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PAGES 1 OF 11

ORDERING INFORMATION : Phone : +1 450 424-0288 | Fax : +1 450 424-7211 | [email protected] | amylior.com

*IN RED SHOWS THE ADDITION OF NEW OPTIONS, UPGRADES, PRICING MODIFICATIONS OR ADDED NOTES

(K0848/K0856/K0861)

Specifications are subject to change without notice. © Amylior Inc. 2018 (December). All rights reserved

MKT.F23 | OF | TMK-181018-1 | Rev.01

ACCOUNT INFORMATIONP.O. # or Quote: ________________________________________________________________________________

Dealer Contact Name:____________________________________________________________________________

Email Address: __________________________________________________________________________________

Phone Number: _________________________________ Fax Number: _________________________________

Bill to (Name): ___________________________________________________________________________________

Bill to (Location): _________________________________________________________________________________

Ship to (Name): __________________________________________________________________________________

Address: ________________________________________________________________________________________

City: ___________________________________________________________________________________________

State: ____________________________________________________ Zip Code: _________________________

User Name or Number: __________________________________________________________________________

User Weight: ___________________________________________________________________________________

User Height: ____________________________________________________________________________________

Seat Cushion Thickness: _________________________________________________________________________

Knee to Heel Length: Left: ________________________________" Right: ____________________________"

f THE ORDER CANNOT BE PROCESSED WITHOUT THE FOLLOWING:- A user name or number, the client’s measurements and weight - Amysystems is not responsible for configuration or size discrepancies resulting from customer errors on the order form. - Order confirmations will be provided by Amysystems summarizing the items selected. Please review this carefully. - Once the order is shipped, any changes are subject to the returns policy and may be prohibited.

STANDARD OPTIONS FOR HCPCS CODES (K0848, K0856, K0861, K0011) Alltrack R3 Power Base, 6-wheel independent wheel suspension, an additional seat suspension system, tie-down hardware for strap systems, 8A offboard charger, 8" front casters, and standard auto style buckle seat positioning strap, 6.5mph motors, Weight Capacity = 300 lb

T ALLTRACK R3 POWER WHEELCHAIR ATR3-3S-SS ALLTRACK R3 Power Wheelchair – (K0848 / K0011) – (Group 3 STD, No Power) $8,195 ATR3-3S-SP ALLTRACK R3 Power Wheelchair – (K0856 / K0011) – (Group 3 STD, Single Power) $8,195 ATR3-3S-MP ALLTRACK R3 Power Wheelchair – (K0861 / K0011) – (Group 3 STD, Multiple Power) $8,195

T USER WEIGHT PACKAGES WCA3 300 lb Maximum user weight capacity STD

T STANDARD FRAME COLORS T OPTIONAL FRAME COLORS (MAY INCREASE LEAD TIMES) FCBLK Black STD FCMYG Military Green N/C FCSBM Matte Black STD FCBOR Burnt Orange Metallic N/C FCGMC Gun Metal (Charcoal) STD FCBAO Black Opal Metallic N/C FCSVM Silver Metallic STD FCOPM Sparkle Orange N/C FCCBU Candy Blue STD FCMYT Military Tan N/C FCCRE Candy Red STD FCPKP Pearl Pink N/C FCMPL Midnight Purple STD FCHDD Desert Digital Camo Hydro Graphics $995 FCRZB Razzleberry STD FCHWL Woodland Camo Hydro Graphics $995 FCMWT Matte White STD FCHCF CarbonfiberHydroGraphics-(Matte black base) $995

T MATCHING ACCESSORIES TO THE FRAME COLOR FC***-M Matching Accessories to the Frame Color – (Wheels, front access door, headrest mount and back shell when selected) $295

c This options is included at no charge with the Hydro Graphics Frame Color option.

T TRANSPORT OPTION TTD4 4-Pointwheelchairtransportbrackets STD

c 4-Point wheelchair transport brackets have not yet received WC-19 crash-testing approval.

WC19-ISO WC-19andISO7176-19OccupiedTransitPackage(K0108) $584 c To confirm if your overall wheelchair configuration is WC-19 and ISO 7176-19 compliant, please refer to this website:

http://wc-transportation-safety.umtri.umich.edu/crash-tested-product-lists/wheelchairs

c Other restrictions may apply, please contact CSR for details. This option is only available on new power wheelchairs as an "on-chair" option. It is not available to install on a delivered wheelchair.

c This option is not compatible with the MP65B Motor Package with brake release.

PAGES 2 OF 11



(K0848/K0856/K0861)


MKT.F23 | OF | TMK-181018-1 | Rev.01

T MOTOR PACKAGE MP65B NEW 6.5mph4-PoleMotorPackage–(with Brake Release) STD

d These motors are not interchangeable with MP65B without modifying some of the frame components.

MP65-OPT 6.5mph4-PoleMotorPackage–(with COG Release) $395 MP85 8.5mph4-PoleHigh-SpeedMotorPackage – (with COG Release) $595

c Maximum user weight for this option is 250 lb and requires the R-net 120 Amp Expandable Controller (ECR120).

T ASSISTIVE DRIVING PACKAGE SMARTT Smart-Track–(K0108) $1,495

c Smart-Track technology provides increased tracking capabilities with enhanced traction and steering precision. This is ideal for those with marginal hand function or switch control.

c Requires the R-net PM 120 Amp Expandable Controller (ECR120).

c This option requires the MP65-OPT or the MP85 Motor Packages as they are not compatible with the MP65B Motor Package with brake release

T BATTERY CHARGER BCOB 8A Offboard Battery Charger N/C

T BATTERY TRAY AND FRAME SIZE FS22B Battery Tray for Group 22NF Batteries – (Total frame width = 23 3/8") STD

c The 23 3/8" compact frame is not compatible with most of the Center Mount Front Rigging Options due to Mechanical conflicts.

