customer contact details - bike-on...xg040 heavy duty backrest upgrade xg130 (recommended for hand...
TRANSCRIPT
SERIAL NO: _ ______________
PROD DATE: _______ / _____
Customer Contact Details
Customer Name: Ship to Customer Address:
Advisor: Shipping Name:
Address: Shipping Address:
Phone: Phone:
Email: Email:
Additional Information
Notes: Current Wheelchair:
Customer Weight:
Customer Height:
Customer Disability:
Other
I declare that I am chronically sick or disabled by reason of:
I would like to be contacted by RGK:
Signature: Date: Signature: Date:
VAT Excemption Declaration (UK Only): RGK Contact Authorisation:
From time to time, RGK would like to send you exclusive information, news and
offers on everything RGK, by email or post. We will not pass any of your details
to any third party.
and that I am receiving from RGK Wheelchairs Ltd, the wheelchair specified
herein and I claim relief from Value Added Tax under group 12 of schedule 8 to
Value Added Tax Act 1994.
[email protected] Page 1RGK_MAXLITE_2021_V1_USD
ENGLISH
SERIAL NO: _ ______________
PROD DATE: _______ / _____
Guide:
Base product Required option Optional Extra Critical Information Information Needed
XA080
Max User Weight 100kg (220lbs)
Yes, I am within the max user weight
XW010 CAD drawing for approval XW011 CAD drawing for approval in 48 hours
XY010
XY020
XY030 Extra seat length (Provides additional leg support & hand grip)
XY050
XY060
XY070
(Max - 650mm)(Min XY020 + XY030 + 110mm)
XY072
Optimise measurements
XA020
Specify length(Standard = 120mm)
$66.00
mm
mm(Max - 440mm)(Min - 250mm)
mm
mm
Frame ergonomic seat
Castor position
mm
(Max - 550mm)(Min - 380mm)
Rear frame height
mm(Max - 550mm)(Min - 360mm)
Frame length
PRODUCT STYLE
$135.00
CAD APPROVAL
$203.00
mm
MAXLITETMLXZ011$3,848.00
KEY MEASUREMENTS
Closed design
Front frame height
Seat length
mm(Max - 440mm)(Min - 250mm)
Seat width (Inside of sideguards)
[email protected] Page 2RGK_MAXLITE_2021_V1_USD
ENGLISH
SERIAL NO: _ ______________
PROD DATE: _______ / _____
XY080 Seat taper design XY091
Specify width Specify width
XY100 Round design XY105 Square design
XB200 XB200
XY115
XY120
(Std = 20 lower than front height)
XY125
(Std = 100mm)
(160mm and over requires heavy duty upgrade XB150)
XB020 Tubular titaniuam footrest XB030 Flip up plastic footrest
(Height adjustable) (Angle/height adjustable)
XB070 Angle adjust aluminium footrest XB150 Heavy duty tubular footrest
(Angle/height adjustable) (Height adjustable)
TMLXB080 Tubular footrest welded into frame
(No height adjustment)
XB050 Carbon fibre cover XB170 Aluminium cover
(Not XB070 & XB030) (Not XB070 & XB030)
XB040 Plastic Cover XB165 Rubber grip tape (not with XB030)
(Not XB070 & XB030) (3M Safety walk)$57.00 $31.00
$105.00
Footrest Cover
$110.00 $57.00
$93.00
Footrest Style
$222.00
$117.00
High level footrest (Only with XB010, XB080 &
XB150)
High level footrest (Only with XB010, XB080 &
XB150)$117.00 $117.00
Footrest Individual Measurements
Front footrest height
mm
Rear footrest height
mm
Footrest length
mm
(When combined with
XY080, Dimensions must be
smaller)
Footrest Design (Choose One)
(When combined with
XY091 , dimension is
inbetween the centre of the
main bends)
FRONT FRAME AND FOOTRESTFront Frame Options
Parallel taper design
mm mm
[email protected] Page 3RGK_MAXLITE_2021_V1_USD
ENGLISH
SERIAL NO: _ ______________
PROD DATE: _______ / _____
XC150 Aluminium centre 3"x1.4" (Silver hub and black urethane tyre)
XC060 Soft roll 4"x1.3"(Black)
