Passport RxThe Affordable Safety Eyewear SolutionSM

SafetySavingsServiceSimplicity

TM

Passport Rx Tiered Frame Schedule Tier ARMOURX UVEX HUDSON ON-GUARD U.S. SAFETY Rx Inserts

TR306S 53, 58, 76 ,77, 85, 86, 87, 301, 302, 304, 311, 314

97, 98, 99, 100

Clip-onsSee pricelist

See pricelist

Uvex XC

Clear

Gray

Mirror

Non-Prescription Eyewear (Rx Insert sold separately) UVEX

3119B Terrace St. Kansas City, MO 64111Tel: 800-821-5218 Rx Fax: 800-428-7304

JPPRX3948 2/14

$ 9.50

$12.00

$15.00

TM

1

234

5

6

7

8

9

10

SP83, SC900, 70F

3003

FC704, FC705, FC601, SC910, SC915, SW06, TM10

BC101, BC102, BC104, BC109, BC115, BC116, FC702, FC703, FC706, FC707, FC709,SW06E, SW07, SW09

PC261,PC264, PC266, PC267, PC268, PC269, PC280

PC250, TR301S, TR302S, TR303, TR304, TR306S, TR307S, TR308S, TR309S, TR310S, TR311S. TR312S

EX259, EX275S, EX281S, HP01, SW02, SW03, SW04, SW08

EXT2, EXT4, EXT5, EXT8, EXT9, EXT10, EXT11, EXT12, EXT13, EXT14

EXT6, EXTS1, EXTS2

27S, 43, 43S, 68S, 78, SG200, SG201

70, 71, 85, 91, 92, 93, 94, 95, 104, 105, 107, 250S, SG232

101, 102, 112, 113, 114, 210S, 220S, SG300, SG301, SG302, SG303

16, 19, 56, 65, 80, 81, 86, 87, 90, 103, SG107, SG108, SG110, SG111, SG121, SG122

16C, 108, 115, 125, 133, 135, 143, 144, 145, 301, 309, 309NP, 310, 310NP 311, 314, 317, 318, 321, 322, SG101, SG102, SG103, SG104, SG105, SG106, SG115, SG118, SG130, SG131, SG228

88, 96, 136S, 138, 151, 151S

60, 98, 99, 122, 140, 140S, 141, 141S, SG400T, SG401T, SG402T, SG403T, SG404T, SG405T, SG406T, SG407T

76, 77, 83, 109, 110, 130, SG600FT, SG601FT, SG602FT, SG604FT

124

7012, 7013, 7014

6000, 6001

7000, 7001, 7002, 7003, 7004, 7005, 7006, 7007, 7008, 7009, 7010, 7011, 7015, 7016, 7017, 7018

SL920, SL921

SL1, SL2, SL3 , SL4, SL5, SL6

EL1, EL2, EL3

VL1, VL2, VL3, VL4, VL5, VL6

VL7, VL8

DG88, DG89, DG90, DG91, DG92, DG93, DG94, DG95, DG96, DG97, DG98, DGXL1, DGXL2, DGXL3, MS1, ST1, ST2, ST3, ST4

DG83, DG85, DG87, FG1–4, FG10-12, HD61, HD62, HD63, HD81, HD82, SR1-SR13, TH1 - TH12

TI1, TI2, TI3, TI4, TI5

110

Pantera, InfraSpec

Aviator,Glider,Roanoke

Newport, 410, 420, 430

Body Specs - BSG, BSG2, BSG3, BSG4, Hoops, Zappa, Z001

Essex

Wiley X - Airrage, Blink, Brick, Jake, Slay, XL1,Zak

Hornet DX*, Versio DX*, Klondike, Legend XT , North65, Uvex Stealth*

Uvex XC Insert

Avon0046

Avon0501, Scott442

North023, Scott 5753

3M6878

3M 7894, MSA3581, MSA4638, MSA6137, MSA4819, MSARSP50

*Hornet DX, Versio DX and Uvex Stealth insert only included with Tier 1 pricing. Frame sold separately.

TitmusSW06

Eye/Bridge Size - 57-16-125Temples - 125Sideshields - Integrated

Matte Brown w/ Orange Tips; Matte Black w/ Yellow Tips

Brown; Charcoal; Khaki

Antique Brown; Dark Gunmetal

TitmusFC706

Eye/Bridge Size - 49-20-140; 51-20-145Temples - 140, 145 Adjustable nose pads

TitmusBC115

Eye/Bridge Size - 48-20-140; 51-20-145Temples - 140, 145Spring Hinges Adjustable nose pads

U.S. Safety410

Eye/Bridge Size - 50-20-140; 52-20-145Temples - 135, 140, 145Adjustable nose pads

Dark Bronze; Dark Steel

Antique Brown ; Dark Gunmetal

U.S. Safety420

Eye/Bridge Size - 48-19-140; 51-19-145Temples - 135, 140, 145Adjustable nose pads

U.S. Safety430

Eye/Bridge Size - 53-17-140; 56-17-145Temples - 135, 140, 145Adjustable nose pads

TitmusFC703

Eye/Bridge Size - 52-20-140; 54-20-145Temples - 140, 145 Adjustable nose pads

Gunmetal; Goldtone

All frames shown above are available with detachable or permanent sideshields.

Passport Rx Suggested Frame SelectionIncluded in the Complete Price (from Tier 1-4)

Sideshield is available in clear and gray.

