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PV: PC:( ) Fax: ( )
PV: PC:( ) Fax: ( )
To order any JAY cushions on-chair, please see the JAY price list. Cushion name or part number must be filled out with desired width and depth
4. REAR WHEELS
Mark For:
Dealer City:
Confirmation Email:
$276.00
2. SIZE / SEATING
Quote Order
Attention:
Quickie M6™AADL - W848
EIF1, October 2018
Submitting for:
PO#:
Dealer:
Dealer Phone:
Dealer Contact:
Dealer Acct #:ADDITIONAL SHIPPING INFORMATION
Dealer Address:Address:
Seat Height
115SD33 22" (Long frame only)
Address:
Frame Length
1. FRAME
NCNC
Cushion115CU31 2" Cushion
3. CASTERS
Date:
Option #
115HT11 18.5" Only available w/ 5" casters
Ship To City:
Definition
Ship To:
Email Ship To Phone:
PriceOption #
Confirm Via: Fax
Price Definition
20"
115HT65 17" Includes low adjustable axle plate and shorter fork. Only available with 5" caster
$503.00
115HT14
Axle115AX1 Quick Release NC
NC115AL28 Low (only for 17" Seat Ht.) NC
115HR7
115AL2 Standard (for 18.5", 20" Seat Ht.)
Omit Handrim -$12.00
$221.00
Handrim115HR1 Aluminum Anodized NC115HR4 Plastic Coated
115RT2 Pneumatic Airless Insert Tire
Rear Wheel Tire
115RT1 Pneumatic Tire
Rear Wheel Type115RW2 24" Spoke Wheel NC
Adjustable Axle Plate
$130.00
$4,313.00Base Model
Quickie M6115WM21
Regular (18"-19" depth) NC115FL18
NC
115FL9Long (18"-22" depth)
19"
Seat Depth115SD11 18" NC
$276.00115SD12 $276.00115SD13 20" (Long frame only)
$276.00115SD14 21" (Long frame only)
$168.00
Seat Height Matrix
$352.00115CW37
115CW36 8" x 2" Pneumatic $221.00
8" x 2" Pneumatic w/Airless Insert
115W17
22" 24"
$276.00115W14
Frame Width115W13
28" NC26" NC
30" NC
NC
Depth:
NC115W15
Casters
115W16
115CW6 5" Soft Roll $113.00
JAY Cushions (Optional)
JAY Bundled Cushion115JC20 Price ListCushion Name or Part #
Width:
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! !Option # Definition PriceOption #Price Definition
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Heel loop or leg strap not included, See Footplate Options Section!
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5. WHEEL LOCKS
6. HANGERS AND FOOTREST
8. ARMREST
Footplates
115F25 Adult Angle Adj
Extension Handle115EH1
115C38 Blue Opal NC
$151.00115F1 Composite
Positioning Belt9. KEY OPTIONS & ACCESSORIES
NC
$65.00
115WL10 NC
6" Pair
10. COLOR
115F5 Aluminum NC
$935.00
NCNCNC
Medium (15.5"-18")115E5
Lower Leg Length Range Matrix
115E1
! 115H41 ELR - Heavy-Duty ReinforcedOnly available with aluminum footplates
! 115H14670° Heavy-Duty Ft. Mount Lift OffOnly available with 5" caster and ang adj footplates. NA w/ extension tubes
! 115H13280° Heavy-Duty Ft. Mount Lift OffOnly available with 5" caster and ang adj footplates. NA w/ extension tubes
115WL12
$173.00
Long (18"-20.5") NA w/ 5" caster$173.00
Short (13"-15.5")115E2
Front Hangers115H1 60° Swing Away NC
Miscellaneous115A83 Tool Kit $38.00
115A142 Belt 1.5" Auto Buckle $87.00
Do Not Mount Wheel Lock NC
115A13 Belt 2" Aircraft Buckle Padded $183.00115A12 Belt 2" Aircraft Buckle $125.00
Wheel Lock115WL1 High Mount Push Wheel Lock NC
$108.00
Omit Wheel Lock
115AT3 Omit Rear Anti-Tip NC
$341.00
Armrest115AA33 Dual Post Height Adj - Desk 10" $341.00115AA34 Dual Post Height Adj - Full 14"
115B98 20-1/8" NC115B39 19" NC
16-3/4" NC115B96 17-7/8" NC
Back Height Preset
! 115BT34 8° w/ Push Handles Adjustable (16-3/4" to 20-1/8") NC
115B91
115C150 Matte Electric Blue115C149 Matte Evergreen
NC115C151 Matte Black Cherry NC
Matte Frame Colors115C116 Matte Black NC
115C8 Yellow NC115C113 Titanium Color Paint NC115C145 Sunrise Orange NC115C114 Sparkle Silver NC
Rootbeer NC115C148 Mauve Pink NC115C103
115C147 Hot Sparkle Pink NC
115C143 Evergreen NC
115C144
115C36 Candy Blue NC
115C142 Electric Blue NC115C35
Aztec Gold NCBlack (Not avail as base w/Zebra) NCBlack Cherry NC
Standard Frame Colors
$30.00
115AT1 Rear Anti-Tip
115C140115C2
115C141
Heel Loop
Rear Anti-Tip
Extension Tubes
Backrest7. BACKREST
Footplate Options115HL1
115C10
115C14
Green Apple NC115C126 Glow NC
Candy Purple NC
Black Opal NC
Candy Red NC
NC115C152 Matte Purple NC
Custom Frame Color115C112 Desert Camouflage $330.00115C43 Mossy Oak Camouflage $330.00115C42 Stars & Stripes $330.00
! 115C108Zebra (Choose above base color) Std with White unless above base paint is chosen NA w/ Blck, Matte Black, Blck Opal or Titanium)
$330.00