FS24B Battery Tray for Group 24 Batteries – (Total frame width = 25 3/8") N/C Please Select One Option: Front Caster Arms Flared out (STD) Straight (Optional)

c The Straight Front Arm option is not available with any of the Center Mount Front Rigging Options due to Mechanical conflicts.

T BATTERIES BAT22NFGEL Premium CGPower-GELBattery–Group22NF–50Amps(Each) – (E2361) $325 BAT22NFAGM Premium CGPower-AGMBattery–Group22NF–55Amps(Each) – (E2361) $300 BAT24GEL Premium CGPower-GELBattery–Group24–70Amps(Each) – (E2363) $430 BAT24AGM Premium CGPower-AGMBattery–Group24–75Amps(Each) – (E2363) $400

T CHOOSE TIRE COLOR (APPLIES TO ALL TIRES OR CASTERS) BLACK GREY

T DRIVE WHEEL DW14PT 14" Cast Wheel Pneumatic Tire STD DW14PI 14" Cast Wheel Pneumatic with Foam Filled N/C DW144PT 14" x 4" Extra Wide Cast Wheel Pneumatic Tire (Requires the Black Tire Selection) $550 DW144PI 14" x 4" Extra Wide Cast Wheel Pneumatic with Foam Filled (Requires the Black Tire Selection) $550

c The 14" x 4" Extra Wide Wheel increases the overall width of the Base by 2 ½".

c The option to Match the Wheels to the Shroud Color (FC…-M) is not available with the 14" x 4" Extra Wide wheels.

c The 14" x 4" option is not available with VR2 electronics (ECV902A).

DW12PT 12 ½" Cast Wheel Pneumatic Tire N/C DW12PI 12 ½" Cast Wheel Pneumatic with Foam Filled N/C

c 12 ½" Drive wheels reduce overall seat to floor height by ¾", lowers ground clearance and speed, but increases motor torque.

T FRONT CASTERS FC8PTR 8" Pneumatic Casters STD FC8PIR 8" Pneumatic Casters with Foam Filled N/C FC9PT 9"PneumaticCasters $150 FC9PI 9"PneumaticCasterswithFoamFilled $175

c The 9" casters will increase the minimum seat to floor height by ½" and are NOT compatible with the 12 ½" Drive wheel configuration (DW12PT and DW12PI)

c The 9" casters are NOT compatible with many front rigging options.

c Please see details in the Front Rigging sections.

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(K0848/K0856/K0861)


MKT.F23 | OF | TMK-181018-1 | Rev.01

T SEAT TO FLOOR HEIGHT (APPROXIMATE MEASUREMENT TO THE TOP OF SEAT PAN ± ¼") f OPTIONS FOR A SEAT ONLY

d The Heavy Duty Swing-Away footrests (SOAAF) are not available with (15 ¼" - 16" - 17") seat to floor height.

STFH1525 15¼"-(Possible Seat angle of 0° only) – (Requires the 12 ½" Drive wheels (DW12PT or DW12PI)).

STFH16 16"-(Possible Seat angle of 0° only) STFH19 19"-(Possible Seat angle of 0°, 3° and 6°)

STFH17 17"-(Possible Seat angle of 0° and 3°) STFH20 20"-(Possible Seat angle of 0°, 3°, 6°, 9°)

STFH18 18"-(Possible Seat angle of 0° and 3°)

f OPTIONS FOR A POWER TILT OR A STD POWER ELEVATE MODULE d The Heavy Duty Swing-Away footrests (SOAAF) are not available with (15 ¾" - 16 ½" - 17 ½") seat to floor height.

STFH1575 15¾"-(Possible Seat angle of 0° only) – (Requires the 12 ½" Drive wheels (DW12PT or DW12PI)). STFH165 16½"-(Possible Seat angle of 0° only) STFH185 18½"-(Possible Seat angle of 0° only) STFH175 17½"-(Possible Seat angle of 0° only) STFH19 19"-(Possible Seat angle of 0° only)

STFH18 18"-(Possible Seat angle of 0° only)

f OPTIONS FOR A COMBO - POWER TILT WITH A STD POWER ELEVATE MODULE STFH1775 17¾"-(Possible Seat angle of 0° only) – (Requires the 12 ½" Drive wheels (DW12PT or DW12PI)). STFH185 18½"-(Possible Seat angle of 0° only)

T SEAT TO FLOOR HEIGHT SPECIFICATION (IF NOT STANDARD)

SOMHSS Specificseattofloorheightrequirementotherthanstandard– (Custom upcharges may apply) RFQ c Required at: _______________" (± ¼" Range)

T PRE-SET SEAT FRAME ANGLE SFE-0 0oPre-setseatframeseatangle–(Must be selected when using power options) STD SFE-3 3oPre-setseatframeseatangle–(Only available with a seat configuration without power options) N/C SFE-6 6oPre-setseatframeseatangle–(Only available with a seat configuration without power options) N/C SFE-9 9oPre-setseatframeseatangle–(Only available with a seat configuration without power options) N/C

T LIGHTING PACKAGE EOLP LED Light Package – (Includes front beams, side flashers, rear tail light with flashers & brake light) $1,195

c Requires the upgraded Joystick with Light Operation or the OMNI (ECVJ6KL, ECELJL, ECRJCL, ECRJC35B or EDIB). The Light Package is not compatible with the EPSEL option.

T NON-EXPANDABLE ELECTRONICS - PG DRIVES VR2 CONTROLLER AND JOYSTICKS f VR2 Electronics can only accommodate a single power seat function. The only choices are Power Tilt or Elevating seat.

ECV902A VR290AmpDriveController– (Requires the selection of VR2 joystick below) STD ECVJ4K VR2Standard4-KeyJoystick STD ECVJ6K VR26-KeyJoystick– (Allows for a single power option to operate through this joystick) $250 ECVJ9KL VR29-KeyJoystickwithLightingOperation– (Allows for a single power function to operate through this joystick) $350

T EXPANDABLE ELECTRONICS - PG DRIVES RNET CONTROLLERS ECEL90 R-netEL90AmpExpandableController– (E2377) $595 ECR120 R-netPM120AmpExpandableController – (E2377) $695 ECRNH Harness for Expandable Controller – (E2313) $625

c Must be ordered with the expandable controller ECEL90 or ECR120 to interface with Joysticks or OMNI screen.

