M400(S) Corpus 3G R-Net

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1 list: 27 Spain EUR Dealer Information Contact: Customer Code: Customer Name: Address 1: City: Post code: Phone: Fax: PO: Client Information First Name: Last Name: Diagnosis: Address 1: Address 2: Postal code: City: Country: Phone: Client Measurements Weight: Height: 1) Upper leg length: 2) Chest Depth: 3) Seat pan to elbow: 4) Arm pit height: 5) Top of shoulders: 6) Top of head: 7) Elbow to Hand: 8) Chest width: 9) Knee to Foot: 10) Hip width: kg All specifications and prices are subject to change without notice. Please note that displayed prices are only valid if ordered with the wheelchair. Any parts ordered for service or future alterations will carry different prices and warranty. Rabobank Parkstad Limburg Rekening: IBAN: NL84RABO BIC/SWIFT: RABONL2U Permobil Europe B.V. De Doom 22 NL 6419 CX HEERLEN Phone: +31 (0) Fax: +31 (0) Page 1 of 12

2 Chassis Model M400 R-NET WITH CORPUS 3G -SEAT 10km/h EUR 9, M400S R-NET WITH CORPUS 3G-SEAT 12km/h (7,5mph) EUR 10, Colour covers COVER KIT BLACK ONYX M400 EUR COVER KIT BLACK ONYX M400 S EUR COVER KIT RED METALLIC M400 EUR COVER KIT RED METALLIC M400 S EUR COVER KIT SILVER METALLIC M400 EUR COVER KIT SILVER METALLIC M400S EUR COVER KIT BRIGHT GREEN M400 EUR COVER KIT BRIGHT GREEN M400 S EUR COVER KIT TITAN BLUE M400 EUR COVER KIT TITAN BLUE M400 S EUR - Hub cap HUB CAP BLACK ONYX EUR HUB CAP BRIGHT GREEN EUR HUB CAP RED METALLIC EUR HUB CAP SILVER METALLIC EUR HUB CAP TITAN BLUE EUR - Suspension setting SUSPENSION ADJUSTMENT A 0-90kg EUR SUSPENSION ADJUSTMENT B kg EUR - Wheels drive WHEELS 3.00x8" AIR FILLED TIRES EUR WHEELS 3.00x8" SOLID TIRES EUR WHEEL " MUD/SNOW AIR TIRE (1 pair) EUR Accessories chassis Batteries ACCU MK 60 (new deliv 2 pcs) M400 EUR ACCU MK 73 (new deliv 2 pcs) M400S EUR - Charger CHARGER PERMOBIL 24V/8A EU EUR - Light kit LIGHT KIT M300/M400 EUR WITHOUT LIGHT KIT (Ref- lector) M300/M400 EUR - Chassis adaption for Permolock C3 (+) ADAPT C300/350 FOR PERMOLOCK C3 EUR Rain cover (+) TARPAULIN/RAINCOVER FOR ALL MODLES EUR Seat assembly Seat lift system SEAT ELEVATOR M300/M400 R-NET C 3G EUR 1, SEAT ELEVATOR WITHOUT TILT M300/M400 R-NET C3G EUR 1, SEAT TUBE FIXED C300 C350 M300 M400 C 3G EUR - Seat tilt options SEAT MOUNT FIXED C 3G EUR SEAT TILT 30 C 3G EUR 2, SEAT TILT 50 C 3G EUR 2, Mounting position seat SEAT MOUNT ANTERIOR -5 C 400/C500 C 3G EUR SEAT MOUNT HORIZONTAL C300/C350 C 3G EUR - Seat Page 2 of 12

