160 Armand-Majeau Sud

Saint-Roch-de-l'Achigan, QC, Canada J0K 3H0T.450 588-6555 1 866 650-6555 F.450 588-0200

orders@motioncomposites.comwww.motioncomposites.com

Helio A7ORDER FORM - CANADA

P.O. number:* Ship to:*

Company Name:* Name:

Date: Address:

Contact name:* Phone:* City: Prov:

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Marked for: Phone:

* Required - Missing information may cause delays Manual English □ Manuel Français □

1 A7WC02 Ultralight Helio A7 wheelchair 7000 series aluminum (250 lbs. weight capacity) □2 A7WC09 □3 A7WC10 □

4 A7FC01 Basalt Black □ STD □Sunkissed Orange □ Burgundy □ Sapphire Blue □ Monster Green □

Charcoal □ Fuchsia □ Steel Blue □ Ferrari Red □ Acid Green □6 A7FC99 Custom Color Specify PPG Paintit color: $400 □

7 A7SW14 14" □ 15" □ 16" □ 17" □ 18" □ 1 NC □8 A7SW19 19" □ 1 20" □ 1 21" □ 2 22" □ 2 $285 □

9 A7SD14 14" □ 15" □ 16" □ 17" □ 18" □ NC □10 A7SD19 19" □ 20" □ $215 □

1: Available with HD kit 2: Only available with HD kit 3. Width calculator

11 A7BC11 15 - 18" □ 18 - 21" □ STD NC □(measured from seat sling to top of back upholstery / see drawing at the end of the order form)

12 A7BC12 15 - 18" □ 18 - 21" □ STD NC □

13 A7BC13 15 - 18" □ 18 - 21" □ STD $250 □14 A7BC14 15 - 18" □ 18 - 21" □ STD $300 □15 85° □ 90° □ 95° □ STD 100° □ 105° □ 110° □

* If not indicated, default height setting is at the lowest position

16 A7PH01 STD □17 A7PH02 NC □18 A7PH04 $210 □19 A7PH03 $250 □

Aluminum back cane 8° bend

Select back cane angle: 1

Straight extensions, 0-3" height adjustable

Set height to: *

4.4

(measured from seat sling to top of back upholstery / see drawing at the end of the order form)

MODEL

WAMF $740

Set height to: *

Taxes not included

WM0001020

8° BEND BACK

HD Heavy Duty package (350 lbs weight capacity )

5

Aluminum back cane

A7FC03

E-Motion adaptor Kit (4 adaptors)

$2 295

STRAIGHT BACK (90° cane angle)

PUSH HANDLES

Aluminum back cane straight

FRAME COLOR (with black hydroforming aluminum crossbrace)

Seat depth:

$196

SEAT WIDTH 3

Seat width:

Seat width:

SEAT DEPTH

Seat depth:

Aluminum back cane

Set height to: *

ADJUSTABLE ANGLE BACK

$270 □

(measured from seat sling to top of back upholstery / see drawing at the end of the order form)

WAMW

Push handles, 0 - 3" height adjustable

Stroller handle (only available with push handle) - (not available with the HD option)

Folding Stabilizer bar (only available with push handle)

WAMA

WAMB

Motion CompositesT.450 588-6555 1 866 650-6555 F.450 588-0200 HELIO A7 Orderform CAN 4.4 June 24, 2016 1 of 7

20 A7SC01 $168 □21 A7SC02 $195 □22 □

23 A7BH01 NC □24 A7BH02 $195 □25 A7BH99 Omit Back upholstery STD □

26 □

FLIP BACK ARMREST (Convertible to “T" armrest) Height Adjustment

27 A7AR01 8 - 12" □ STD 10 - 14" □ $370 □28 A7AR02 8 - 12" □ STD 10 - 14" □ $370 □

“T" ARMREST Height Adjustment

29 A7AR03 8 - 12" □ STD 10 - 14" □ $350 □30 A7AR04 8 - 12" □ STD 10 - 14" □ $350 □

SWING AWAY ARMREST Height Adjustment

31 A7AR05 8 - 11" $288 □32 A7AR06 8 - 11" $288 □

33 A7SG01 $220 □34 A7SG02 $248 □35 A7SG04 $490 □

If not indicated, footrest wil be set at 2" from the ground

36 A7FR03 60° Swing-in/swing-out footrest Range guide: 13.5 - 17.5" □ 15.75 - 20" □ 17 - 21" □ $240 □37 A7FR04 70° Swing-in/swing-out footrest Range guide: 13.5 - 17.5" □ 15.75 - 20" □ 17 - 21" □ $240 □38 A7FR05 90° Swing-in/swing-out footrest Range guide: 11 - 13.75" □ 13.5 - 15.5" □ $240 □

90° Swing-in/swing-out footrest front mount

(Footplate mounted to hanger tube)

40 A7FR10 Elevating legrest with calf pad, 14” - 20” Length adjustable * Left □ Right □ $400 □41 A7FR11 Length modification, between 12.5" and 13.5" $90 □

*The elevating legrest replaces the footrest. If the same side footrest is required, it will need to be ordered separately.