T EXPANDABLE ELECTRONICS - PG DRIVES RNET JOYSTICKS f Selection of one joystick option below is required with the expandable controller ECEL90 or ECR120

ECO OmitJoystick–(For use with an Omni Display) N/C ECELJ R-net-(LED) –Joystick STD ECRJC R-netJoystickwithColorscreen $75

f JOYSTICKS WITH LIGHTING OPERATION ECELJL R-net–(LED) –JoystickwithLightingOperation $525 ECRJCL R-netJoystickwithColorscreenandLightingOperation $625

f ADVANCED JOYSTICK ECRJC35B R-netAdvancedBluetoothJoystick(3.5" Screen). Lighting Operation, paddle switches, shortcut keys and stereo jacks $995

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(K0848/K0856/K0861)


MKT.F23 | OF | TMK-181018-1 | Rev.01

T JOYSTICK MOUNT JSMF FixedJoystickMount N/C JSMSA SwingAwayJoystickMount–Heightadjustable,AngleadjustableandMulti-Axis–(E1028) $375

Set-up with standard installation to swing-away sideways Set-up at 35° to swing-away sideways and downwards

JSMCM MidlineMountedSwingAwayJoystickMount–(E1028) $375

T JOYSTICK MOUNT SUPPORT JSMFH JoystickmountsupportBracket STD

T JOYSTICK HAND MOUNT HML InstallJoystickonLefthandside HMR InstallJoystickonRighthandside

T JOYSTICK HANDLE JSH StandardJoystickGimble STD JBAT Stick Handle 3" in Length – (E2323) $86 JBH Ball Handle – (E2323) $86 JFBH Foam Ball Handle – (E2323) $86 JTH T-Handle–(E2323) $86 JMUSH Bodypoint2.5"MushroomHandle–(E2323) $112 JGP Bodypoint4"U-shapedHandle–(E2323) $112

T ATTENDANT DRIVE CONTROL OPTION EADC AttendantHandControlforR-netEL&PMControls–(E2331) $895

T ATTENDANT JOYSTICK HAND MOUNT EADCL InstallAttendantJoystickonRearLefthandside EADCR InstallAttendantJoystickonRearRighthandside

T ENHANCED DISPLAY & DIGITAL INTERFACE BOX (INCLUDED WITH SPECIALTY CONTROLS)

EDIB Omni – (Enhanced Display & Digital Interface Box with Infrared) $1,075 c Allows the switch operation of alternative devices through driver controls. Requires one of the R-net fully Expandable Controllers (ECEL90 or ECR120).

T ENHANCED DISPLAY MOUNT EDSAM User Swing Away Mount – (E1028) N/C

EDML – (Install Display on LH side) EDMR – (Install Display on RH side)

T ENVIRONMENTAL CONTROL MODULE ECU Environment control module – (Output Module) – (E2351) $825

c Requires one of the fully expandable R-net controllers (ECEL90 or ECR120).

T BLUETOOTH MOUSE EMULATOR

EDBT Bluetooth Mouse Emulator – (USB Dongle included) $795 c Requires one of the fully expandable R-net controllers (ECEL90 or ECR120).

Not required if the ECRJC35B joystick has been selected

c Not limited to only one selection. Any two can be installed on the same chair, but only one can be used at a time.

Windows and MAC OS Android Devices Iphone, Ipad and Ipod

T POWER OPTIONS & SEATING SAABA Amyseat Rehab Seat – (Seat Frame only) STD SAPTX CG Power Tilt – (E1002) – (This option includes the Amyseat Rehab Seat) – (SAABA) $7,895 SAPRX PowerReclinewithIntegratedShearReduction – (ISR) – (E1004) – (This option includes the Amyseat Rehab Seat) – (SAABA) $8,795

c It is recommended to use the NXT Back Support option with the power or manual recline (NOACB or NOPCB).

SAPTPRX CGPowerTiltandPowerReclinewithIntegratedShearReduction– (ISR) – (E1007) – (This option includes the Amyseat Rehab Seat) – (SAABA) $12,395 c It is recommended to use the NXT Back Support option with the power or manual recline (NOACB or NOPCB).

SAPESX 11" Power Elevate Module for transfer assist – (E2300) – (This option includes the Amyseat Rehab Seat) – (SAABA) $4,175 ADDPESX Module – Add an 11" Power Elevate to either SAPTX, SAPRX or SAPTPRX – (E2300) $2,995 ADDMR Module–ManualReclinewithIntegratedShearReduction – (ISR) – (E1226) $695

c It is recommended to use the NXT Back Support option with the power or manual recline (NOACB or NOPCB).

c The maximum user weight capacity with this option is 250 lb.

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(K0848/K0856/K0861)


MKT.F23 | OF | TMK-181018-1 | Rev.01

T ELECTRONICS - SINGLE OR DUAL (1 OR 2 ACTUATORS) POWER SEAT FUNCTION CONTROLLERS EPSV Tilt or Elevating seat activaton through 6-key VR2 Hand Control – (ECVJ6K or ECVJ9KL) – (E2310) $1,895 EPSEL Tilt or Elevating seat activaton through RNET 90 Amp Expandable Controller – (ECEL90) – (E2310) $1,895

c EPSV and EPSEL allows for the activation of a single power option through the VR2 or R-net 90 Amp Controllers.

c Only the Power Tilt or Elevating seat options are available with this feature.

c These options do not require the SAC controller as they connect via the chair's power module directly.

