helio C2
519, J-Oswald Forest, suite 101 Saint-Roch-de-l'Achigan, QC, Canada J0K 3H0 T.450 588-6555 1 866 650-6555 F.450 588-0200
www.motioncomposites.com
Helio C2 ORDER FORM - CANADA
User manual : Account :
□ English
PO :
□ Français
Ship to :
Vendor :
Name :
Date :
Address:
Ordered by :
City :
Marked for :
Postal Code :
1
Province :
Ultralight Folding Carbon Fiber Helio C2 Wheelchair (250 lbs. weight capacity)
FRAME COLOR (with Carbon Finish Crossbrace) Carbon Finish □ Sunkissed Orange □ 2 Basalt Black □ Fushia □ Charcoal □
Ferrari Red □
Burgundy □ Steel Blue □ Sapphire Blue □
Custom Color COLOR HIGHLIGHTS ON FRONT HANGERS 4 Red □ Blue □ White □ Charcoal □ (std on basalt black & carbon finish frame) SEAT WIDTH 5 Seat width : 14 “ □ 15 “ □ 16 “ □ 17 “ □ 18 “ □ 6 Seat width : 19 “ □ 20 “ □
Phone : WM0000964/ WAMC Monster Green □ Acid Green □
3
SEAT DEPTH 7 Seat depth : 8 Seat depth :
14 “ □ 19 “ □
15 “ □ 20 “ □
16 “ □
NEWTON ULTRALIGHT PACKAGE Includes : Carbon fiber angle adjustable oversize footplates Newton Infinity ultra-light rear wheels
17 “ □
$410 (save $210 over the regular price)
$2950
□
NC
□
$200
□
Black □ (std with color frame)
□
WAMA
NC $285
□ □
WAMB
NC $215
□ □
18 “ □
□
STRAIGHT BACK 9 Lightweight carbon fiber back cane NC □ 10 Select height : 9 - 12” □ 12 - 15” □ 15 - 18” □ 18 - 21” □ Set height to : (measured from seat sling to top of back upholstery / see drawing at the end of the order form) 8° BEND BACK 11 Aluminum back cane $80 □ 12 Lightweight carbon fiber back cane $140 □ 13 Select height : 13 ½ - 15” □ 15 - 18” □ 18 - 21” □ Set height to : (measured from seat sling to top of back upholstery / see drawing at the end of the order form) ADJUSTABLE ANGLE BACK 14 Lightweight carbon fiber back cane straight $236 □ 15 Lightweight carbon fiber back cane 8° bend $296 □ 16 Select height : 13 ½ - 15” □ 15 - 18” □ 18 - 21” □ 17 Select back cane angle : 85° □ 90° □ 95° □ 100° □ 105° □ 110° □ Set height to : (measured from seat sling to top of back upholstery / see drawing at the end of the order form) PUSH HANDLES 18 Push handles, 0 - 3” height adjustable NC □ 19 Omit push handle NC □ 20 Stroller handle WAMW $145 □ 21 Folding Stabilizer bar (not available with stroller handle.) $175 □
Page 1 of 5
version 2.6-CAN- May 1st 2013
helio C2
519, J-Oswald Forest, suite 101 Saint-Roch-de-l'Achigan, QC, Canada J0K 3H0 T.450 588-6555 1 866 650-6555 F.450 588-0200
www.motioncomposites.com
SEATING CUSHION 22 2” Cushion 23 3” Cushion 24 nXt FIT cushion series (See nXt FIT pricelist) 25 Omit Cushion BACK UPHOLSTERY 26 Slip on back upholstery 27 Adjustable tension back upholstery 28 Omit back upholstery RIGID BACK 29 nXt back series (See nXt back pricelist)
$115 $135 NC
WAMD/WAME
SIDEGUARDS 36 Plastic side guards (removable) 37 Carbon fiber side guards (fixed) 38 Carbon fiber mud guards (removable) 39 Custom cut to match wheel profile (available only with carbon fiber side guards) 14 - 19.5” □ 14 - 19.5” □ 10 - 12.5” □
15 - 20.5” □ 15 - 20.5” □ 11 - 13.5” □
55
WAMV WAMV WAMV
$348 $348
□ □
