Invacare Corporation Top End Division All rights reserved. Trademarks are identified by the symbols ™ and ®. All trademarks are owned by or licensed to Invacare Corporation unless otherwise noted. Specifications and prices are subject to change without notification. ©2015 Invacare Corporation 1181424 REV D SWATSON 2019 06 03

Page of

Invacare® Top End® Pro Basketball ™ Wheelchair

Order Form and Price List: All products must be ordered directly from TopEnd or through an Invacare provider. Our provider locator is available at www.topendwheelchair.com

BASE MODEL:10000 Top End Pro BB Wheelchair $2,395

PROVIDER / CUSTOMER INFORMATION: Provider Information: End User Information:

Date: Name: Height:

IVC Acct #: Ship to Address: Weight (lbs.):

Contact: Address Line 2: Leg Length (in.):

Phone #: City: Hip Width (in.):

Fax/Email: State: Zip: Phone #:

Ship to Provider Ship to End User Email:

ORDER REQUEST TYPE:Quote Quote and CAD Order PO #

SIZING: (See exclusions and diagrams below)

SEAT WIDTH:1500515007150091501115013150151501715019150211502315025

10" Seat Width $011" Seat Width $012" Seat Width $013" Seat Width $014" Seat Width $015" Seat Width $016" Seat Width $017" Seat Width $018" Seat Width $019" Seat Width $020" Seat Width $0

SEAT DEPTH:150341503615038150401504215044150461504815050

10" Seat Depth $011" Seat Depth $012" Seat Depth $013" Seat Depth $014" Seat Depth $015" Seat Depth $016" Seat Depth $017" Seat Depth $018" Seat Depth $0

BACK HEIGHT:151261512715128

Adjustable 9" to 11" $0Adjustable 10" to 14" $0Adjustable 14" to 18" $0

SEAT HEIGHT:

15099

15100

Adjustable Front: 19" to 21" (Tall) Adjustable Rear: 15" to 21"

$0

Adjustable Front: 17" to 19" (Short) Adjustable Rear: 13" to 17" $0

WHEELBASE: (See diagrams below)

750667506875070

15" Wheebase $017" Wheelbase $019" Wheelbase $0

CAMBER ANGLE:450084500945010

15 Degree Camber $018 Degree Camber $020 Degree Camber $0

WHEELBASE GUIDE:Seat Depth: 10" - 14" 15" - 16" 17" - 18"

Recommeded Wheelbase: 15" 17" 19"

Invacare Corporation Top End Division All rights reserved. Trademarks are identified by the symbols ™ and ®. All trademarks are owned by or licensed to Invacare Corporation unless otherwise noted. Specifications and prices are subject to change without notification. ©2015 Invacare Corporation 1181424 REV D SWATSON 2019 06 03

Page of

Invacare® Top End® Pro Basketball ™ Wheelchair

Order Form and Price List: All products must be ordered directly from TopEnd or through an Invacare provider. Our provider locator is available at www.topendwheelchair.com

BACK TYPE:15159 Non-Fold-Down, Angle Adjustable back $0

CENTER OF GRAVITY: 45072 Adjustable 3.5" to 5.5" $0

ANTI-TIP:2003020031

Single, Adjustable Height $0Double, Adjustable Height $120

FOOTREST:60001 Platform, Height Adjustable $060030 Click Strap, Single Pad $75

SIDE GUARDS:2001620004

Omit Side Guards $0Fixed, Aluminum, Clamp-on $125

AXLES:50400 Quick Release, 1/2" Steel $0

WHEEL SETS: (See exclusions and diagram below)

WHEEL SIZE:501905019150192

24" (540) $025" (559) $026" (590) $0

WHEEL STYLE: High Performance Wheels:

5019450196

501955019750198

Omit Wheels, Build for HP $0High Performance $300

Spinergy Wheels: Omit Wheels, Build for Spinergy $0Spinergy SLX $850Spinergy XSLX $950

SPOKE COLOR: (only applicable to Spinergy Wheels)

502735027450275502765027750278502795028050281

Red $0Yellow $0Green $0Blue $0Pink $0Purple $0Orange $0Black $0Custom (See Page 5) $150

HANDRIMS:50297

50299

6 Tabs, Aluminum, Anodized $012 Tabs, Aluminum, Anodized Spinergy Only

$150

HANDRIM MOUNTING:503085030950310

Standard Mount $0Close Mount $0Close Mount with Cut Tabs $40

TIRES:5021650217

Primo Grey $0Kenda Red $0

UPHOLSTERY:MATERIAL & COLOR:

300013000230003

Nylon, Black $0Nylon, Woodland Camouflage $100Nylon, Digital Camouflage $100

SEAT STYLE:30019 Screw - On Seat Upholstery $0

BACK STYLE:30012

30004

Adjustable Tension Back Upholstery $0Adjustable Tension Back Upholstery with Leather Flaps and Aluminum Dome Plugs (see definitions)

$100

SEAT CUSHIONS:30005 2" Soft Cushion $7530006 3" Soft Cushion $7530008 2" Hard Cushion $12530009 3" Hard Cushion $12530010 4" Hard Cushion $125

WHEEL SIZE GUIDE:Rear Seat

Height: Short Short or Tall Tall

Player Specifications:

Junior's/Short Arms

Adult/3.0 or Lower

Adult/3.5 or Higher

Recommended Wheel Size: 24" 25" 26"

Invacare Corporation Top End Division All rights reserved. Trademarks are identified by the symbols ™ and ®. All trademarks are owned by or licensed to Invacare Corporation unless otherwise noted. Specifications and prices are subject to change without notification. ©2015 Invacare Corporation 1181424 REV D SWATSON 2019 06 03

Page of

Invacare® Top End® Pro Basketball ™ Wheelchair

Order Form and Price List: All products must be ordered directly from TopEnd or through an Invacare provider. Our provider locator is available at www.topendwheelchair.com

FRAME COLOR:55018550195501755010550115501255023550535500855054550065500555051550155505755055550015500255003550505502055016550075505255070

Black Wet Black $0Black Black Prism $0Black Stealth Black $0Blue Midnight Blue $0Blue Royal Blue $0Blue Electric Blueberry $0Gray Stealth Gray $0Green Agriculture Green $0Green Grasshopper Green $0Green Neon Green $0Orange Sunkissed Orange $0Orange Simple Orange $0Orange Neon Orange $0Pink Bubblegum Pink $0Pink Neon Pink $0Purple Lilac Purple $0Red Simple Red $0Red Tangerine Red $0Red Raspberry Red $0Red Neon Red $0Silver Silver Metallic $0White White Snow $0Yellow Safety Yellow $0Yellow Neon Yellow $0Raw Buffed Aluminum $0

DEFINITIONS:

Leather Flaps with Aluminum Dome

Plugs:

When the Leather Upgrade is chosen the flaps (part of the upholstery that goes goes down over the back posts) will be made of leather. Also, the caps on the backrest post will be aluminum. This is used to help reinforce the back upholstery and help prevent tearing.

EXCLUSIONS:

Wheels and Tires: Must choose the same size tires and handrims as wheels.

Width and Depth Specifications:

All sizes for Width (W) by Depth (D) that is represented by a red box can not be ordered.

Note: All special requests are subject to approval, additional charges, and additional lead time.Special Request 1)Special Request 2)Special Request 3)Special Request 4)Special Request 5)

ACCESSORIES: STANDARD:

25066 Calf Strap $0UPGRADABLE: SAFETY:

25004 Rear Frame Protector (Required for Tournament Play)

$20

25015 Light, Front (White) $25POSITIONING:

25013 Hook and Loop Strap $4025012 Metal O-Ring Strap $6025001 Click Strap, 8" Small $7525002 Click Strap, 10" Medium $8025003 Click Strap, 12" Large $86

PERFORMANCE ENHANCEMENTS:25022 Wheel Alignment Gauge $75

BAGS:25011 Basketball Carrying Bag $75

APPAREL: 250842508525086

Lemon Yellow T-Shirt $20Army Green T-Shirt $20Army Green Racer Back Tank Top $20

Please select a size for your shirt selection:25087 25088 25089 25090 25091 25092 25093

Extra Small Small Medium Large Extra LargeXX LargeXXX Large

Invacare Corporation Top End Division All rights reserved. Trademarks are identified by the symbols ™ and ®. All trademarks are owned by or licensed to Invacare Corporation unless otherwise noted. Specifications and prices are subject to change without notification. ©2015 Invacare Corporation 1181424 REV D SWATSON 2019 06 03

Page of

Invacare® Top End® Pro Basketball ™ Wheelchair

Order Form and Price List: All products must be ordered directly from TopEnd or through an Invacare provider. Our provider locator is available at www.topendwheelchair.com

CUSTOM SPINERGY XSLX: Spoke Color:

F1B1F2B2F3B3F4B4F5B5F6B6F7B7F8B8F9B9F10B10F11B11F12B12

CUSTOM SPINERGY XSLX: Wheel SizeHub Color

CUSTOM SPINERGY SLX: Spoke Color:

F1B1F2B2F3B3F4B4F5B5F6B6F7B7F8B8F9B9F10B10F11B11F12B12

CUSTOM SPINERGY SLX: Wheel SizeHub Color

F = Front Spoke B = Back Spoke

F = Front Spoke B = Back Spoke