SAC Single – (1)–PowerSeatFunctionControllertoInterfacethroughR-netElectronics–(E2310) $2,895 DAC Dual – (2)–PowerSeatFunctionControllertoInterfacethroughR-netElectronics–(E2310) $3,695

c The SAC or DAC options requires the R-net 90 Amp (ECEL90) or the 120 Amp (ECR120) Fully Expandable Controllers.

c Not available with both Tilt and Recline together. This option requires the (MAC).

f WITH THE SAC OR DAC, PLEASE SELECT ONE ACTIVATION AND POSITION FROM THE LIST BELOW SWTJSS SingleactuatoractivationthroughR-netJoystickorSpecialtyControls STD

c Requires the Single (1 Actuator) Power Seat Function Controller (SAC) and a R-Net Fully expandable Controllers (ECEL90 or ECR120).

SWTJSD DualactuatoractivationthroughR-netJoystickorSpecialtyControls STD c Requires the Dual (2 Actuators) Power Seat Function Controller (DAC) and a R-Net Fully expandable Controllers (ECEL90 or ECR120).

SWDUALACT Dual Activation – (Allows to operate all seat functions with external switches and through the joystick) $295 SWTOGGLE Single Toggle Switch – (Single Mode: DAC – Dual Mode: SAC) User Activation Attendant Activation N/C

c Requires the Single (1 Actuator) Power Seat Function Controller (SAC) or the Dual (2 Actuators) Power Seat Function Controller (DAC).

SWPUSH1 Single Push Button Switch – (Single Mode: SAC) User Activation Attendant Activation N/C c Requires the Single (1 Actuator) Power Seat Function Controller (SAC)

SWPUSH2 Dual Push Button Switch – (Single Mode: DAC – Dual Mode: SAC) User Activation Attendant Activation N/C c Requires the Single (1 Actuator) Power Seat Function Controller (SAC) or the Dual (2 Actuators) Power Seat Function Controller (DAC).

T ELECTRONICS - MULTIPLE (3 TO 6 ACTUATORS) POWER SEAT FUNCTION CONTROLLER MAC Multiple – (3 to 6 Actuators)–PowerSeatFunctionControllertoInterfacethroughR-netElectronics–(E2311) $3,695

c The MAC option requires the R-net 90 Amp (ECEL90) or the 120 Amp (ECR120) Fully Expandable Controllers.

f WITH THE MAC, PLEASE SELECT ONE ACTIVATION AND POSITION FROM THE LIST BELOW SWTJSM MultipleActuatoractivationthroughR-netJoystickorSpecialtyControls STD

c Requires the Multiple (3 to 6 Actuators) Power Seat Function Controller (MAC).

SWDUALACT Dual Activation – (Allows to operate all seat functions with external switches and through the joystick) $295 SWMULTI 4-WayToggleSwitch–(Up to 4 Activations) User Activation Attendant Activation N/C

c Requires the Multiple (3 to 6 Actuators) Power Seat Function Controller (MAC).

SWMULTIT Triple Toggle Switch – (Up to 5 Activations) User Activation Attendant Activation N/C c Requires the Multiple (3 to 6 Actuators) Power Seat Function Controller (MAC).

SWPUSH4 4-WayPushButtonSwitch User Activation Attendant Activation N/C c Requires the Multiple (3 to 6 Actuators) Power Seat Function Controller (MAC).

SWPUSH5 5-WayPushButtonSwitch User Activation Attendant Activation N/C c Requires the Multiple (3 to 6 Actuators) Power Seat Function Controller (MAC).

T SWITCH ACTIVATION HAND MOUNT Switch Installation: TSML – (Install Switch on LH side) TSMR – (Install Switch on RH side) N/C

T STANDARD ADJUSTABLE SEAT WIDTH RANGE BETWEEN 15" AND 20" SOWN15-20-19 – (Width adjustment from 15" to 20" with a maximum Depth of 19") N/C SOWN15-20-22 – (Width adjustment from 15" to 20" with a maximum Depth of 22") – (The minimum seat depth with this seat option is 18" Deep) N/C 15" (SOWN15) 16" (SOWN16) 17" (SOWN17) 18" (SOWN18) 19" (SOWN19S) 20" (SOWN20S)

T LARGE ADJUSTABLE SEAT WIDTH RANGE BETWEEN 19" AND 24" SOWN19-24-22 – (Width adjustment from 19" to 24" and Depth range of 18" to 22") – (The minimum seat depth with this seat option is 18" Deep) N/C 19" (SOWN19L) 20" (SOWN20L) 21" (SOWN21) 22" (SOWN22) 23" (SOWN23) 24" (SOWN24)

T ADJUSTABLE SEAT DEPTH RANGE BETWEEN 15" AND 22" d With a 22" long Seat Pan SOWN15-20-22 and SOWN19-24-22,

the minimum possible seat depth is 18". 15" (SODN15) 16" (SODN16) 17" (SODN17) 18" (SODN18) 19" (SODN19) 20" (SODN20) 21" (SODN21) 22" (SODN22)

T BACK CANE HEIGHT (THE BACK CANE HEIGHT MEASUREMENT IS TAKEN FROM THE SEAT PAN TO THE TOP OF THE PUSH HANDLES)

d 22" is the minimum back cane height required with a power or manual recline.

16" (SOBCH16) 18" (SOBCH18) 20" (SOBCH20) 22" (SOBCH22) 24" (SOBCH24) 26" (SOBCH26)

PAGES 6 OF 11



(K0848/K0856/K0861)


MKT.F23 | OF | TMK-181018-1 | Rev.01

T PRE-SET BACK ANGLE (FOR NON-RECLINING BACKS)

SOBAA Please Select one: 86° 90° 94° 98° 102° 106° 110° 114° 118° 122° N/C

T BACK SUPPORT STDSB Standard Contour Back Support – (15" to 24" Wide with a maximum shell height of 22") – (Not Coded). N/C

c The minimum space between the back and seat pan is 3" with a fixed back and 6" with a reclining back.