C101

CS64

CS60

CS60

CS60

CS64

159SSCS94

120SS

CS8850

A B ED54 45 62.056 47 64.058 47 64.9060 49 66.90

Goldtone; Gunmetal; Demi-Amber

A B ED52 35 53.654 36 55.6

A B ED47 32 4950 35 52

HudsonVL4

Eye/Bridge Size - 47-20-145; 50-20-150Temples - 145, 150Spring Hinges Adjustable nose pads

A B ED50 33.35 51.552 35.35 53.5

TitmusFC707

Eye/Bridge Size - 50-21-140; 52-21-145Temples - 140, 145 Adjustable nose pads

Antique Silver Matte; Antique Brown

A B ED49 33.26 51.051 35.26 53.0

A B ED48 33 49.151 36 52.1

A B ED49.6 34.3 51.952.7 35.6 54.7

Dark Gunmetal; Antique Brown

Antique Brown; Dark Gunmetal

A B ED48.2 37.4 49.051.0 39.0 51.8

A B ED53.8 46.6 60.456.9 45.9 61.8

Gray; Brown

A B ED50.0 32.0 51.452.0 34.0 53.4

TitmusFC705

Eye/Bridge Size - 50-19-140; 52-19-145Temples - 140, 145

A B ED57.1 34.65 59.4

HudsonVL2

Eye/Bridge Size - 47-20-145; 50-20-150Temples - 140, 145, 150Spring Hinges Adjustable nose pads

PSS-50

Brown; Charcoal

A B ED47 32 4850 35 51

TM

TitmusBC102

Eye/Bridge Size - 54-15-140; 56-15-14; 58-15-145; 60-15-145Temples - 140, 145, 150 Adjustable nose pads

Passport Rx is a unique approach to prescription safety eyewear that combines all the elements of a comprehensive program into an affordable, simplified price structure with convenient service options.

SafetyThis program includes everything you need to protect your employees from a variety of eye hazards in virtually any work environment. We offer the latest products available and use the most modern manufacturing methods. All prescription safety products offered by U.S. Safety meet the current ANSI Z87.1 Standard.

SavingsPassport Rx is economical, straightforward and complete. We have assembled the best products and services available, applied competitive pricing, and put it into one program that is guaranteed to reduce your costs and ensure OSHA compliance.

ServiceOur service is backed by over 75 years of experience and a company-wide dedication to quality, timeliness and accuracy. Courteous, professional people at our home office and in the field will provide you with expert support and responsive service.

Simplicity“No headaches” is our promise to you. Four easy steps are all that is necessary to provide a hassle-free prescription program.1. Contact your U.S. Safety representative.2. Provide information regarding the location that requires service.3. Choose any additional options you plan to cover for your employees.4. Select a dispensing service that best fits your needs.

For more information, or to request additional Passport Rx brochures, please visit www.ussafety.com and click on "Contact Us".

Passport Rx Passport RxTM

Passport Rx Price Schedule

Complete Price: $95 00 per order

Includes the following:- Tier 1-4 Safety Frame - Any Lens Material- Single Vision, Bifocal or Trifocal Lens - Any Prescription Power- Level 1 Progressive (1) - Protective Carrying Case (#2617 or #5967)- Solid Tint (Gray, Brown, Rose, etc.) - Shipping & Handling (2)

- Scratch Resistant Coating - U.S. Safety Warranty- Permanent or Detachable Sideshields - Meets ANSI Z87.1 Standard

SINGLE VISION BIFOCAL TRIFOCAL PROGRESSIVE

Dispensing Services

We offer a variety of convenient options for providing dispensing services to your employees. Use the following general guidelines, based on the number of people at each location, to determine the best method for your company.

Frame Kit (less than 100 employees) Purchase Passport Frame Kits for the locations that require service. The employee chooses a frame and takes the sample to an eye care professional of their choice to be fitted. Orders are placed with U.S. Safety by fax or mail, and completed glasses are shipped back to the employee or the eye care professional for fitting.**Frame kit options: 3 place kit - $35.00; 6 place kit - $75.00; 12 place kit - $125.00*.

Panel Optician*** (100-500 employees) A U.S. Safety Panel Optician is selected that is conveniently located near your facility. A frame kit is provided to the optician by U.S. Safety. The optician assists the employee with their frame and lens selection, and places your order directly with U.S. Safety. Completed orders are shipped back to the optician, and the optician notifies the employee that their glasses are ready for fitting.

On-Site Optician*** (500 or more employees) The U.S. Safety Optician visits your facility on a regularly scheduled basis. They assist employees with their order, fit completed glasses and perform minor repairs. The optician places your orders directly with U.S. Safety. Completed orders are shipped back to the optician, and the optician notifies the employee that their glasses are ready for fitting.

* This price is based on the Suggested Frame Selection. Additional frame samples are available at a discounted price.** Some states require that a licensed optician dispense glasses.*** Dispensing services are in addition to the complete price and will vary from state to state.

(1) Levels 2-5 are available at an additional cost. For more information on Progressive Lens Options, visit www.ussafety.com and click on "Prescription".(2) Standard shipping method is first class mail. Alternate shipping methods may carry additional charges.

STRAIGHT-TOP28mm

STRAIGHT-TOP7x28mm

Level 1

TM

ANSI StandardsAll safety eyewear products provided by U.S. Safety meet the current ANSI Z87.1 standard for occupational eyewear and ANSI Z80.1 standard for ophthalmic prescriptions.