3 Model SEAT FRAME NARROW 370 DEPTH C 3G EUR SEAT FRAME NARROW 395 dep th -5 C3G MWD EUR SEAT FRAME NARROW 395 DEP TH C 3G EUR SEAT FRAME NARROW 420 DEPTH C 3G EUR SEAT FRAME NARROW 420 DEP TH POS -5 C3G M400 M400S EUR SEAT FRAME NARROW 445 DEP TH C 3G EUR SEAT FRAME NARROW 445 DEP TH POS -5 C3G M400 M400S EUR SEAT FRAME NARROW 470 DEPTH C 3G EUR SEAT FRAME NARROW 470 DEP TH POS -5 C3G M400 M400S EUR SEAT FRAME NARROW 495 DEPTH C 3G EUR SEAT FRAME NARROW 520 DEPTH C 3G EUR SEAT FRAME NARROW 545 DEPTH C 3G EUR SEAT FRAME NARROW 570 DEPTH C 3G EUR SEAT FRAME WIDE 395 depth -5 C3G MWD EUR SEAT FRAME WIDE 420 DEPTH C 3G EUR SEAT FRAME WIDE 420 DEPTH POS -5 C 3G M400 M400S EUR SEAT FRAME WIDE 445 DEPTH C 3G C400 C500 EUR SEAT FRAME WIDE 445 DEPTH POS -5 C3G M400 M400S EUR SEAT FRAME WIDE 470 DEPTH C 3G EUR SEAT FRAME WIDE 470 DEPTH POS -5 C 3G M400 M400S EUR SEAT FRAME WIDE 495 DEPTH C 3G C400 C500 EUR SEAT FRAME WIDE 520 DEPTH C 3G EUR SEAT FRAME WIDE 545 DEPTH C 3G C400 C500 EUR SEAT FRAME WIDE 570 DEPTH C 3G EUR - Seat width SEAT WIDTH 420 C 3G EUR SEAT WIDTH 470 C 3G EUR SEAT WIDTH 520 C 3G EUR SEAT WIDTH 570 C 3G EUR - Seat cushion SEAT CUSHION 420x420 (17" x17") MESH BLACK C 3G EUR SEAT CUSHION 420x470 (17" x19") MESH BLACK C 3G EUR SEAT CUSHION 420x520 (17" x21") MESH BLACK C 3G EUR SEAT CUSHION 470x420 (19" x17") MESH BLACK C 3G EUR SEAT CUSHION 470x470 (19" x19") MESH BLACK C 3G EUR SEAT CUSHION 470x520 (19" x21") MESH BLACK C 3G EUR SEAT CUSHION ERGO 500x600 FABRIC EUR SEAT CUSHION 520x420 (21" x17") MESH BLACK C 3G EUR SEAT CUSHION 520x470 (21" x19") MESH BLACK C 3G EUR SEAT CUSHION 520x520 (21" x21") MESH BLACK C 3G EUR SEAT CUSHION ERGO 550x600 FABRIC EUR SEAT CUSHION ERGO 600x450 FABRIC EUR SEAT CUSHION ERGO 600x500 FABRIC EUR SEAT CUSHION ERGO 600x550 FABRIC EUR SEAT CUSHION ERGO 600x600 FABRIC EUR SEAT CUSHION 420x420 (17" x17") SKAI C 3G EUR SEAT CUSHION 420x470 (17" x19") SKAI C 3G EUR SEAT CUSHION 420x520 (17" x21") SKAI C 3G EUR SEAT CUSHION 470x420 (19" x17") SKAI C 3G EUR SEAT CUSHION 470x470 (19" x19") SKAI C 3G EUR SEAT CUSHION 470x520 (19" x21") SKAI C 3G EUR SEAT CUSHION ERGO 500x600 LEATHERETTE EUR SEAT CUSHION 520x420 (21" x17") SKAI C 3G EUR SEAT CUSHION 520x470 (21" x19") SKAI C 3G EUR SEAT CUSHION 520x520 (21" x21") SKAI C 3G EUR SEAT CUSHION ERGO 550x600 LEATHERETTE EUR SEAT CUSHION ERGO 600x450 LEATHERETTE EUR SEAT CUSHION ERGO 600x500 LEATHERETTE EUR SEAT CUSHION ERGO 600x550 LEATHERETTE EUR SEAT CUSHION ERGO 600x600 LEATHERETTE EUR WITHOUT SEAT CUSHION C 3G EUR Page 3 of 12

