Rev 2/2018 Accessories Adjustable Headrest $310 Headrest Quick Release Lever (Adjusts Without Tools) $100 Bike Stand $125 LED Light System (Battery Operated Front & Rear Light) $235 Footrest Quick Release Lever (Adjusts Without Tools) $150 Raised Footboard (4’0” and under) $340 Molded Foot Supports with Straps Size: Small Medium Large X-Large $325 Wheelchair Spoke Covers $365 Seat Reduction (Removable Upholstery Pieces) Seat Width (Standard = 18”) 15” 13” 10” $270 Custom Split Footplates $550 Order Form / Price List Ordered By: Net Amount Freight Charges **Sales Tax Total $350.00 Delivery Time: 5-15 days via UPS Freight Payment Terms: Prepaid Orders Only Delivery Time subject to change Prices subject to change without notice. Thigh Harness $145 Foot Strap Calf Strap $75 “H” Style Harness $195 Elevated Handlebar for Wheelchair (For Tall Bike Riders) $215 Handlebar Quick Release Lever (Adjusts without tools) $150 Raised Armrests, Removable $265 Hand Shields (Keeps Hands Off Tires) $295 Bicycle Basket: XL Basket $80 XXL Basket $160 (Select Size. Baskets only compatible with Basic & Plus) Anti-Tip Support for Wheelchair $520 Puncture Proof Resistant (Wheelchair & Bike) $500 Payment Method Visa MasterCard Check by Mail Discover American Express Name as it Appears on Card Card Bill to Address Card Number Expiration Date Signature Phone: Standard Features Include: 26” x 1.75” Bike Tires Alloy Luggage Rack 90mm Twin Drum Brakes Wheelchair Parking Brake Adjustable & Removable Footrest Adjustable Lap Belt Adjustable Handlebars Removable & Washable Seat Upholstery Folding Seat with 3 Position Seat Angle Chain Guard Coaster Brakes On-Board Tools for Headrest/Footrest Basic - $4,995.00 Includes standard features with: Shimano Nexus 8-Speed Gears Blue Bike Frame Yellow Wheelchair Seat Yellow Footrest Includes standard features plus: Shimano Nexus 8-Speed Gears Puncture Proof Resistant Adjustable Headrest LED Light System Bike Stand Bike Lock Tire Pump, Tool Set “H” Style Harness Wheelchair Spoke Covers Suspension Bike Seat Choice of Frame Color: o Red o Blue Plus - $5,995.00 Includes “Plus” features plus: Includes same features on the Plus model and 7-Speed Chain Gear System 250 W Heinzmann Direct Power Drive Motor 36V, 1 x 11Ah Li-Ion Battery 110V Charger Silver Frame Only 30 Miles per Charge Note there is an Additional $100 Freight Charge for the Electro Electro Plus - $8,995.00 WHEELCHAIR B ICYCLE T ANDEM ® 1003 INTERNATIONAL DRIVE • OAKDALE, PA 15071 Phone (724) 695-1590 • Fax (724) 695-1593 Facebook.com/DuetWheelchairBicycleTandem Email • info@MobilityAccess.com Web • www.MobilityAccess.com