WarrantyU.S. Safety guarantees that all products sold to the original purchaser are free of defects in material and workmanship. Proof of purchase must be provided upon request. The warranty applies only to products handled under normal use and service.

Lenses: If a lens proves to be defective or was fabricated outside the tolerances as set forth in ANSI Z80.1, we will remake the lens or lenses at no charge. Frames: If a frame proves to be defective under normal use and service, we will repair or replace the frame with the same style, color and size or provide one of nearest likeness, at no charge for a period of 12 months from the date of purchase.

Polycarbonate Lens MaterialPolycarbonate lens material is strongly recommended due to its superior impact protection compared to other lens materials, such as CR-39 (Plastic) and glass. For this reason, polycarbonate is included in the Passport Rx Complete Price. Polycarbonate lenses will be provided by U.S. Safety unless otherwise specified on your order. If the lens style ordered is not available in Polycarbonate, CR-39 lens material may be substituted.

To view and print a complete copy of U.S. Safety’s Policies and Recommendations, please visit www.ussafety.com and click on Prescription.

Frame Options: (see back page for Tiered Frame Schedule) Tier 1-4 Safety Frames (included in Complete Price) ...........................................................................................$ 0.00 Tier 5 Safety Frame ...............................................................................................................................................$15.00 Tier 6 Safety Frame ...............................................................................................................................................$20.00 Tier 7 Safety Frame ...............................................................................................................................................$25.00 Tier 8 Safety Frame ...............................................................................................................................................$35.00 Tier 9 Safety Frame ...............................................................................................................................................$45.00 Tier 10 Safety Frame .............................................................................................................................................$65.00

Progressive Lens Options: Level 1: Standard Progressive (included in Complete Price) .............................................................................$ 0.00 Level 2: AO Compact, Sola VIP / XL, Sola Access .............................................................................................$22.25 Level 3: Sola Max, Illumina, Natural ....................................................................................................................$49.50 Level 4: AO Easy, AO b’Active, Varilux Comfort / Ellipse / Liberty, Accolade, Ovation, Percepta ......................$79.00 Level 5: Sola One, Compact Ultra ......................................................................................................................$97.50

Special Lens Options: Rolled and Polished Lens Edges (Recommended for powers over -4.00D) ..................................................$14.00 High Index Plastic Lenses (Recommended for powers ±6.00D) .....................................................................$37.25 35mm Bifocals and Full Width Bifocals ..................................................................................................................$14.00 Double Segment Bifocals, 28mm ..........................................................................................................................$74.25

Tint & Coating Options: Solid Tints (included in Complete Price) ...............................................................................................................$ 0.00 Gradient Tints ........................................................................................................................................................$15.00 UV400 Coating (plastic lenses only) ......................................................................................................................$11.25 Photochromic Glass Lenses ..................................................................................................................................$23.25 Photochromic Polycarbonate & Plastic Lenses .....................................................................................................$65.00 Polarized Lenses ...................................................................................................................................................$37.25 Infrared (IR) Shade (Green 2.0 & 3.0, Gray 3.0) (1) ...............................................................................................$37.25 Anti-Fog Coating - High Performance ....................................................................................................................$42.00 Anti-Reflective Coating - High Performance ..........................................................................................................$37.25 Ultra Hard Coat .....................................................................................................................................................$24.00

Replacement Products: Replacement Detachable or Permanent Sideshields ............................................................................................$ 2.50 Replacement Frame, Tier 1-4 (Add Frame Option Price for Frame Tiers 5-10) ....................................................$35.00 Replacement Lenses (Add Progressive Options, Special Options, Tints & Coatings) ..........................................$70.00

Passport Rx

(Items in bold are options we recommend the employer cover)(1) Available in Single Vision Polycarbonate Lenses Only.

TM

Passport Rx is a unique approach to prescription safety eyewear that combines all the elements of a comprehensive program into an affordable, simplified price structure with convenient service options.

SafetyThis program includes everything you need to protect your employees from a variety of eye hazards in virtually any work environment. We offer the latest products available and use the most modern manufacturing methods. All prescription safety products offered by U.S. Safety meet the current ANSI Z87.1 Standard.

SavingsPassport Rx is economical, straightforward and complete. We have assembled the best products and services available, applied competitive pricing, and put it into one program that is guaranteed to reduce your costs and ensure OSHA compliance.

ServiceOur service is backed by over 75 years of experience and a company-wide dedication to quality, timeliness and accuracy. Courteous, professional people at our home office and in the field will provide you with expert support and responsive service.

Simplicity“No headaches” is our promise to you. Four easy steps are all that is necessary to provide a hassle-free prescription program.1. Contact your U.S. Safety representative.2. Provide information regarding the location that requires service.3. Choose any additional options you plan to cover for your employees.4. Select a dispensing service that best fits your needs.

For more information, or to request additional Passport Rx brochures, please visit www.ussafety.com and click on "Contact Us".

Passport Rx

TM

Passport Rx Price Schedule

Complete Price: $95 00 per order

Includes the following:- Tier 1-4 Safety Frame - Any Lens Material- Single Vision, Bifocal or Trifocal Lens - Any Prescription Power- Level 1 Progressive (1) - Protective Carrying Case (#2617 or #5967)- Solid Tint (Gray, Brown, Rose, etc.) - Shipping & Handling (2)

- Scratch Resistant Coating - U.S. Safety Warranty- Permanent or Detachable Sideshields - Meets ANSI Z87.1 Standard

SINGLE VISION BIFOCAL TRIFOCAL PROGRESSIVE

Dispensing Services

We offer a variety of convenient options for providing dispensing services to your employees. Use the following general guidelines, based on the number of people at each location, to determine the best method for your company.