4 Ergo support seat (+) THIGH SUPPORT ERGO (L/R) EUR - Adjustment backrest MANUAL CONTROL BACKREST 120 C 3G EUR POWER CONTROL BACKREST 15 0 C 3G EUR 1, POWER CONTROL BACKREST 18 0 C 3G EUR 1, Backrest Fixed/Bio-mech BACKREST FIXED C 3G EUR BACKREST SHEERING C 3G EUR Backrest BACKREST WIDTH 360 x HEIGHT C 3G EUR BACKREST WIDTH 410 x HEIGHT C 3G EUR BACKREST WIDTH 460 x HEIGHT C 3G EUR BACKREST SHORT WIDTH 360 x HEIGHT470 C 3G EUR BACKREST SHORT WIDTH 410 x HEIGHT 470 C 3G EUR BACKREST SHORT WIDTH 460 x HEIGHT 470 C 3G EUR WITHOUT BACKREST NARROW ARMREST MOUNT mm EUR WITHOUT BACKREST WIDE ARM REST MOUNT mm EUR Backrest height (+) BACKREST HEIGHT 545 C 3G EUR BACKREST HEIGHT 570 C 3G EUR BACKREST HEIGHT 595 C 3G EUR BACKREST HEIGHT 620 C 3G EUR BACKREST HEIGHT 645 C 3G EUR BACKREST HEIGHT 670 C 3G EUR - Backrest cushion BACKREST CUSHION 360x480 (14"x19") MESH BLACK C 3G EUR BACKREST CUSHION 360x (14"x22-24") MESH BLA EUR BACKREST CUSHION 360x (14"x25-27") MESH BLA EUR BACKREST CUSHION 410x480 (16"x19") MESH BLACK C 3G EUR BACKREST CUSHION 410x (16"x22-24") MESH BL EUR BACKREST CUSHION 410x (16"x25-27") MESH BLA EUR BACKREST CUSHION 460x480 (18"x19") MESH BLACK EUR BACKREST CUSHION 460x (18"x22-24") MESH BLA EUR BACKREST CUSHION 460x (18"x25-27") MESH BLA EUR BACKREST CUSHION 360x480 (14"x19") SKAI C 3G EUR BACKREST CUSHION 360x (14"x22-24") SKAI EUR BACKREST CUSHION 360x (14"x25-27") SKAI EUR BACKREST CUSHION 410x480 (16"x19") SKAI C 3G EUR BACKREST CUSHION 410x (16"x22-24") SKAI EUR BACKREST CUSHION 410x (16"x25-27") SKAI EUR BACKREST CUSHION 460x480 (18"x19") SKAI C 3G EUR BACKREST CUSHION 460x (18"x22-24") SKAI EUR BACKREST CUSHION 460x (18"x25-27") SKAI EUR WITHOUT BACKREST CUSHION C 3G EUR Ergo support back (+) LATERAL SUPPORT LARGE (ERGO) C 3G EUR LATERAL SUPPORT SMALL (ERGO) C 3G EUR - Width between armrests MOUNT POS BETWEEN ARMREST 380mm C 3G EUR MOUNT POS BETWEEN ARMREST 430mm C 3G EUR MOUNT POS BETWEEN ARMREST 480mm C 3G EUR MOUNT POS BETWEEN ARMREST 530mm C 3G EUR MOUNT POS BETWEEN ARMREST 580mm C 3G EUR - Armrest mounting MOUNT POS 2 LOW ARMREST 240mm C 3G EUR MOUNT POS 4 HIGH ARMREST 300mm C 3G EUR - Armrest holders ARMREST ASSEMBLY FIXED RIGHT C 3G EUR ARMREST ASSEMBLY SWIVELL- ING RIGHT C 3G EUR Armrest Left Page 4 of 12