NOACB- NXTOPTIMAFHACCONTOURBACK – (15" to 21" Wide) – (E2620). $660 NOACB- NXTOPTIMAFHACCONTOURBACK – (22" to 24" Wide) – (E2621). $705

c The actual back shell heights only come in 13", 16" or 19" high.


NOPCB- NEW NXTOPTIMAFHPCDEEPCONTOURBACK–(15" to 21" Wide) – (E2620). $660 NOPCB- NEW NXTOPTIMAFHPCDEEPCONTOURBACK–(22" to 24" Wide) – (E2621). $705

c The actual back shell heights only come in 13", 16" or 19" high.


c This product is not compatible with Lateral Trunk Supports.

STDSBO Omission of the Contour Back Support t Specify Model of Back Support: _____________________________ N/C c It is recommended to use the Back Support option with the power or manual recline.

T BACK SUPPORT TOTAL HEIGHT (MEASURED FROM THE SEAT PAN TO THE TOP OF THE BACK)

d 22" is the minimum back height required with a power or manual recline.

16" (SOBH16) 18" (SOBH18) 20" (SOBH20) 22" (SOBH22) 24" (SOBH24) 26" (SOBH26) 28" (SOBH28) – (This height is not available with the NXT Optima AC and PC options)

T SEAT CUSHIONS f CG AIR – THERAPEUTIC AIR CUSHION

d The actual cushion sizes only come in even numbers for width and depth measurements.

Single valve (15" to 21" wide (E2622)) Single valve (22" to 24" wide (E2623)) Custom Cushion (Please use the CG Air order form) Cell Height: 2" 3" 4"

CGA1VSCxxxx-x CG Air Single Valve – (with Standard 2-way Stretch Cover) $510 CGA1V3Dxxxx-x CG Air Single Valve – (with 3D Mesh Cover) $564 CGA1VICxxxx-x CG Air Single Valve – (with Incontinence Cover) $535

f NXT BIO-FIT CUSHION d The actual cushion sizes only come in even numbers for width and depth measurements.

NXTBIOFIT - NXTBIOFITCushion–(15" to 21" Wide) – (E2607) $418 NXTBIOFIT - NXTBIOFITCushion–(22" to 24" Wide) – (E2608) $445

T CANTILEVER – HEIGHT ADJUSTABLE ARMRESTS – OPENS WITH A 5° ANGLE (FOR NON-RECLINING BACKS - CHOOSE 2)

SOAFBFLH Flip-BackCantilever–FullLengthLeftSide–(Height Adjustable from 7" to 15" with 1" increments) STD SOAFBFRH Flip-BackCantilever–FullLengthRightSide–(Height Adjustable from 7" to 15" with 1" increments) STD SOAFBDLH Flip-BackCantilever–DeskLengthLeftSide–(Height Adjustable from 7" to 15" with 1" increments) N/C SOAFBDRH Flip-BackCantilever–DeskLengthRightSide–(Height Adjustable from 7" to 15" with 1" increments) N/C

T DUAL POST – HEIGHT ADJUSTABLE ARMRESTS – INCLUDES TRANSFER GRIPS (FOR NON-RECLINING BACKS - CHOOSE 2)

SOADPFLH Dual Post Height Adjustable – Full Length Left Side – (Height Adjustable from 10 1/4" to 15 1/4") – (E0973) $120 SOADPFRH Dual Post Height Adjustable – Full Length Right Side – (Height Adjustable from 10 1/4" to 15 1/4") – (E0973) $120 SOADPDLH Dual Post Height Adjustable – Desk Length Left Side – (Height Adjustable from 10 1/4" to 15 1/4") – (E0973) $120 SOADPDRH Dual Post Height Adjustable – Desk Length Right Side – (Height Adjustable from 10 1/4" to 15 1/4") – (E0973) $120

T RECLINING FLIP-UP, HEIGHT ADJUSTABLE ARMRESTS (FOR RECLINING BACKS - CHOOSE 2)

SOANIFLH Reclining armrest – Full Length Left Side – (Height Adjustable from 10 1/2" to 14" with 1/2" increments) N/C SOANIFRH Reclining armrest – Full Length Right Side – (Height Adjustable from 10 1/2" to 14" with 1/2" increments) N/C SOANIDLH Reclining armrest – Desk Length Left Side – (Height Adjustable from 10 1/2" to 14" with 1/2" increments) N/C SOANIDRH Reclining armrest – Desk Length Right Side – (Height Adjustable from 10 1/2" to 14" with 1/2" increments) N/C

T ARMREST HEIGHT ADJUSTMENT AT FACTORY f Please set the Armrest Height at: ________________ " c The Armrest Height is taken from the seat pan to the top of the armpad.

c Not required for Dual Post.

PAGES 7 OF 11



(K0848/K0856/K0861)


MKT.F23 | OF | TMK-181018-1 | Rev.01

T ARMPADS f FOAM TYPE SELECTION SOWAPD Desk Length Waterfall – (10") Select Side: Left Hand Side Right Hand Side STD

c The Waterfall armpads may interfere with flipping back the armrests when combined with Lateral Trunk supports.

SOWAPF Full Length Waterfall – (14") Select Side: Left Hand Side Right Hand Side STD c The Waterfall armpads may interfere with flipping back the armrests when combined with Lateral Trunk supports.

f HYBRID GEL AND FOAM TYPE SELECTION (THE GEL ALWAYS STAYS SOFT) SOGELD Desk Length Hybrid Gel and Foam Flat armpad – (10" x 2 ½") Select Side: Left Hand Side Right Hand Side $35 SOGELF Full Length Hybrid Gel and Foam Flat armpad – (14" x 2 ½") Select Side: Left Hand Side Right Hand Side $35 SOWGELD Desk Length Hybrid Gel and Foam Waterfall armpad – (10") Select Side: Left Hand Side Right Hand Side $45

c The Waterfall armpads may interfere with flipping back the armrests when combined with Lateral Trunk supports.