XC110 Aluminium centre 4"x1" (Silver hub and black urethane tyre)
XC130 Aluminium centre 4"x1.4" (choose colour below)
Silver hub & red tyre
XC070 Soft roll 5"x1.3" XC120 Aluminium centre 5"x1"
(Black) (Silver hub and black urethane tyre)
XC100 Pneumatic Aluminium centre 5"x1" XC140 Aluminium centre 5"x1.4"
(Grey) (Silver hub and black urethane tyre)
XC080 Soft roll 6"x1.3" XC145
(Silver hub and black urethane tyre)
XC190 Low ride castor fork XC210 Froglegs suspension castor fork
(Standard when no option selected)
Note: Colour follows the accent Black Silver
XY330 Castor pin width
XD020 XD050
XD030 XD046
XD035
XD045 XD010
Silver hub & blue tyre
Omit wheel locks
Aluminium centre 6"x1.4"
150mm (6")
$105.00$118.00
125mm (5")
Silver hub & black tyre
$105.00
Optimise measurements
(Minimum width for clear castor rotation and
maximum wheelbase length)
$384.00
Green hub & black tyreBlue hub & black tyreBlack hub & red tyre
$143.00
Compact scissor with lightweight fixing
Wheel Lock Options
$83.00 $143.00
Push to lockUnderseat Scissor
Compact scissor Out Front push to lock
$98.00 (Only with fixed centre of gravity)
Out Front Compact scissor
CASTOR WHEELS, FORKS & WHEEL LOCKSCastor Wheels
mm
Castor Pin Width
Castor Forks
$105.00
75mm (3")
$105.00
Black hub & blue tyre
Red hub & black tyre
$105.00
$105.00
100mm (4")
Gold hub & black tyreBlack hub & black tyre
Purple hub & black tyre
[email protected] Page 4RGK_MAXLITE_2021_V1_USD
ENGLISH
SERIAL NO: _ ______________
PROD DATE: _______ / _____
XE030 Screw on aluminium XE040 Screw on aluminium with fender
XE080 Lift out aluminium XE090 Lift out aluminium with fender
XE180 Flip back aluminium XE190 Flip back aluminium with fender
XE050 Screw on carbon fibre
XE060 Screw on carbon fibre with fender
XE100 Lift out carbon fibre
XE110 Lift out carbon fibre with fender
XE200 Flip back carbon fibre
XE210 Flip back carbon fibre with fender
XE070 Screw on ABS plastic
XE120 Lift out ABS plastic
TMLXE220 Welded with 6mm bead
XF010 Lift out armrest with plastic sideguard
(Indicate fixed height)
XF020 Lift out armrest with Aluminium sideguard
(Indicate fixed height)Centre of tyre
(Standard if no option selected)
25mm above tyre (Follow tyre)
Outside of tyre
Level with tyre (Follow tyre)
SIDEGUARDS AND ARMRESTS
$365.00
$175.00
mm
mm
Sideguard height
Optimised measurements
Individual measurements
Height (Top of seatrail to top of armrest)
Sideguard length
Individual above tyre (Follow tyre)
Individual above tyre
mm
mm
Sideguard Measurements
$311.00Armrest Options
$376.00
$376.00
$175.00 $203.00
Fender position
$429.00
Sideguard Measurements
$354.00$531.00
$456.00
ABS Plastic Options $429.00
Welded Options
(Min = 10mm)
mm
$337.00
Carbon Fibre Options
$327.00
Carbon Fibre Options
Sideguard Sideguard with FenderAluminium Options Aluminium Options
$146.00
Fender height$146.00
$219.00 10mm above tyre
(Standard)
[email protected] Page 5RGK_MAXLITE_2021_V1_USD
ENGLISH
SERIAL NO: _ ______________
PROD DATE: _______ / _____
XY230 Backrest height fixed XY245 Backrest height adjustable
(+/-25mm)
XG010 Fixed backrest (Non-folding) TMLXG020
XY360 Backrest angle XG100 Ergonomic backrest
# # #
Individual
XG110 Inward taper XG120 Outward flare
XG070 Screw in push handles XG090
(N/A with XY245)
XG080 Flip down push handles Optimise
(N/A with XY245) (1000mm from floor)
XG085 Flip down push handles height adjustable XG097 Integrated push handle(N/A with XY245) (Quickie design)