5 Armrest Left ARMREST 260 MESH BLACK LEFT C 3G EUR ARMREST 335 MESH BLACK LEFT C 3G EUR ARMREST 410 MESH BLACK LEFT C 3G EUR ARMREST 260 SKAI LEFT C 3G EUR ARMREST 335 SKAI LEFT C 3G EUR ARMREST 410 SKAI LEFT C 3G EUR WITHOUT ARMREST LEFT C 3G EUR Armrest Right ARMREST 260 MESH BLACK RIGHT C 3G EUR ARMREST 335 MESH BLACK RIGHT C 3G EUR ARMREST 410 MESH BLACK RIGHT C 3G EUR ARMREST 260 SKAI RIGHT C 3G EUR ARMREST 335 SKAI RIGHT C 3G EUR ARMREST 410 SKAI RIGHT C 3G EUR WITHOUT ARMREST RIGHT C 3 G EUR Adjustment legrest CONTROL MANUAL LEGREST C 3G EUR CONTROL POWER LEGREST M400 C 3G EUR 1, Legrest LEGREST LONG EXTENSION (205mm) C 3G EUR LEGREST PWR ADJ LONG INCL FOOTPLATE NARROW C 3G EUR 2, LEGREST PWR ADJ SHORT INCL FOOTPL NARROW C 3G EUR 2, LEGREST POWER TRANSFER C 3G EUR 2, LEGREST SHORT EXTENSION (185mm) C 3G EUR - Footplate FOOTPLATE NARROW (160mm) LONG LEG ( ) C 3G EUR FOOTPLATE NARROW (160MM) SHORT LEG ( ) C 3G EUR FOOTPLATE NARROW PWR TRANSFER C 3G EUR WITHOUT FOOTPLATES EUR - Program Parameters seat _Program software adjust fooplate (+) SOFTWARE CORPUS 3G R-NET LEGREST POWER EXT EUR - _Program software Transfer footplate (+) SOFTWARE CORPUS 3G R-NET LEGREST RA EUR - Accessories seat Headrest (+) HEADREST ERGO FABRIC C 3G EUR HEADREST ERGO SHORT BACK FABRIC C 3G EUR HEADREST FABRIC C 3G EUR HEADREST LEATHERETTE C 3G EUR HEADREST SHORT BACK FABRI C C 3G EUR HEADREST SHORT BACK SKAI C 3G EUR Lateral support adjustable (+) LATERAL SUPPORT mod A (SMALL) FABRIC C 3G EUR LATERAL SUPPORT F 220x90 FABRIC C 3G EUR LATERAL SUPPORT E 220x150 FABRIC C 3G EUR Thigh support (+) THIGH SUPPORTS TEXTILE (MESH) 200x90 LARGE (C) EUR THIGH SUPPORTS TEXTILE (MESH) 165x120 MEDIUM (J) EUR THIGH SUPPORTS TEXTILE (MESH) 110x90 SMALL (B) EUR THIGH SUPPORTS TEXTILE (MESH) 300x90 XLARGE (G) EUR Hip support (+) HIP SUPPORTS SMALL (B) 110x90 TEXTILE (MESH) EUR HIP SUPPORTS MEDIUM (A) 150x140 TEXTILE (MESH) EUR HIP SUPPORTS LARGE (C) 200x90 TEXTILE (MESH) EUR HIP SUPPORTS X LARGE (D) 200x200 TEXTILE (MESH) EUR Page 5 of 12

6 Calf support (+) CALF REST B 110x90 FABRIC C 3G EUR CALF REST J 165x120 FABRIC C 3G EUR CALF REST A 150x140 FAB- RIC C 3G EUR CALF REST H 170x175 (CONTOUR) FABRIC C 3G EUR CALF REST D 200x200 FAB- RIC C 3G EUR Seatbelt (+) SAFETY BELT,BUCKLE EUR SAFETY BELT,AUTOTENSION EUR SAFETY BELT,AUTOTENSION LONG VERSION EUR SAFETY BELT,4-POINT EUR BELT 2-POINT LARGE NONPAD BODYPOINT INCL BRACK UT EUR BELT 2-POINT LARGE PADDED BODYPOINT INCL BRACK UT EUR BELT 2-POINT MEDIUM NONPA D BODYPOINT INCL BRACK UT EUR BELT 2-POINT MEDIUM PADDE D BODYPOINT INCL