42 A7FR12 Swing away stump support: 8" x 11" Left □ Right □ $375 □

43 A7FP01 STD □44 A7FP02 Newton adjustable angle (Composite) $140 □45 A7FP03 $160 □46 A7FP04 $370 □47 A7FP06 $200 □48 A7FP07 $440 □49 A7FP08 NC □50 A7FP09 $50 □51 A7FP10 $80 □

10" Desk Length *

2" Cushion

10" Desk Length arm pad *

New WAMJ

Unlocked □ STD

See pricelist

Adjustable tension back upholstery

nXt back series (See nXt back pricelist)

RIGID BACK

WAMD/WAME

STUMP SUPPORT (Height and angle adjustable)

SEFND0005

SEFND0010

WAMJ

WAMJ

Padded calf strap

Set at:

Set at:

Locked □

SIDE GUARDS (not available with Flip Back and "T" Armrest)

Plastic side guards (removable)

Carbon fiber side guards (fixed)

14" Full Length

Tubular arm pad

14" Full Length

Removable function

Locked □

Slip on back upholstery

39 □Set at:

SEAT CUSHION

BACK UPHOLSTERY

See pricelist

3" Cushion

nXt FIT cushion series (See nXt FIT pricelist)

10" Desk length arm pad

Unlocked □ STD

SWING-IN/SWING-OUT FOOTREST

Set at:

WAMJ

$240

Set at:

SEFND0015

Standard (Composite)

Newton Adjustable angle (Aluminum)

Carbon fiber mud guards (removable)

8"-14" □

WAMJ

Set at:

FOOTPLATES

SEFND0015 One piece adjustable angle flip-up (Carbon fiber with rubber inserts)

Newton Adjustable angle (Carbon fiber with rubber inserts)

WAMK

Set Length at:

A7FR06

Length adjustable heel loop (not available with one piece footplate)

Calf strap SEFND0010

One piece adjustable angle flip-up (Aluminum)

Motion CompositesT.450 588-6555 1 866 650-6555 F.450 588-0200 HELIO A7 Orderform CAN 4.4 June 24, 2016 2 of 7

52 A7CA01 Composite wheel w/ PU tire (1" width) 3"□ 4"□ 5"□ 6"□ 7"□ 8"□ NC □53 A7CA10 Pneumatic casters 6" x 1 ¼" $160 □54 A7CA11 Pneumatic casters 8" x 1 ¼" $160 □

55 A7CA14 4" x 1 ½ " $120 □56 A7CA15 5" x 1 ½ " $130 □57 A7CA16 6" x 1 ½ " $140 □58 A7CA17 4" x 1 ½" $175 □59 A7CA18 5" x 1 ½" $185 □60 A7CA19 6" x 1 ½" $195 □

61 A7CA12 $250 □62 A7CA13 Frog Legs suspension forks (Not available with caster pin locks) $475 □

1: Newton Ultracaster wheels are designed to absorb vibrations 2: Max weight: 220 lbs

STD +1" +2" STD +1" +2" STD +1" +2" STD +1" +2" STD +1" +2" STD +1" +2"