Frame Kit (less than 100 employees) Purchase Passport Frame Kits for the locations that require service. The employee chooses a frame and takes the sample to an eye care professional of their choice to be fitted. Orders are placed with U.S. Safety by fax or mail, and completed glasses are shipped back to the employee or the eye care professional for fitting.**Frame kit options: 3 place kit - $35.00; 6 place kit - $75.00; 12 place kit - $125.00*.

Panel Optician*** (100-500 employees) A U.S. Safety Panel Optician is selected that is conveniently located near your facility. A frame kit is provided to the optician by U.S. Safety. The optician assists the employee with their frame and lens selection, and places your order directly with U.S. Safety. Completed orders are shipped back to the optician, and the optician notifies the employee that their glasses are ready for fitting.

On-Site Optician*** (500 or more employees) The U.S. Safety Optician visits your facility on a regularly scheduled basis. They assist employees with their order, fit completed glasses and perform minor repairs. The optician places your orders directly with U.S. Safety. Completed orders are shipped back to the optician, and the optician notifies the employee that their glasses are ready for fitting.

* This price is based on the Suggested Frame Selection. Additional frame samples are available at a discounted price.** Some states require that a licensed optician dispense glasses.*** Dispensing services are in addition to the complete price and will vary from state to state.

(1) Levels 2-5 are available at an additional cost. For more information on Progressive Lens Options, visit www.ussafety.com and click on "Prescription".(2) Standard shipping method is first class mail. Alternate shipping methods may carry additional charges.

STRAIGHT-TOP28mm

STRAIGHT-TOP7x28mm

Level 1

TM

ANSI StandardsAll safety eyewear products provided by U.S. Safety meet the current ANSI Z87.1 standard for occupational eyewear and ANSI Z80.1 standard for ophthalmic prescriptions.

WarrantyU.S. Safety guarantees that all products sold to the original purchaser are free of defects in material and workmanship. Proof of purchase must be provided upon request. The warranty applies only to products handled under normal use and service.

Lenses: If a lens proves to be defective or was fabricated outside the tolerances as set forth in ANSI Z80.1, we will remake the lens or lenses at no charge. Frames: If a frame proves to be defective under normal use and service, we will repair or replace the frame with the same style, color and size or provide one of nearest likeness, at no charge for a period of 12 months from the date of purchase.

Polycarbonate Lens MaterialPolycarbonate lens material is strongly recommended due to its superior impact protection compared to other lens materials, such as CR-39 (Plastic) and glass. For this reason, polycarbonate is included in the Passport Rx Complete Price. Polycarbonate lenses will be provided by U.S. Safety unless otherwise specified on your order. If the lens style ordered is not available in Polycarbonate, CR-39 lens material may be substituted.

To view and print a complete copy of U.S. Safety’s Policies and Recommendations, please visit www.ussafety.com and click on Prescription.

Frame Options: (see back page for Tiered Frame Schedule) Tier 1-4 Safety Frames (included in Complete Price) ...........................................................................................$ 0.00 Tier 5 Safety Frame ...............................................................................................................................................$15.00 Tier 6 Safety Frame ...............................................................................................................................................$20.00 Tier 7 Safety Frame ...............................................................................................................................................$25.00 Tier 8 Safety Frame ...............................................................................................................................................$35.00 Tier 9 Safety Frame ...............................................................................................................................................$45.00 Tier 10 Safety Frame .............................................................................................................................................$65.00

Progressive Lens Options: Level 1: Standard Progressive (included in Complete Price) .............................................................................$ 0.00 Level 2: AO Compact, Sola VIP / XL, Sola Access .............................................................................................$22.25 Level 3: Sola Max, Illumina, Natural ....................................................................................................................$49.50 Level 4: AO Easy, AO b’Active, Varilux Comfort / Ellipse / Liberty, Accolade, Ovation, Percepta ......................$79.00 Level 5: Sola One, Compact Ultra ......................................................................................................................$97.50

Special Lens Options: Rolled and Polished Lens Edges (Recommended for powers over -4.00D) ..................................................$14.00 High Index Plastic Lenses (Recommended for powers ±6.00D) .....................................................................$37.25 35mm Bifocals and Full Width Bifocals ..................................................................................................................$14.00 Double Segment Bifocals, 28mm ..........................................................................................................................$74.25

Tint & Coating Options: Solid Tints (included in Complete Price) ...............................................................................................................$ 0.00 Gradient Tints ........................................................................................................................................................$15.00 UV400 Coating (plastic lenses only) ......................................................................................................................$11.25 Photochromic Glass Lenses ..................................................................................................................................$23.25 Photochromic Polycarbonate & Plastic Lenses .....................................................................................................$65.00 Polarized Lenses ...................................................................................................................................................$37.25 Infrared (IR) Shade (Green 2.0 & 3.0, Gray 3.0) (1) ...............................................................................................$37.25 Anti-Fog Coating - High Performance ....................................................................................................................$42.00 Anti-Reflective Coating - High Performance ..........................................................................................................$37.25 Ultra Hard Coat .....................................................................................................................................................$24.00

Replacement Products: Replacement Detachable or Permanent Sideshields ............................................................................................$ 2.50 Replacement Frame, Tier 1-4 (Add Frame Option Price for Frame Tiers 5-10) ....................................................$35.00 Replacement Lenses (Add Progressive Options, Special Options, Tints & Coatings) ..........................................$70.00

Passport Rx

(Items in bold are options we recommend the employer cover)(1) Available in Single Vision Polycarbonate Lenses Only.