BRACK UT EUR Mounting position seatbelt (+) MOUNT POS SEATBELT ROLL RIGHT EUR MOUNT POS SEATBELT ROLL LEFT EUR - Wedge backrest (+) WEDGE NARROW BACKREST C 3 G EUR WEDGE STD BACKREST C 3G EUR WEDGE WIDE BACKREST C 3G EUR Seat stabiliser (+) SEAT SUPPORT -5 SEAT M400 C 3G EUR SEAT SUPPORT FOR TILT -5 M400 C 3G EUR SEAT SUPPORT FOR TILT M400 C 3G EUR SEAT SUPPORT M400 EUR - Support handles set (+) SUPPORT HANDLES SET (pair) C 3G EUR Stump support (+) STUMP SUPPORT SMALL (A) 150x140 TEXTILE (MESH) EUR STUMP SUPPORT MEDIUM (J) 165x120 TEXTILE (MESH) EUR STUMP SUPPORT LARGE (H) 170x175 TEXTILE (MESH) EUR STUMP SUPPORT XLARGE (D) 200x200 TEXTILE (MESH) EUR Mounting position stump support (+) MOUNT POS AMPUTATION SUPP -ORT LEFT EUR MOUNT POS AMPUTATION SUPP -ORT RIGHT EUR - Push handles back (+) PUSH HANDLES C 3G EUR Table Swing able (+) TABLE SWING AWAY SIDE CUT R-NET C 3G 600 EUR TABLE SWING AWAY SIDE CUT R-NET C 3G 650 EUR Mounting position table (+) MOUNT POS TABLE SWINGABLE LEFT EUR MOUNT POS TABLE SWINGABLE RIGHT EUR - Table adjust angel (+) TABLE ADJUSTABLE ANGLE 350mm C 3G EUR TABLE ADJUSTABLE ANGLE 400mm C 3G EUR TABLE ADJUSTABLE ANGLE 450mm C 3G EUR TABLE,ANGLE ADJUST. 1-SIDE FIXATION EUR _Table small armrest (+) TABLE SMALL LEFT MOUNT C 3G EUR TABLE SMALL RIGHT MOUNT C 3G EUR Incontinence protection (+) INCONTINENCE PROTECTION 430x360/430x410 EUR INCONTINENCE PROTECTION 430x460/430x510/430x560 EUR INCONTINENCE PROTECTION 480x410 EUR INCONTINENCE PROTECTION 480x460/480x510/480x560 EUR Armrest pouch Right (+) ARMREST POUCH,RIGHT EUR - Page 6 of 12

7 Armrest pouch Left (+) ARMREST POUCH,LEFT EUR - Seat frame pouch (+) SEATFRAME POUCH EUR Bag hooks (+) BAG HOOKS OPEN UNITRACK EUR Back pack (+) BACK PACK INCL. HOOKS EUR Foot straps (+) FOOTSTRAPS WITHOUT PADS EUR FOOTSTRAPS WITH PADS EUR Lumbar support (+) LUMBAR SUPPORT,AIR EUR Crutch holder (+) CRUTCH HOLDER C 3G EUR Mounting position crutch holder (+) MOUNT POS CRUTCH HOLDER LEFT EUR MOUNT POS CRUTCH HOLDER RIGHT EUR - Holder oxygen bottle (+) OXYGEN HOLDER C 3G EUR User control User control JOYSTICK R-NET CJSM HEAVY DUTY EUR JOYSTICK R-NET STANDARD EUR JOYSTICK R-NET WITH TOGGLESWICH ON/OFF - MODE EUR CONTROL PANEL LED R-NET EUR CONTROL PANEL COLOUR DIS- PLAY R-NET EUR JOYSTICK COMPACT ADV. R-NET EUR TABLESTEERING R-NET FLIP- OVER PANEL C 3G 600 EUR 1, TABLESTEERING R-NET FLIP- OVER PANEL C 3G 650 EUR 1, NON STANDARD STEERING EUR - Parameters Disbale JS Menu Memory Recall (+) SOFTWARE