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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 HStyle 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: 26x 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 HStyle Harness Wheelchair Spoke Covers Suspension Bike Seat Choice of Frame Color: o Red o Blue Plus - $5,995.00 Includes Plusfeatures 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
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Order Form / Price List - frankmobility.com RETAIL ORDERFORM 2018.pdf250 W Heinzmann Direct Power Drive Motor ...

Mar 20, 2018

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Page 1: Order Form / Price List - frankmobility.com RETAIL ORDERFORM 2018.pdf250 W Heinzmann Direct Power Drive Motor ...

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 & WashableSeat Upholstery

Folding Seat with 3Position Seat Angle

Chain Guard

Coaster Brakes

On-Board Tools forHeadrest/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 $100Freight Charge for the Electro

Electro Plus - $8,995.00

WHEELCHAIR BICYCLE TANDEM

®

1003 INTERNATIONAL DRIVE • OAKDALE, PA 15071

Phone (724) 695-1590 • Fax (724) 695-1593 Facebook.com/DuetWheelchairBicycleTandem Email • [email protected] Web • www.MobilityAccess.com