TM

Passport Rx is a unique approach to prescription safety eyewear that combines all the elements of a comprehensive program into an affordable, simplified price structure with convenient service options.

SafetyThis program includes everything you need to protect your employees from a variety of eye hazards in virtually any work environment. We offer the latest products available and use the most modern manufacturing methods. All prescription safety products offered by U.S. Safety meet the current ANSI Z87.1 Standard.

SavingsPassport Rx is economical, straightforward and complete. We have assembled the best products and services available, applied competitive pricing, and put it into one program that is guaranteed to reduce your costs and ensure OSHA compliance.

ServiceOur service is backed by over 75 years of experience and a company-wide dedication to quality, timeliness and accuracy. Courteous, professional people at our home office and in the field will provide you with expert support and responsive service.

Simplicity“No headaches” is our promise to you. Four easy steps are all that is necessary to provide a hassle-free prescription program.1. Contact your U.S. Safety representative.2. Provide information regarding the location that requires service.3. Choose any additional options you plan to cover for your employees.4. Select a dispensing service that best fits your needs.

For more information, or to request additional Passport Rx brochures, please visit www.ussafety.com and click on "Contact Us".

Passport Rx

TM

Passport Rx Price Schedule

Complete Price: $95 00 per order

Includes the following:- Tier 1-4 Safety Frame - Any Lens Material- Single Vision, Bifocal or Trifocal Lens - Any Prescription Power- Level 1 Progressive (1) - Protective Carrying Case (#2617 or #5967)- Solid Tint (Gray, Brown, Rose, etc.) - Shipping & Handling (2)

- Scratch Resistant Coating - U.S. Safety Warranty- Permanent or Detachable Sideshields - Meets ANSI Z87.1 Standard

SINGLE VISION BIFOCAL TRIFOCAL PROGRESSIVE

Dispensing Services

We offer a variety of convenient options for providing dispensing services to your employees. Use the following general guidelines, based on the number of people at each location, to determine the best method for your company.

Frame Kit (less than 100 employees) Purchase Passport Frame Kits for the locations that require service. The employee chooses a frame and takes the sample to an eye care professional of their choice to be fitted. Orders are placed with U.S. Safety by fax or mail, and completed glasses are shipped back to the employee or the eye care professional for fitting.**Frame kit options: 3 place kit - $35.00; 6 place kit - $75.00; 12 place kit - $125.00*.

Panel Optician*** (100-500 employees) A U.S. Safety Panel Optician is selected that is conveniently located near your facility. A frame kit is provided to the optician by U.S. Safety. The optician assists the employee with their frame and lens selection, and places your order directly with U.S. Safety. Completed orders are shipped back to the optician, and the optician notifies the employee that their glasses are ready for fitting.

On-Site Optician*** (500 or more employees) The U.S. Safety Optician visits your facility on a regularly scheduled basis. They assist employees with their order, fit completed glasses and perform minor repairs. The optician places your orders directly with U.S. Safety. Completed orders are shipped back to the optician, and the optician notifies the employee that their glasses are ready for fitting.

* This price is based on the Suggested Frame Selection. Additional frame samples are available at a discounted price.** Some states require that a licensed optician dispense glasses.*** Dispensing services are in addition to the complete price and will vary from state to state.

(1) Levels 2-5 are available at an additional cost. For more information on Progressive Lens Options, visit www.ussafety.com and click on "Prescription".(2) Standard shipping method is first class mail. Alternate shipping methods may carry additional charges.

STRAIGHT-TOP28mm

STRAIGHT-TOP7x28mm

Level 1

TM

ANSI StandardsAll safety eyewear products provided by U.S. Safety meet the current ANSI Z87.1 standard for occupational eyewear and ANSI Z80.1 standard for ophthalmic prescriptions.

WarrantyU.S. Safety guarantees that all products sold to the original purchaser are free of defects in material and workmanship. Proof of purchase must be provided upon request. The warranty applies only to products handled under normal use and service.

Lenses: If a lens proves to be defective or was fabricated outside the tolerances as set forth in ANSI Z80.1, we will remake the lens or lenses at no charge. Frames: If a frame proves to be defective under normal use and service, we will repair or replace the frame with the same style, color and size or provide one of nearest likeness, at no charge for a period of 12 months from the date of purchase.

Polycarbonate Lens MaterialPolycarbonate lens material is strongly recommended due to its superior impact protection compared to other lens materials, such as CR-39 (Plastic) and glass. For this reason, polycarbonate is included in the Passport Rx Complete Price. Polycarbonate lenses will be provided by U.S. Safety unless otherwise specified on your order. If the lens style ordered is not available in Polycarbonate, CR-39 lens material may be substituted.

To view and print a complete copy of U.S. Safety’s Policies and Recommendations, please visit www.ussafety.com and click on Prescription.