SOWGELF Full Length Hybrid Gel and Foam Waterfall armpad – (14") Select Side: Left Hand Side Right Hand Side $45 c The Waterfall armpads may interfere with flipping back the armrests when combined with Lateral Trunk supports.

f SPECIALTY TYPE SELECTION SOCAR Arm Trough with Hand Support (18" x 4 ½") – (E2209) Select Side: Left Hand Side Right Hand Side $128

c Arm Trough Armpads may interfere with Armrests Flipping back.

T FOOTRESTS SOSAAF AdultSwing-AwayFootrests. Set at: 60° 70° STD

Select Footrest Range: SOFLA10 (10 ½" – 15 ½") SOFLA14 (14 ½" – 19 ½")

c The 70° footrest angle is not compatible with the 9" front casters (FC9PT and FC9PI) and may interfere with the casters when selecting the straight front caster arm option.

SOAAF Adult Heavy DutySwing-AwayFootrests.Set at: 60° 70° $475 Select Footrest Range: SOFLHD12 (12 ½" – 15 ½") SOFLHD14 (14 ½" – 19 ½")

c The 70° footrest angle is not compatible with the 9" front casters (FC9PT and FC9PI) and may interfere with the casters when selecting the straight front caster arm option.

ADDPL AdultPowerElevating&ArticulatingLegrests–(E1010) $3,795 Select Function: Individual Combined Select Footrest Range: SOFLPW12 (12 ½" – 15 ½") SOFLPW14 (14 ½" – 19 ½")

c This option includes calf pads. Individual legs count as two power functions. Combined legs count as one power function.

T FOOTPLATES & ACCESSORIES SOSFAF Flip-upFootplates STD SOAFP AngleAdjustable&Flip-upFootplates–(Each) – (K0040) $85 SOAHL Heel Loops – (Each) – (E0951) $21 SOACPFR CalfPadsforAdultHeavy-DutySwing-Awayfootrests–(SOAAF) – with adjustable hardware – (Each) – (E0995) $38

T FOOTREST LENGTH ADJUSTMENT AT FACTORY f Please set the Footrest Length at: ________________ " c The Footrest Length is taken from the top of the seat pan to the top of the footplate.

T CENTER MOUNTS SOAAF90 90°FixedCenterMountInterfaceBracket–(Offers Manual adjustability from 94° to 70°) N/C

Select Foot Platform Range: SOFBA12 (12 ½" – 16 ½") SOFBA16 (16 ½" – 19 ½") c Please Select the one piece center mount foot platform (SOFUFP) or the split footplates (SOAFPFB). c With the split footplates option (SOAFPFB), this bracket offers independent height adjustability for each footplate.

c This option is not compatible with the 9" Casters or the Straight Front Arm option due to Mechanical conflicts.

ADDPF NEW 90°PowerCenterMountElevating&ArticulatingFootPlatform – (E1012 / K0108) $3,795 Select Foot Platform Range: SOFBPW12 (10 ½"- 16") SOFBPW16 (16"- 20")

c This option includes calf pads. The power center mount counts as one power function.

c Please Select the one piece center mount foot platform (SOFUFP) or the split footplates (SOAFPFB). c This option is not compatible with the 9" Casters or the Straight Front Arm option due to Mechanical conflicts and is not available with the 12 ½" Drive Wheel.

T FOOT PLATFORMS & ACCESSORIES SOFUFP Flip-uponepieceFootPlatform N/C SOAFPFB AngleAdjustable&Flip-upSplitFootplatesforcentermount–(Each) – (K0040) $85 SOACPCM CalfPadsfor90°FixedCenterMount–(SOAAF90) with adjustable hardware – (Each) – (E0995) $38

T FOOT PLATFORM LENGTH ADJUSTMENT AT FACTORY f Please set the Foot Platform Length at: ________________ " c The Foot Platform Length is taken from the top of the seat pan to the top of the foot platform or split foot plates.

PAGES 8 OF 11



(K0848/K0856/K0861)


MKT.F23 | OF | TMK-181018-1 | Rev.01

T SEAT POSITIONING (NOT COMPATIBLE WITH THE WC19-ISO OPTION) SOAUTO 55" Seat Positioning Strap STD SOAUTO80 80"SeatPositioningStrap $75 SOBPHP2C Bodypoint padded Hip Belt – (Two Point – Center Pull) – (E0978) $150 SOBPCS Bodypoint padded Chest Strap – (E0960) $215

T HEADREST d Please select one of the headrest options with the mounting hardware and specify where the headrest will be installed.

SONUAHR UsingheadrestmountinghardwareotherthanSOMAHlocatedbellow.t Specify: _____________________________ N/C SOFHRS Small Curved Headrest Pad – 4" x 9" – (E0955) $233 SOFHRM MediumCurvedHeadrestPad–5"x10"– (E0955) $233 SOFHRL LargeCurvedHeadrestPad–6"x11"–(E0955) $233 SOMAH Multi-axisRemovableMountingHardware–(E1028) $238 SOHRBC Bracket to Mount on the Contour Back Support – (Without Recline) N/C SOHRPR Bracket to Mount on the Seat Frame – (For Reclining Backs) N/C

T LATERAL TRUNK SUPPORTS d Please select one of the lateral pads and the adjustable & removable hardware.

(The Lateral Trunk Supports are not compatible with the NXT Optima FH PC 6" Deep Contour Fixed Thoracic Back Support (NOPCB).)

SOSLS3 Adjustable Laterals with Small Curved Pads – (Each) – 3" x 5" – (E0956) $112 SOSLM4 Adjustable Laterals with Medium Curved Pads – (Each) –4"x6"– (E0956) $112 SOSLL5 Adjustable Laterals with Large Curved Pads – (Each)–5"x7"– (E0956) $112 SOSLHM AdjustableSwing-AwayHardwareMounts–(Each) – (E1028) $238

T HIP & THIGH SUPPORTS d Please select one of the hip & thigh support pads and the adjustable & removable hardware.

