (559) $230.00156RW57 24" Spinergy Whl 540 Blk $695.00156RW59 24" Spinergy Whl 559 Blk $695.00156RW61 26" Spinergy Whl 590 Blk $695.00156RW63 Omit Rear Wheel & Axle (540) NC156RW64 Omit Rear Wheel & Axle (559) NC156RW65 Omit Rear Wheel & Axle (590) NCRear Wheel Tire156RT31 High Pressure Clincher Tire NC156RT5 Turbo Tread Tire NCORDERING INFORMATION PHONE: (800) 236-4215, FAX: (602) 279-0952, WEBSITE: www.southwestmedical.com