Frame Options: (see back page for Tiered Frame Schedule) Tier 1-4 Safety Frames (included in Complete Price) ...........................................................................................$ 0.00 Tier 5 Safety Frame ...............................................................................................................................................$15.00 Tier 6 Safety Frame ...............................................................................................................................................$20.00 Tier 7 Safety Frame ...............................................................................................................................................$25.00 Tier 8 Safety Frame ...............................................................................................................................................$35.00 Tier 9 Safety Frame ...............................................................................................................................................$45.00 Tier 10 Safety Frame .............................................................................................................................................$65.00

Progressive Lens Options: Level 1: Standard Progressive (included in Complete Price) .............................................................................$ 0.00 Level 2: AO Compact, Sola VIP / XL, Sola Access .............................................................................................$22.25 Level 3: Sola Max, Illumina, Natural ....................................................................................................................$49.50 Level 4: AO Easy, AO b’Active, Varilux Comfort / Ellipse / Liberty, Accolade, Ovation, Percepta ......................$79.00 Level 5: Sola One, Compact Ultra ......................................................................................................................$97.50

Special Lens Options: Rolled and Polished Lens Edges (Recommended for powers over -4.00D) ..................................................$14.00 High Index Plastic Lenses (Recommended for powers ±6.00D) .....................................................................$37.25 35mm Bifocals and Full Width Bifocals ..................................................................................................................$14.00 Double Segment Bifocals, 28mm ..........................................................................................................................$74.25

Tint & Coating Options: Solid Tints (included in Complete Price) ...............................................................................................................$ 0.00 Gradient Tints ........................................................................................................................................................$15.00 UV400 Coating (plastic lenses only) ......................................................................................................................$11.25 Photochromic Glass Lenses ..................................................................................................................................$23.25 Photochromic Polycarbonate & Plastic Lenses .....................................................................................................$65.00 Polarized Lenses ...................................................................................................................................................$37.25 Infrared (IR) Shade (Green 2.0 & 3.0, Gray 3.0) (1) ...............................................................................................$37.25 Anti-Fog Coating - High Performance ....................................................................................................................$42.00 Anti-Reflective Coating - High Performance ..........................................................................................................$37.25 Ultra Hard Coat .....................................................................................................................................................$24.00

Replacement Products: Replacement Detachable or Permanent Sideshields ............................................................................................$ 2.50 Replacement Frame, Tier 1-4 (Add Frame Option Price for Frame Tiers 5-10) ....................................................$35.00 Replacement Lenses (Add Progressive Options, Special Options, Tints & Coatings) ..........................................$70.00

Passport Rx

(Items in bold are options we recommend the employer cover)(1) Available in Single Vision Polycarbonate Lenses Only.

TM

Passport RxThe Affordable Safety Eyewear SolutionSM

SafetySavingsServiceSimplicity

TM

Passport Rx Tiered Frame Schedule Tier ARMOURX UVEX HUDSON ON-GUARD U.S. SAFETY Rx Inserts

TR306S 53, 58, 76 ,77, 85, 86, 87, 301, 302, 304, 311, 314

97, 98, 99, 100

Clip-onsSee pricelist

See pricelist

Uvex XC

Clear

Gray

Mirror

Non-Prescription Eyewear (Rx Insert sold separately) UVEX

3119B Terrace St. Kansas City, MO 64111Tel: 800-821-5218 Rx Fax: 800-428-7304

JPPRX3948 2/14

$ 9.50

$12.00

$15.00

TM

1

234

5

6

7

8

9

10

SP83, SC900, 70F

3003

FC704, FC705, FC601, SC910, SC915, SW06, TM10

BC101, BC102, BC104, BC109, BC115, BC116, FC702, FC703, FC706, FC707, FC709,SW06E, SW07, SW09

PC261,PC264, PC266, PC267, PC268, PC269, PC280

PC250, TR301S, TR302S, TR303, TR304, TR306S, TR307S, TR308S, TR309S, TR310S, TR311S. TR312S

EX259, EX275S, EX281S, HP01, SW02, SW03, SW04, SW08

EXT2, EXT4, EXT5, EXT8, EXT9, EXT10, EXT11, EXT12, EXT13, EXT14

EXT6, EXTS1, EXTS2

27S, 43, 43S, 68S, 78, SG200, SG201

70, 71, 85, 91, 92, 93, 94, 95, 104, 105, 107, 250S, SG232

101, 102, 112, 113, 114, 210S, 220S, SG300, SG301, SG302, SG303

16, 19, 56, 65, 80, 81, 86, 87, 90, 103, SG107, SG108, SG110, SG111, SG121, SG122

16C, 108, 115, 125, 133, 135, 143, 144, 145, 301, 309, 309NP, 310, 310NP 311, 314, 317, 318, 321, 322, SG101, SG102, SG103, SG104, SG105, SG106, SG115, SG118, SG130, SG131, SG228

88, 96, 136S, 138, 151, 151S

60, 98, 99, 122, 140, 140S, 141, 141S, SG400T, SG401T, SG402T, SG403T, SG404T, SG405T, SG406T, SG407T

76, 77, 83, 109, 110, 130, SG600FT, SG601FT, SG602FT, SG604FT

124

7012, 7013, 7014

6000, 6001

7000, 7001, 7002, 7003, 7004, 7005, 7006, 7007, 7008, 7009, 7010, 7011, 7015, 7016, 7017, 7018

SL920, SL921

SL1, SL2, SL3 , SL4, SL5, SL6

EL1, EL2, EL3

VL1, VL2, VL3, VL4, VL5, VL6

VL7, VL8

DG88, DG89, DG90, DG91, DG92, DG93, DG94, DG95, DG96, DG97, DG98, DGXL1, DGXL2, DGXL3, MS1, ST1, ST2, ST3, ST4

DG83, DG85, DG87, FG1–4, FG10-12, HD61, HD62, HD63, HD81, HD82, SR1-SR13, TH1 - TH12

TI1, TI2, TI3, TI4, TI5

110

Pantera, InfraSpec

Aviator,Glider,Roanoke

Newport, 410, 420, 430

Body Specs - BSG, BSG2, BSG3, BSG4, Hoops, Zappa, Z001

Essex

Wiley X - Airrage, Blink, Brick, Jake, Slay, XL1,Zak

Hornet DX*, Versio DX*, Klondike, Legend XT , North65, Uvex Stealth*

Uvex XC Insert

Avon0046

Avon0501, Scott442

North023, Scott 5753

3M6878

3M 7894, MSA3581, MSA4638, MSA6137, MSA4819, MSARSP50

*Hornet DX, Versio DX and Uvex Stealth insert only included with Tier 1 pricing. Frame sold separately.