P1 13 14 15 13 ½ 14 ½ 15 ½

P2 13 ½ 14 ½ 15 ½ 14 15 16 14 ½ 15 ½ 16 ½

P1

P2 14 ¼ 15 ¼ 16 ¼ 14 ¾ 15 ¾ 16 ¾

P3 14 ¼ 15 ¼ 16 ¼ 14 ¾ 15 ¾ 16 ¾ 15 ¼ 16 ¼ 17 ¼ 15 ¾ 16 ¾ 17 ¾

P4 14 ¾ 15 ¾ 16 ¾ 15 ¼ 16 ¼ 17 ¼ 15 ¾ 16 ¾ 17 ¾ 16 ¼ 17 ¼ 18 ¼ 16 ¾ 17 ¾ 18 ¾

P1 16 ¼ 17 ¼ 18 ¼ 16 ¾ 17 ¾ 18 ¾

P2 16 ¼ 17 ¼ 18 ¼ 16 ¾ 17 ¾ 18 ¾ 17 ¼ 18 ¼ 19 ¼

P3 16 ¾ 17 ¾ 18 ¾ 17 ¼ 18 ¼ 19 ¼ 17 ¾ 18 ¾ 19 ¾ 18 ¼ 19 ¼ 20 ¼

P4 16 ¾ 17 ¾ 18 ¾ 17 ¼ 18 ¼ 19 ¼ 17 ¾ 18 ¾ 19 ¾ 18 ¼ 19 ¼ 20 ¼ 18 ¾ 19 ¾ 20 ¾

P5 16 ¾ 17 ¾ 18 ¾ 17 ¼ 18 ¼ 19 ¼ 17 ¾ 18 ¾ 19 ¾ 18 ¼ 19 ¼ 20 ¼ 18 ¾ 19 ¾ 20 ¾ 19 ¼ 20 ¼ 21 ¼

REAR WHEELS

63 A7RW01 Mag (aluminum or plastic handrim only) 20" □ 22" □ 24" □ NC □64 A7RW02 Newton One - spoke wheel 22" □ 24" □ NC □65 A7RW03 Newton Gravity - ultralight wheel 20" □ 22" □ 24" □ 25" □ 26" □ $350 □66 A7RW04 Spinergy Spox 22" □ 24" □ 25" □ 26" □ $800 □67 Spinergy Spox spokes colors* Blk □ Wht □ Blue □ Red □ Yel □ NC □68 A7RW05 Spinergy LX 22" □ 24" □ 25" □ 26" □ $995 □69 Spinergy LX spokes colors * Blk □ Wht □ Blue □ Red □ Yel □ Pink □ Grn □ Org □ NC □

* Black spokes standard lead-time / Colour spokes up to 2 weeks extra lead-time

TIRES

70 A7TI01 Soft Urethane 1 1/4 " STD □71 A7TI02 Soft Urethane knobby 1 3/8 " $110 □72 A7TI04 Soft Urethane - Shox 1" $130 □73 A7TI05 Pneumatic 1 3/8 " * NC □74 A7TI06 Pneumatic HP - Schwalbe Right Run 1" $110 □75 A7TI07 Pneumatic HP - Schwalbe Marathon Plus 1'' $190 □

* Block tread (20", 22", 24" and 26") and V tread (25") - Grey (20", 22", 25", 26") and Black (24")

Specify desired height:22" wheel

20", 22", 24", 25", 26"

14 ½ " to 19"

5"

4"

24", 25"

Stem bolt Length

24" wheel

15 ½" to 20"26" wheel

15" to 19 ½"

Available

24"

4" caster

7"

Stem bolt Length

Forks

REAR Seat-to-floor Height

12 ½ " to 17"

Height available +- 1/4"WHEEL SIZES

25" wheel

Stem bolt LengthStem bolt Length

8" caster7" caster

Stem bolt Length

20", 22" 24"

20", 22", 24", 25", 26"

24", 25", 26"

Stem bolt Length

5" caster 6" caster3" caster

New

CASTERS

Specify weight of user 2:

CASTER OPTIONS

Caster Pin Locks (Available with +1" or +2" Stem bolt ONLY)

Newton UltraCaster Aluminum wheels1

Newton UltraCaster Composite wheels1

NEWTON ULTRACASTER (Soft-Roll)

WAMS

FRONT Seat-to-floor Height - Please, circle your choice

20" wheel

13 ½ " to 18"

Motion CompositesT.450 588-6555 1 866 650-6555 F.450 588-0200 HELIO A7 Orderform CAN 4.4 June 24, 2016 3 of 7

HANDRIM

76 A7HR01 STD □77 A7HR07 Newton Air Grip* Black □ $150 □

Newton Air Grip * 08 Orange □ 09 Burgundy □ 10 Blue Sapphire □

11 Monster Green □ 12 Charcoal □ 13 Fuchsia □ Regular STD □

14 Steel Blue □ 15 Red □ 16 Acid Green □ Narrow* □

79 A7HR02 $150 □80 A7HR03 $230 □81 A7HR05 Surge LT* 1 (oval aluminum handrim w/ a rubber high friction strip) $370 □82 A7HR04 Natural Fit* 2 (oval aluminum handrim w/thumb piece) $370 □