SOHTSS10 AdjustableHip&ThighSupportPads–(Each)–Small10"x4"–(E0956) $112 SOHTSM12 AdjustableHip&ThighSupportPads–(Each) – Medium 12" x 5" – (E0956) $112 SOHTSL14 AdjustableHip&ThighSupportPads–(Each)–Large14"x6"– (E0956) $112 SOHTSARH AdjustableandRemovableHip&ThighSupportHardware–(Each) – (E1028) $238

T ACCESSORIES SOCH Cup Holder – (Self-Leveling) $90 SOCPH RamMountsX-GripCellPhoneHolder $120 SOTHS RamMountsX-GripSmallTabletHolder $170 SOTHL RamMountsX-GripLargeTabletHolderwithSwivel $270

T REFLECTOR KIT REFLECT Red&WhiteReflectorKitStickers(They will not be installed – Included in a bag with the owner's manual) N/C

T BACK PACK AND ARMREST SIDE POUCHES SOBP Back Pack – (Comes with durable straps that can be hooked around the back canes) $79 SOAP Armrest Side Pouch – (Comes with durable straps that can be hooked around the armrest tubes) Order: 1 2 $57

If only choosing one (1) armrest pouch, please show what side it should be installed: Left Side Right Side

T SWITCHES AND OPTIONS ASCPCP PGDT RNET Dongle and PC programmer kit $345 ASCPVR2 PGDT VR2 Dongle and PC programmer kit $895 SSBS Buddy Button Switch – (K0108) $150 SSES EggSwitch-Black–(K0108) $150 SSML Ultra Light Switch – (K0108) $155

PAGES 9 OF 11



(K0848/K0856/K0861)


MKT.F23 | OF | TMK-181018-1 | Rev.01

SPECIALTY DRIVER CONTROL OPTIONS d Specialty Drive Control options all requires the Omni Enhanced Display & Digital Interface Box (EDIB)

T THERAFIN SIP-N-PUFF KIT SCSNPK TherafinSip-N-PuffKit–(E2325) $1,545 SCSNPBTK TherafinSip-N-PuffBreathTubeKit–(E2326) $400

c Required with the Therafin Sip-N-Puff kit.

SCSRMSNP StealthRock-n-LockSwingawayArmforSip-N-Puff–(E1028) SWL (Swings on Left) SWR (Swings on Right) N/C c Required with the Therafin Sip-N-Puff kit.

SCSRM StealthRock-n-LockSwingawayMountforModeSwitch–(E1028) SWL (Swings on Left) SWR (Swings on Right) $395 SSES-STD Egg Switch for Changing Modes – Black – (K0108) MLH (Mount on Left) MRH (Mount on Right) N/C

c Required with the Stealth Rock-n-Lock Swing Away mount.

c The Mode Switch Type can be changed from this selection in SWITCHES & OPTIONS section.

SSBS-STD Buddy Button Switch – (Stop Switch) – Red – (K0108) N/C c Required with the Therafin Sip-N-Puff kit.

SOMAH Multi-axisHeadrestRemovableMountingHardware–(E1028) $238 c Required with the Therafin Sip-N-Puff kit.

f CHOOSE ONE (1) HEADREST PAD SOFHRS Small Curved Headrest Pad – 4" x 9" – (E0955) SOFHRM MediumCurvedHeadrestPad–5"x10"– (E0955) $233 SOFHRL LargeCurvedHeadrestPad–6"x11"–(E0955)

T SWITCH-IT PROXIMITY HEAD ARRAY SCSIHAA Adult–3SwitchProximityHeadArraywith1/8"MonoJackformode/reverse–(E2330) $4,859 SCSRM StealthRock-n-LockSwingawayMountforModeSwitch– (E1028) SWL (Swings on Left) SWR (Swings on Right) $395 SSES-STD Egg Switch for Changing Modes – Black – (K0108) MLH (Mount on Left) MRH (Mount on Right) N/C



SSBS-STD Buddy Button Switch – (Stop Switch) – Red – (K0108) N/C c Required with the Switch-It Proximity Head Array.

SOMAH Multi-axisHeadrestRemovableMountingHardware–(E1028) $238 c Required with the Switch-It Proximity Head Array.

T PROPORTIONAL RIM HEAD CONTROL PACKAGE SCPHC ProportionalRIMHeadControlPackage–(E2327) $4,595 SCSRM StealthRock-n-LockSwingawayMountforModeSwitch–(E1028) SWL (Swings on Left) SWR (Swings on Right) $395 SSES-STD Egg Switch for Changing Modes – Black – (K0108) MLH (Mount on Left) MRH (Mount on Right) N/C



SOMAH Multi-axisHeadrestRemovableMountingHardware–(E1028) $238 c Required with the Proportional RIM Head Control.

PAGES 10 OF 11



(K0848/K0856/K0861)


MKT.F23 | OF | TMK-181018-1 | Rev.01

SPECIALTY DRIVER CONTROL OPTIONS (CONTINUED) d Specialty Drive Control options all requires the Omni Enhanced Display & Digital Interface Box (EDIB)

T SWITCH-IT MICROPILOT LIGHT TOUCH PROPORTIONAL MINI JOYSTICK FOR CHIN / LIP CONTROL SCSIMP MicroPilotLighttouchminiProportionalJoystick–(E2312) $3,643 SCSRMMP StealthRock-n-LockSwingawayArmforChinMP–(E1028) SWL (Swings on Left) SWR (Swings on Right) $395

c Required with the Switch-It Proximity Micro-Pilot.