DISABLE SEAT MEMORIES RECALL VIA JS EUR - Parameters Disbale JS Menu Memory Save (+) SOFTWARE DISABLE SEAT MEMORIES SAVE VIA JS EUR - Parameters Disbale JS Menu Seat Functions (+) SOFTWARE DISABLE SEAT POSITIONING VIA JS EUR - Joystick holder (+) PANELHOLDER VR2/R-NET STD L=335 EUR PANELHOLDER VR2/R-NET L=435 EUR PANELHOLDER PAR. SW. AWAY VR2/R-NET L/R EUR WITHOUT PANELHOLDER EUR - Mounting position joystick (+) MOUNT POS CONTROLBOX LEFT EUR MOUNT POS CONTROLBOX RIGHT EUR - Mounting centre steering (+) MOUNT POS TABLE STEERING FLIPOVER LEFT EUR MOUNT POS TABLE STEERING FLIPOVER RIGHT EUR - Switch box SWITCH BOX WITH PUSH BUTTONS EUR SWITCH BOX WITH TOGGLE SWITCHES EUR WITHOUT SWITCH BOX EUR - Bracket switch box (+) BRACKET SWITCH BOX BACKREST EUR BRACKET SWITCH BOX JOYSTICK EUR BRACKET SWITCH BOX UNITRACK ARMREST EUR - Mounting position switch box (+) Page 7 of 12

8 Mounting position switch box (+) MOUNT POS SWITCH KIT LEFT EUR MOUNT POS SWITCH KIT RIGHT EUR SWITCHBOX NOT MOUNTED EUR - Layout switch box (+) SWITCHBOX LAYOUT "A" EUR SWITCHBOX LAYOUT "B" EUR SWITCHBOX LAYOUT "C" EUR SWITCHBOX LAYOUT "D" EUR LAYOUT "L" SWITCH BOX EUR LAYOUT "M" SWITCH BOX EUR - Indication level switch box (+) SWITCHBOX INDICATION LEVEL 1 EUR SWITCHBOX INDICATION LEVEL 2 EUR SWITCHBOX INDICATION LEVEL 3 EUR SWITCHBOX INDICATION LEVEL 4 EUR - External charger socket (+) CHARGER SOCKET EXTERNAL MOUNTED ON ACC. RAIL EUR CHARGER SOCKET EXTERNAL MOUNTED ON THE ARMREST EUR CHARGER SOCKET EXTERNAL MOUNTED UNDER SEAT FRAME EUR Mounting position charger socket (+) MOUNT POS CHARGER SOCKET LEFT EUR MOUNT POS CHARGER SOCKET RIGHT EUR - Key (+) LOCKING KEY R-NET EUR Joystick knobs (+) JOYSTICK KNOB BALL SMALL EUR JOYSTICK KNOB BALL BIG EUR JOYSTICK KNOB CHIN CUP EUR JOYSTICK KNOB MUSHROOM EUR JOYSTICK KNOB SOFT BALL EUR JOYSTICK KNOB STICK EUR JOYSTICK KNOB T-GRIP EUR JOYSTICK SOFTBALL BLACK WITH CONE EUR Attendant control Attendant control (+) ATTENDANT CONTROL CO-PILO T R-NET INCL BRACK./PANEL EUR 2, ATTENDANT CONTROL R-NET INCL BRACKET C 3G EUR ATTENDANT CONTROL STD R-NET INCL BRACKET C 3G EUR ATTENDANT CONTROL TOGGLE R-NET INCL BRACKET C 3G EUR 1, JOYSTICK ATTENDANT COLOR R-NET DISPLAY COMPL VS EUR Mounting position attendant control (+) MOUNT POS ATTENDANT CON- TROL LEFT EUR MOUNT POS ATTENDANT CON- TROL RIGHT EUR - Emergency switch (+) EMERGENCY STOP SWITCH EUR Bracket switch box (+) BRACKET SWITCH BOX BACKREST EUR - Special controls Type special control (+) MD CONTROL: JS COMPACT EUR MD CONTROL: JS COMPACT (LOW FORCE) EUR MD EC JOYSTICK COMPACT TILT SENSOR EUR MD CONTROL: MINI JOYSTICK EUR MD CONTROL: VIC FINGER JOYSTICK EUR 1, MD CONTROL: TABLET INCL TABLE 600x500 EUR 3, MD CONTROL: TABLET WITHOUT MOUNT. AND TABLE EUR 2, Page 8 of 12