83 A7HR06 Bbraver 1 (ultra-performance aluminum handrim , adjustable) Orange □ White □ Black □ □

84 A7HR99 NC □* Not available with Mag wheels 1 - Not available in 20" and 26" 2 - Not available in 20"

85 A7AX01 STD □86 A7AX02 NC □87 A7AX03 $170 □

88 A7AX04 $240 □

89 A7CM00 0° camber STD □90 A7CM03 NC □91 A7CM06 $80 □

92 A7WL08 Newton Wheel lock - push to lock STD □93 A7WL09 Newton wheel lock with 6" removable extension handle $65 □94 A7WL02 Pull to lock NC □95 A7WL03 Pull to lock with 6" removable extension handle $65 □96 A7WL04 $165 □97 A7WL05 $300 □

98 A7WL06 $220 □

99 A7SB01 $40 □100 A7SB02 $50 □101 A7SB07 Hardware attachment for 2 point seatbelt (1 pair) NC □102 A7SB03 $12 □103 A7SB04 BodyPoint Hip Belt - 2 point non padded M □ L □ $80 □104 A7SB05 BodyPoint Hip Belt - 2 point padded S □ M □ L □ $150 □105 A7SB06 BodyPoint Hip Belt - 4 point padded S □ M □ L □ $190 □

106 A7AC01 Profiled Headrest Small □ Medium □ Large □ $200 □107 A7AC02 $328 □

* Only available with push handles

108 A7AC03 Anti tippers $110 □109 A7AC04 Transit Tie Down - Unoccupied NC □110 A7AC05 Short 20-41" □ Long 20-46" □ $345 □111 A7AC06 Cane carrier Left □ Right □ $98 □112 A7AC07 Oxygen tank holder - D Type Left □ $360 □113 A7AC08 Spoke guards* $140 □114 A7AC09 Footrest neoprene impact guard (pair) - Black $75 □115 A7AC10 Seat pouch $95 □116 A7AC11 Backpack $120 □

117 A7AC12 Velcro Closing Strap $50 □118 A7AC13 Tool kit $50 □119 A7AC14 Motion Composites T-Shirt S □ M □ L □ XL □ XXL □ $28 □

POSITIONING BELT

ACCESSORIES

Headrest mounting hardware with tension bar *

Q-Grip High friction Neoprene coated*

WAMO

Aluminum anodized

78 A7HR08

New WAMO

New WAMO

Assembly

Quick release axle

Omit handrim

New

3° camber

Permanent axle

WC-19 Transit Tie Down w/Q'straint belt - 250 lbs only

$330

New

Newton Grade aid push to lock (suggested with pneumatic or high pressure tire)

Velcro adjustable

Attendant Lock (additional set of wheel lock mounted to the back)

Scissor Lock

TOTAL

WHEEL LOCK

HEADREST

SERND0020

6° camber (not available with amputee axle plate)

AXLE (0° camber)

Quad release axle

New

WAMU

REAR WHEEL CAMBER ANGLE

See pricelist

Amputee adjustable axle plate (may interfere with swing away armrest)

Plastic coated

WAMO

New

WAMT

SERND0030

WAMR

WAMP

□

* Not available with Mag wheels

Available: 20", 22", 24", 26"

Auto buckle

Additional hardware for 2 extra attachment points (needed for the 4 point seat belt) (1 pair)

SEFND0035

New

WAMX

WAMU

AXLE PLATE

Motion CompositesT.450 588-6555 1 866 650-6555 F.450 588-0200 HELIO A7 Orderform CAN 4.4 June 24, 2016 4 of 7

Choose position of rear wheel axle plate:

Measure distance X from front of back post to center of axle receiver.

Most stable Most responsive

X = 1" 1/4" 1/2" 3/4" 2" 1/4" 1/2" 3/4" 3" 1/4" 1/2" 3/4" 4"

□ □ □ □ □ □ □ □ □ □ □ □ □

If not indicated, default setting is at 1.5’’

Possible conflict between a seat depth under 16’’ and a center of gravity over 2.5’’.

Possible conflict between a 26’’ rear wheel and a center of gravity over 2.5’’.

BACK UPHOLSTERY HEIGHT

Back upholstery height

3" of adjustability

The slip-on or adjustable tension back upholstery is attached

to the push handle offering 3" of height adjustment

with increment of 1/2".

Rigid backs are attached to the back cane and the height

of the push handle is adjusted independently.

CENTER OF GRAVITY

BACK UPHOLSTERY HEIGHT

If a configuration issue arises due to the choice of the Center Of Gravity (COG) Motion Composites reserves the right

to reduce or increase the COG by one inch without notice

Fork and Stem bolt combinations

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