TitmusSW06

Eye/Bridge Size - 57-16-125Temples - 125Sideshields - Integrated

Matte Brown w/ Orange Tips; Matte Black w/ Yellow Tips

Brown; Charcoal; Khaki

Antique Brown; Dark Gunmetal

TitmusFC706

Eye/Bridge Size - 49-20-140; 51-20-145Temples - 140, 145 Adjustable nose pads

TitmusBC115

Eye/Bridge Size - 48-20-140; 51-20-145Temples - 140, 145Spring Hinges Adjustable nose pads

U.S. Safety410

Eye/Bridge Size - 50-20-140; 52-20-145Temples - 135, 140, 145Adjustable nose pads

Dark Bronze; Dark Steel

Antique Brown ; Dark Gunmetal

U.S. Safety420

Eye/Bridge Size - 48-19-140; 51-19-145Temples - 135, 140, 145Adjustable nose pads

U.S. Safety430

Eye/Bridge Size - 53-17-140; 56-17-145Temples - 135, 140, 145Adjustable nose pads

TitmusFC703

Eye/Bridge Size - 52-20-140; 54-20-145Temples - 140, 145 Adjustable nose pads

Gunmetal; Goldtone

All frames shown above are available with detachable or permanent sideshields.

Passport Rx Suggested Frame SelectionIncluded in the Complete Price (from Tier 1-4)

Sideshield is available in clear and gray.

C101

CS64

CS60

CS60

CS60

CS64

159SSCS94

120SS

CS8850

A B ED54 45 62.056 47 64.058 47 64.9060 49 66.90

Goldtone; Gunmetal; Demi-Amber

A B ED52 35 53.654 36 55.6

A B ED47 32 4950 35 52

HudsonVL4

Eye/Bridge Size - 47-20-145; 50-20-150Temples - 145, 150Spring Hinges Adjustable nose pads

A B ED50 33.35 51.552 35.35 53.5

TitmusFC707

Eye/Bridge Size - 50-21-140; 52-21-145Temples - 140, 145 Adjustable nose pads

Antique Silver Matte; Antique Brown

A B ED49 33.26 51.051 35.26 53.0

A B ED48 33 49.151 36 52.1

A B ED49.6 34.3 51.952.7 35.6 54.7

Dark Gunmetal; Antique Brown

Antique Brown; Dark Gunmetal

A B ED48.2 37.4 49.051.0 39.0 51.8

A B ED53.8 46.6 60.456.9 45.9 61.8

Gray; Brown

A B ED50.0 32.0 51.452.0 34.0 53.4

TitmusFC705

Eye/Bridge Size - 50-19-140; 52-19-145Temples - 140, 145

A B ED57.1 34.65 59.4

HudsonVL2

Eye/Bridge Size - 47-20-145; 50-20-150Temples - 140, 145, 150Spring Hinges Adjustable nose pads

PSS-50

Brown; Charcoal

A B ED47 32 4850 35 51

TM

TitmusBC102

Eye/Bridge Size - 54-15-140; 56-15-14; 58-15-145; 60-15-145Temples - 140, 145, 150 Adjustable nose pads

Passport RxThe Affordable Safety Eyewear SolutionSM

SafetySavingsServiceSimplicity

TM

Passport Rx Tiered Frame Schedule Tier ARMOURX UVEX HUDSON ON-GUARD U.S. SAFETY Rx Inserts

TR306S 53, 58, 76 ,77, 85, 86, 87, 301, 302, 304, 311, 314

97, 98, 99, 100

Clip-onsSee pricelist

See pricelist

Uvex XC

Clear

Gray

Mirror

Non-Prescription Eyewear (Rx Insert sold separately) UVEX

3119B Terrace St. Kansas City, MO 64111Tel: 800-821-5218 Rx Fax: 800-428-7304

JPPRX3948 2/14

$ 9.50

$12.00

$15.00

TM

1

234

5

6

7

8

9

10

SP83, SC900, 70F

3003

FC704, FC705, FC601, SC910, SC915, SW06, TM10

BC101, BC102, BC104, BC109, BC115, BC116, FC702, FC703, FC706, FC707, FC709,SW06E, SW07, SW09

PC261,PC264, PC266, PC267, PC268, PC269, PC280

PC250, TR301S, TR302S, TR303, TR304, TR306S, TR307S, TR308S, TR309S, TR310S, TR311S. TR312S

EX259, EX275S, EX281S, HP01, SW02, SW03, SW04, SW08

EXT2, EXT4, EXT5, EXT8, EXT9, EXT10, EXT11, EXT12, EXT13, EXT14

EXT6, EXTS1, EXTS2

27S, 43, 43S, 68S, 78, SG200, SG201

70, 71, 85, 91, 92, 93, 94, 95, 104, 105, 107, 250S, SG232

101, 102, 112, 113, 114, 210S, 220S, SG300, SG301, SG302, SG303

16, 19, 56, 65, 80, 81, 86, 87, 90, 103, SG107, SG108, SG110, SG111, SG121, SG122

16C, 108, 115, 125, 133, 135, 143, 144, 145, 301, 309, 309NP, 310, 310NP 311, 314, 317, 318, 321, 322, SG101, SG102, SG103, SG104, SG105, SG106, SG115, SG118, SG130, SG131, SG228