SCSRM StealthRock-n-LockSwingawayMountforModeSwitch–(E1028) SWL (Swings on Left) SWR (Swings on Right) $395 SSES Egg Switch for Changing Modes – Black – (K0108) MLH (Mount on Left) MRH (Mount on Right) $150



JCC Chin Cup – (E2324) $55 SOMAH Multi-axisHeadrestRemovableMountingHardware–(E1028) $238

c Required with the Switch-It Proximity Micro-Pilot.

f CHOOSE ONE (1) HEADREST PAD SOFHRS Small Curved Headrest Pad – 4" x 9" – (E0955) SOFHRM MediumCurvedHeadrestPad–5"x10"–(E0955) $233 SOFHRL LargeCurvedHeadrestPad–6"x11"–(E0955)

T PROPORTIONAL COMPACT OR MINI JOYSTICK FOR MIDLINE MOUNT SCPGMJS PGDrivesJC200ProportionalCompactRemoteJoystickforMidlineMount–(E2373) $1,395 SCGMJSM GatlinMidlineSwing-awayMountforJC200–(E1028) MLH (Mount on Left) MRH (Mount on Right) $260

c Must be selected for use with the PG Drives JC200 Mini Joystick.

SCSIMP Switch-ItMicroPilotLighttouchminiProportionalJoystick–(E2312) $3,643 SCGMPM GatlinMidlineSwing-awayMountforMicroPilot–(E1028) MLH (Mount on Left) MRH (Mount on Right) $260

c Must be selected for use with the Switch-It MicroPilot.

SCBTM Bullet Hand Tray for MicroPilot – (K0108) MLH (Mount on Left) MRH (Mount on Right) $395 c This option is only compatible with the Switch-It MicroPilot.

T PROPORTIONAL COMPACT OR MINI JOYSTICK FOR ARMREST MOUNT SCPGMJS PGDrivesJC200ProportionalCompactRemoteJoystickforArmrestMount–(E2373) $1,395 SCARMJSM Swing-awayandMulti-Axisarmrestmount–(E1028) MLH (Mount on Left) MRH (Mount on Right) $244

c Must be selected for use with the PG Drives JC200 Mini Joystick.

SCSIMP Switch-ItMicroPilotLighttouchminiProportionalJoystick–(E2312) $3,643 SCARMPM Swing-awayandMulti-Axisarmrestmount–(E1028) MLH (Mount on Left) MRH (Mount on Right) $244

c Must be selected for use with the Switch-It MicroPilot.

SCBTM Bullet Hand Tray for MicroPilot – (K0108) MLH (Mount on Left) MRH (Mount on Right) $395 c This option is only compatible with the Switch-It MicroPilot.

PAGES 11 OF 11


(K0848/K0856/K0861)


MKT.F23 | OF | TMK-181018-1 | Rev.01

CUSTOM SECTION f Lead times will increase depending on the custom order pipeline at the time the purchase order is received. Please call for Quote and specifications for these options.

T O2 HOLDER SUPOXY CustomNon-ArticulatingOxygenTankHolder–(E2208) MLH (Mount on Left) MRH (Mount on Right) $270

c Not available with a power tilt and/or power recline.

SUPOXYA Custom Articulating Oxygen Tank Holder – (K0108) MLH (Mount on Left) MRH (Mount on Right) $1,195 c Required with a power tilt and/or power recline.

D-Size Oxygen Tank – (* 22" Tall x 4.3" Diameter) – * The height includes the valve

E-Size Oxygen Tank – (* 31" Tall x 4.3" Diameter) – * The height includes the valve

T VENT TRAY (PLEASE COMPLETE IN FULL)

d Amysystems does not supply the battery, charger or the wiring for the Vent. These items are normally provided by the Vent Manufacturer.

SOVENT Custom Vent Tray Articulating Vent Box – (Required with Power Tilt and/or Recline) – (E1030) t Model: _____________________________ $1,420 Fixed Vent Box – (E1029) t Model: _____________________________ $400

SOVTBE Extended Battery Compartment – (K0108) $495 c The Vent Tray option is not available with the CUSTOM Battery Tray for Group 24 Batteries with a 24" frame width (FS2424B).

The Vent is being powered by 1 U1 Battery and the chair by 2 Group 22NF batteries The Vent is being powered by 1 U1 Battery and the chair by 2 Group 24 batteries The Vent is being powered by 1 Group 22NF Battery and the chair Powered by 2 Group 22NF Batteries The Vent is being powered by 1 Group 24 Battery and the chair Powered by 2 Group 22NF Batteries

T OTHER CUSTOM OPTIONS (REQUEST FOR QUOTE)

d Please specify details and specifications for these options.

CUSTOM Power Anterior Tilt RFQ CUSTOM PowerLateralTilt15° Raise the Left Side only Raise the Right Side only Raise the Left & Right Side RFQ CUSTOM Power Elevating Stretcher – (Please call CSR for availability with configuration and user weight capacity) RFQ

c This option is not available with the Straight Front Caster Arms on Rear Hybrid Configuration.

CUSTOM PowerFlip-upFootPlatform–(Please call CSR for availability with configuration and user weight capacity) RFQ c This option is not available with the Straight Front Caster Arms on Rear Hybrid Configuration.

CUSTOM Power Vertical Lifting Foot Platform – (Please call CSR for availability with configuration and user weight capacity) RFQ c This option is not available with the Straight Front Caster Arms on Rear Hybrid Configuration.

CUSTOM IndependentDepthAdjustabilitybuiltintotheFootrestReceiverthatisattachedtotheSeatPan RFQ CUSTOM Endomorphic Back Canes – (Pair) 1" per side towards the inside = 2" 2" per side towards the inside = 4" RFQ CUSTOM Transfer Handles – (Pair) RFQ CUSTOM Manual Wheel Locks $345 CUSTOM Non Standard Frame Colors – (Not all custom colors are available, please contact CSR for availability) $295 CUSTOM # 1 Othercustomoptions.Specifyinnotessectionbelow RFQ CUSTOM # 2 Othercustomoptions.Specifyinnotessectionbelow RFQ

T NOTES / SPECIAL REQUESTS / CUSTOM SPECIFICATIONS

Amysystems is an Inc. brand

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