$300 $300
□ □
$250 $250
□ □
$190 $210 $450 $325
□ □ □ □
$55 NC NC
WAMK
$202 $65
□ □ □ □ □ □
SEFND0005
$375
□
NC $138 $320 $190 $380 NC $76
□ □ □ □ □ □ □ □ □
16 - 21.5” □ 16 - 21.5” □ 12 - 14.5” □
8 - 10” □
NC
14 - 18”
left □
left □
right □
FOOTPLATES 47 Standard (Composites) 48 Adjustable angle oversize (Aluminum) 49 Adjustable angle oversize (Carbon fiber with rubber inserts) 50 One piece adjustable angle flip-up (Aluminum) 51 One piece adjustable angle flip-up (Carbon fiber with rubber inserts) 52 Length adjustable heel loop 53 Length adjustable toe strap 54
□ □ □
FLIP BACK ARMREST (Convertible to “T” armrest) 30 Desk Length 8 - 12” □ 10 - 14” □ 31 Full Length 8 - 12” □ 10 - 14” □ “T” ARMREST 32 Desk Length 8 - 12” □ 10 - 14” □ 33 Full Length 8 - 12” □ 10 - 14” □ SWING AWAY ARMREST [ Range : 8 - 11 “ ] 34 Tubular arm pad 35 Desk length arm pad
SWING-IN/SWING-OUT FOOTREST 40 60° Swing-in/swing-out foorests 41 70° Swing-in/swing-out footrests 42 90° Swing-in/swing-out footrests 90° Swing-in/swing-out footrests front mount 43 (Footplate mounted to hanger tube) 44 Elevating legrest with calf pad 45 Length modification outside of specified range STUMP SUPPORT (Height and angle adjustable) 46 Swing away stump support , 8” X 11”
NC $162 $-15
□ □ □ □
right □
WAMJ WAMJ
$36 $58
Calf strap Padded calf strap
Page 2 of 5
version 2.6-CAN- May 1st 2013
helio C2
519, J-Oswald Forest, suite 101 Saint-Roch-de-l'Achigan, QC, Canada J0K 3H0 T.450 588-6555 1 866 650-6555 F.450 588-0200
www.motioncomposites.com
CASTER 56 57
Composite wheel w/ PU tire (1” width)
Pneumatic FROG LEGS SOFT ROLL 58 59 60
Composite wheel Soft-Roll by Frog Legs ©
1
61
3” □ 4” □ 5” □ 6” □ 7” □ 8” □ 6” X 1 ¼” □ 8” X 1 ¼” □
$50 NC $120
□ □ □
4” X 1 ½ ” 5” X 1 ½ ” 6” X 1 ½ ” 4” X 1” □
$85 $95 $105 $128
□ □ □ □
$220 $475
□ □
Ultra light aluminum court wheel by Frog Legs1 5” X 1” □ CASTER OPTIONS 63 Caster Pin Locks (Available with +1” or +2” Stem bolt ONLY) 64 Frog Legs suspension forks (Not available with caster pin locks) 62
1
WAMS
Soft-Roll© by Frog Legs are casters that absorb vibrations
Forks 4”
3” caster
4” caster
5” caster
6” caster
7” caster
8” caster
Stem bolt length
Stem bolt length
Stem bolt length
Stem bolt length
Stem bolt length
Stem bolt length
STD
+1”
+2”
STD
+1”
+2”
STD
+1”
+2”
STD
+1”
+2”
STD
+1”
+2”
P1
13
14
15
13 1/2
14 1/2
15 1/2
P2
13 1/2
14 1/2
15 1/2
14
15
16
14 1/2
15 1/2
16 1/2
P2
13 3/4
14 3/4
15 3/4
14 1/4
15 1/4
16 1/4
14 3/4
15 3/4
16 3/4
P3
14 1/4
15 1/4
16 1/4
14 3/4
15 3/4
16 3/4
15 1/4
16 1/4
17 1/4
15 3/4
16 3/4
17 3/4
P4
14 3/4
15 3/4
16 3/4
15 1/4
16 1/4
17 1/4
15 3/4
16 3/4
17 3/4
16 1/4
17 1/4
18 1/4
16 3/4
17 3/4
18 3/4
16 1/4
17 1/4
18 1/4
16 3/4
17 3/4
18 3/4
16 1/4
17 1/4
18 1/4
16 3/4
17 3/4
18 3/4
17 1/4
18 1/4
19 1/4
STD
+1”
+2”
P1
5”
P1 P2
7”
P3 P4 P5
16 3/4
17 3/4
18 3/4
16 3/4
17 3/4
18 3/4
17 1/4
18 1/4
19 1/4
17 3/4
18 3/4
19 3/4
18 1/4
19 1/4
20 1/4
16 3/4
17 3/4
18 3/4
17 1/4
18 1/4
19 1/4
17 3/4
18 3/4
19 3/4
18 1/4
19 1/4
20 1/4
18 3/4
19 3/4
20 3/4
17 1/4
18 1/4
19 1/4
17 3/4