9 Type special control (+) MD CONTROL: FOUR SWITCHES EUR MD CONTROL: FIVE SWITCHES EUR MD CONTROL: HEAD SWITCHES EUR 2, MD CONTROL: TWO SWITCHES EUR MD CONTROL: ONE SWITCH EUR MD CONTROL: SIP&PUFF EUR 2, MD WITHOUT CONTROL EUR - Basic set special control (+) MD EC BASIC SET R-NET EUR 3, MD EC/RF BASIC SET R-NET EUR 3, Holder (+) HOLDER CHINSTEERING EUR HARNESS FOR CHIN CONTROL EUR PANELHOLDER PAR. SW. AWAY VR2/R-NET L/R EUR PERMOFIX HOLDER COMPACT JOYSTICK EUR PERMOFIX HOLDER COMPACT JOYSTICK + DISPLAY EUR PERMOFIX HOLDER MINI JOYSTICK EUR PERMOFIX HOLDER MINI JOYSTICK + DISPLAY EUR PERMOFIX HOLDER CENTRE MOUNTED COMPACT JOYSTICK EUR PERMOFIX HOLDER CENTRE MOUNTED MINI JOYSTICK EUR WITHOUT PANELHOLDER EUR - Holder Display (+) PERMOFIX HOLDER DISPLAY EUR Panel holder bracket C 3G (+) PANEL HOLDER BRACKET C 3G EUR - Mounting position input device (+) MOUNT POS DL/MD CONTROL LEFT EUR MOUNT POS DL/MD CONTROL RIGHT EUR - On/off switch (+) MD EXTERNAL ON/OFF SWITCH EUR SWITCH KIT FOR COMPACT JS (CHIN) EUR SWITCH DOUBLE FOR COMP JOYSTICK MD EC R-NET OMNI EUR BUDDY BUTTON BLACK 63 MM EUR BUDDY BUTTON RED 63 MM EUR BUDDY BUTTON YELLOW 63 MM EUR CUP SWITCH 45 MM EUR GRASP SWITCH EUR MICRO LIGHT SWITCH EUR MINI CUP SWITCH 24 MM EUR Function select switch (+) MD SCAN SELECT SWITCH EUR MD SCAN SELECT TOUCH CONTACT EUR BUDDY BUTTON BLACK 63 MM EUR BUDDY BUTTON RED 63 MM EUR BUDDY BUTTON YELLOW 63 MM EUR CUP SWITCH 45 MM EUR GRASP SWITCH EUR MICRO LIGHT SWITCH EUR MINI CUP SWITCH 24 MM EUR Joystick knobs (+) JOYSTICK KNOB BALL SMALL EUR JOYSTICK KNOB BALL BIG EUR JOYSTICK KNOB CHIN CUP EUR JOYSTICK KNOB MUSHROOM EUR JOYSTICK KNOB SOFT BALL EUR JOYSTICK KNOB STICK EUR JOYSTICK KNOB T-GRIP EUR JOYSTICK SOFTBALL BLACK WITH CONE EUR Page 9 of 12

10 MD Accessories ESP module (+) ESP M300/M400 EUR Dual Control (+) MD ATTENDANT/DUAL CONTROL EUR IR-mouse receiver (+) MD IR MOUSE RECEIVER USB EUR IR receiver (+) MD EC IR RECEIVER 8 CHANNEL / BOX EUR EC joystick switchbox (+) MD EC JOYSTICK SWITCH BOX EUR Emergency switch (+) EMERGENCY STOP SWITCH EUR Touch contact (+) DL/MD EC TOUCH CONTACT EUR EC cable right mouse click (+) MD EC ADAPT. CABLE DIN PLUG EUR MD EC ADAPT. CABLE 