88, 96, 136S, 138, 151, 151S

60, 98, 99, 122, 140, 140S, 141, 141S, SG400T, SG401T, SG402T, SG403T, SG404T, SG405T, SG406T, SG407T

76, 77, 83, 109, 110, 130, SG600FT, SG601FT, SG602FT, SG604FT

124

7012, 7013, 7014

6000, 6001

7000, 7001, 7002, 7003, 7004, 7005, 7006, 7007, 7008, 7009, 7010, 7011, 7015, 7016, 7017, 7018

SL920, SL921

SL1, SL2, SL3 , SL4, SL5, SL6

EL1, EL2, EL3

VL1, VL2, VL3, VL4, VL5, VL6

VL7, VL8

DG88, DG89, DG90, DG91, DG92, DG93, DG94, DG95, DG96, DG97, DG98, DGXL1, DGXL2, DGXL3, MS1, ST1, ST2, ST3, ST4

DG83, DG85, DG87, FG1–4, FG10-12, HD61, HD62, HD63, HD81, HD82, SR1-SR13, TH1 - TH12

TI1, TI2, TI3, TI4, TI5

110

Pantera, InfraSpec

Aviator,Glider,Roanoke

Newport, 410, 420, 430

Body Specs - BSG, BSG2, BSG3, BSG4, Hoops, Zappa, Z001

Essex

Wiley X - Airrage, Blink, Brick, Jake, Slay, XL1,Zak

Hornet DX*, Versio DX*, Klondike, Legend XT , North65, Uvex Stealth*

Uvex XC Insert

Avon0046

Avon0501, Scott442

North023, Scott 5753

3M6878

3M 7894, MSA3581, MSA4638, MSA6137, MSA4819, MSARSP50

*Hornet DX, Versio DX and Uvex Stealth insert only included with Tier 1 pricing. Frame sold separately.

TitmusSW06

Eye/Bridge Size - 57-16-125Temples - 125Sideshields - Integrated

Matte Brown w/ Orange Tips; Matte Black w/ Yellow Tips

Brown; Charcoal; Khaki

Antique Brown; Dark Gunmetal

TitmusFC706

Eye/Bridge Size - 49-20-140; 51-20-145Temples - 140, 145 Adjustable nose pads

TitmusBC115

Eye/Bridge Size - 48-20-140; 51-20-145Temples - 140, 145Spring Hinges Adjustable nose pads

U.S. Safety410

Eye/Bridge Size - 50-20-140; 52-20-145Temples - 135, 140, 145Adjustable nose pads

Dark Bronze; Dark Steel

Antique Brown ; Dark Gunmetal

U.S. Safety420

Eye/Bridge Size - 48-19-140; 51-19-145Temples - 135, 140, 145Adjustable nose pads

U.S. Safety430

Eye/Bridge Size - 53-17-140; 56-17-145Temples - 135, 140, 145Adjustable nose pads

TitmusFC703

Eye/Bridge Size - 52-20-140; 54-20-145Temples - 140, 145 Adjustable nose pads

Gunmetal; Goldtone

All frames shown above are available with detachable or permanent sideshields.

Passport Rx Suggested Frame SelectionIncluded in the Complete Price (from Tier 1-4)

Sideshield is available in clear and gray.

C101

CS64

CS60

CS60

CS60

CS64

159SSCS94

120SS

CS8850

A B ED54 45 62.056 47 64.058 47 64.9060 49 66.90

Goldtone; Gunmetal; Demi-Amber

A B ED52 35 53.654 36 55.6

A B ED47 32 4950 35 52

HudsonVL4

Eye/Bridge Size - 47-20-145; 50-20-150Temples - 145, 150Spring Hinges Adjustable nose pads

A B ED50 33.35 51.552 35.35 53.5

TitmusFC707

Eye/Bridge Size - 50-21-140; 52-21-145Temples - 140, 145 Adjustable nose pads

Antique Silver Matte; Antique Brown

A B ED49 33.26 51.051 35.26 53.0

A B ED48 33 49.151 36 52.1

A B ED49.6 34.3 51.952.7 35.6 54.7

Dark Gunmetal; Antique Brown

Antique Brown; Dark Gunmetal

A B ED48.2 37.4 49.051.0 39.0 51.8

A B ED53.8 46.6 60.456.9 45.9 61.8

Gray; Brown

A B ED50.0 32.0 51.452.0 34.0 53.4

TitmusFC705

Eye/Bridge Size - 50-19-140; 52-19-145Temples - 140, 145

A B ED57.1 34.65 59.4

HudsonVL2

Eye/Bridge Size - 47-20-145; 50-20-150Temples - 140, 145, 150Spring Hinges Adjustable nose pads

PSS-50

Brown; Charcoal

A B ED47 32 4850 35 51

TM

TitmusBC102

Eye/Bridge Size - 54-15-140; 56-15-14; 58-15-145; 60-15-145Temples - 140, 145, 150 Adjustable nose pads