18 3/4
19 3/4
18 1/4
19 1/4
20 1/4
18 3/4
19 3/4
20 3/4
19 1/4
20 1/4
21 1/4
REAR WHEELS 65 Mag (Aluminum or plastic coated handrim only) Spoke Newton Infinity 68 Spinergy Spox 69 Spinergy LX TIRES 70 Soft urethane 1 3/8 ” 71 Pneumatic 1 3/8 ” 72 Kenda - Ironcap high pressure 1” 73 Kenda - Kourier high pressure 1 3/8 ” 74 Soft Urethane - high performance 1” 66 67
Wheel size 20” wheel 22” wheel 24” wheel 25” wheel 26” wheel
24” 24” 24” 24”
□ □ 25” □ 26” □ □ 25” □ 26” □ □ 25” □ 26” □
NC $300 $800 $900
□ □ □ □ □
20” □ 22” □ 24” 20” □ 22” □ 24” 20” □ 22” □ 24” 24” 24”
□ □ 25” □ 26” □ □ 25” □ 26” □ □ 26” □ □ 25” □
NC NC $80 $80 $120
□ □ □ □ □
$125
22” □ 24” □ 22” 20” □ 22” 22” 22”
□ □ □ □
Height available +- 1/4” 12 ½ ” to 17” 13 ½ ” to 18” 14 ½ ” to 19” 15” to 19 ½” 15 ½” to 20”
Page 3 of 5
Specify desired height:____________
version 2.6-CAN- May 1st 2013
helio C2
519, J-Oswald Forest, suite 101 Saint-Roch-de-l'Achigan, QC, Canada J0K 3H0 T.450 588-6555 1 866 650-6555 F.450 588-0200
www.motioncomposites.com
HANDRIM 75 Aluminum anodized
WAMO WAMO
$130 $200 $320 $360 NC
□ □ □ □ □ □
WAMU WAMU
NC NC $150
□ □ □
WAMT
$165
□
REAR WHEEL CAMBER ANGLE 85 0° camber 86 3° camber 87 6° camber (not available with amputee axle plate)
NC NC $120
□ □ □
WHEEL LOCK 88 Push to lock □ Pull to lock □ 89 6” removable extension handle 90 Grade aid push to lock (suggested with pneumatic or high pressure tire) 91 Scissor brakes
NC $32 $120 $312
□ □ □ □
POSITIONING BELT (2 points seatbelt attachment hardware is included with the helio C2) 92 Velco adjustable 93 Auto buckle 94 Additionnal attachment hardware for 4 points seatbelt
$32 $40 $8
□ □ □
ACCESSORIES 95 Anti tippers 96 Cane Carrier 97 Spoke guards 98 Footrest neoprene impact guard 99 Seat pouch 100 helio T-Shirt small □ medium □
$75 $85 $124 $50 $75 $25
□ □ □ □ □ □
76 77 78 79 80
Assembly regular □ narrow □
Plastic coated High friction plastic coated foam Natural Fit- Standard grip (oval aluminum handrim with thumb piece) [avail. 22”, 24”,26”] Surge LT handrim (oval aluminum handrim with a rubber high friction strip) [avail. 22”, 24”] Omit handrim
AXLE 81 Quick release axle 82 Permanent axle 83 Quad release axle 84
AMPUTEE ADJUSTABLE AXLE PLATE
left □
NC
WAMR
right □ WAMP
large □
X-large □ XX-large □
TRANSIT SECUREMENT POINTS ARE INCLUDED WITH THE HELIO C2 TOTAL Notes
Page 4 of 5
version 2.6-CAN- May 1st 2013
helio C2
519, J-Oswald Forest, suite 101 Saint-Roch-de-l'Achigan, QC, Canada J0K 3H0 T.450 588-6555 1 866 650-6555 F.450 588-0200
www.motioncomposites.com
CENTER OF GRAVITY
Check the desired rear wheel position OR specify the distance : _________________
(measure from front of back post to the center of axle)
BACK UPHOLSTERY HEIGHT
3” of adjustability
• The slip-on adjustable tension back upholstery is attached to the push handle offering 3” of height adjustment with increment of 1/2”.
Back upholstery height
• Rigid backs are attached to the back cane and the height of the push handle is adjusted independently.
Page 5 of 5
version 2.6-CAN- May 1st 2013