3.5MM JACK PLUG EUR Powered swing away steering (+) POWERED SWING AWAY CHIN / SIPP&PUF UNIT EUR 2, EC Messenger (+) MD EC MESSENGER EUR EC Output module (+) MD EC OUTPUT MODULE A0 EUR MD EC OUTPUT MODULE A1 EUR EC Talker (+) MD EC TALKER EUR _Drive Link EC IR phone soundstation (+) DL/MD EC IR PHONE SOUND S TATION 2 EUR 1, EC external speaker (+) MD EC EXTERNAL SPEAKER EUR EC Microphone (+) MD EC MICROPHONE ON GOOSE NECK EUR EC Easy Mobile (+) MD EC EASY MOBILE EUR 1, Supplementary accessories Compact joystick (+) JOYSTICK COMPACT LIGHT R- NET EUR JOYSTICK COMPACT R-NET EUR Mini Joystick (+) JOYSTICK MINI R-NET EUR 1, Chest support table (+) CHEST SUPPORT FOR TABLE CII/VII VINYL EUR Bluetooth mouse (+) MOUSE CONTROL BLUETOOTH I NCL 2 CABLE ADAPT R-NET EUR BLUETOOTH MOUSE CONTROL EUR Switch set Chin control (+) SWITCH KIT FOR COMPACT JS (CHIN) EUR Buddy button 63 mm Black (+) BUDDY BUTTON BLACK 63 MM EUR Buddy button 63 mm Red (+) BUDDY BUTTON RED 63 MM EUR Buddy button 63 mm Yellow (+) BUDDY BUTTON YELLOW 63 MM EUR Page 10 of 12

11 Micro light (+) MICRO LIGHT SWITCH EUR Cup (+) CUP SWITCH 45 MM EUR Mini cup (+) MINI CUP SWITCH 24 MM EUR Grasp (+) GRASP SWITCH EUR Switchbox alternative (+) SWITCH BOX ALTERNATIVE ICS 8-INPUT EUR _Remote button interface (+) REMOTE BUTTON INTERFACE R -NET EUR Program Parameters Accessories Sports driving (+) SOFTWARE M300/M R-N ET SPORT SETTING PROFILE3 EUR SOFTWARE M R-NET SPORT SETTING PROFILE3 EUR - Permolock Permolock (+) PERMOLOCK C3 WITH STANDARD SWITCH EUR Release lever (+) MANUAL RELEASE FOR PERMOLOCK C EUR Quicklock holder release lever (+) QUICKLOCK HOLDER RELEASE LEVER EUR Spacer kit permolock (+) SPACER KIT PERMOLOCK C EUR 7.00 Install kit fixed (+) PERMOLOCK SNAP IN KIT EUR Car seat adapter (+) CAR SEAT ADAPTER PERMOLOCK C3 EUR Spacer kits wheels (+) WHEEL BUMP FOR PERMOLOCK C3 EUR Extension cable Permolock (+) EXTENSION CABLE FOR PERMOLOCK C,C3 EUR Chair Order Policy: For other options and special adaptations, please call Permobil for further details. Please also refer to Permobil s Delivery Policy for further information. Your order cannot be processed without the following: - The client s name - The client s measurements - The client s weight Page 11 of 12

12 For your ordering, please sign below with date and company stamp. Signature: Date: Company Stamp: An order confirmations will be provided by Permobil summarizing the items selected. Please review this carefully. Page 12 of 12