XG040 Heavy duty backrest upgrade XG130
(Recommended for hand cycling) (Not with XY245)
mm
Depth
Extra deep brace bar
Backrest Options
Specify width or per side
mm mm
Push handle Options
$198.00
Stroller push handles height adjustable
(Recommended for JAY backs) (Std - 90mm)
Specify width or per side
$218.00
Height from floor
$129.00
mm
$87.00 $66.00
Rearward position
Deg
mm
(Max -10/+20 Deg)
$218.00
$228.00
$66.00 $66.00(inside of backrest posts) (inside of backrest posts)
Backrest Design
Folding backrest with 2 position snap lock
and angle adjust ( ± 5 Deg)$306.00
Specify height
mm
BACKRESTBackrest Height
$110.00
Specify height
mm
Vertical height
mm
Ergonomic Options
$66.00+3 +5
[email protected] Page 6RGK_MAXLITE_2021_V1_USD
ENGLISH
SERIAL NO: _ ______________
PROD DATE: _______ / _____
XH110 TMLXH090
(25-150mm)
(Open or closed frame)
(Open or closed frame)
XH120
(60-150mm)
(Open or closed frame)
XY390 XY390
Custom0 1 2 3 5 0 1 2 3 5
XH030 Frog Legs suspension camber bar XH040 Handbike camber bar fixed
XH040 Handbike camber bar fixed0 5
0 5
XJ010 XJ100 Single sport anti tip
(centre mounted)
XJ020
Anti-Tip Options
Swingaway anti tip LEFT side (Only with square
back frame. Not with XH040)
Swingaway anti tip RIGHT side (Only with square
back frame. Not with XH040)
$118.00
$118.00
$365.00
Castor height from floor for handbike
fitting
30 50
(Standard 30mm if not indicated)30 50
(Standard 30mm if not indicated)
Camber Bar Options
$555.00 $231.00
Camber angle (Handbike camber bar)$231.00
Camber angle (Handbike camber bar)Castor height from floor for
handbike fitting
CAMBER BARAdjustable Centre of Gravity
Camber angle Camber angle
mm
$275.00
(25-125mm)
mm
mm
Specify Camber Angle
Square back adjustable
centre of gravity
Round back adjustable
centre of gravity
V-style fixed centre of
gravity
[email protected] Page 7RGK_MAXLITE_2021_V1_USD
ENGLISH
SERIAL NO: _ ______________
PROD DATE: _______ / _____
XY420 XY430 25" Wheels
XY460
Individual
XK010 Fusion 16 spoke XK320
(Silver Hub, black spokes)
XK050 Spinergy LX 12 spoke XK060
XK150 Spinergy CLX 18 carbon blade spoke XK070(Black hub only) (Black hub only)
Spinergy Colour Options:
XK180 Individual spoke design(Specify colour)
Inside:
Outside:
Spinergy Anodise Options
XK190 XK200 XK201 XK204 Individual hub/rims
(std option) (n/a with BLXL/CLX) (LX, XLX & BLXL only) Select colour:
XK202 XK203 XK204
(LX, XLX & BLXL only) (LX, XLX & BLXL only) (LX, XLX & BLXL only)
XK040 Supply without Wheels Wheel Type: Tyre Type:
XY480 Narrow set handrim XY485
XL090 Remove excess mounting tabs
(recommended for small wheel gaps)
XL010 Aluminium hard anodised 6 tab XL040 Titanium 6 tab
XL160 Elipse 6 tab XL050 Stainless steel 6 tab(replacement for Surge)
XL020 Tetra grip 6 tab XL140 Ergo gripp 6 tab wide
XL100 Para grip 6 tab
XM010 Kenda Red
XM130 Kenda black
XM020 Schwalbe Marathon Plus XM060 Schwalbe One
(24",25" only)
XM040 Shox solid airless XM050 Kenda K885 mountain bike tyre
(Black) (24",25" only)
XY500 XY490
XK220 XK300
XK240 XK310
$1,241.00
Inner Tube Valve Options
Tyre Options
$93.00 $22.00
Wheel Options (Choose one)
Spinergy XLX 12 spoke
$84.00
Spinergy SPOX 18 spoke $624.00 $470.00
Spinergy BLXL 18 blade spoke$657.00
Black spokes White spokes Yellow spokes
REAR WHEELSRear Wheel Size
24" Wheels
Rear Wheel Gap
Rear wheel gap
15 20 25
mm
$657.00
$146.00
Red spokes Blue spokes Pink spokes
Purple spokes Orange spokes Green spokes
Black hub Silver hub Red hub/rims
$76.00 $154.00 $203.00
Purple hub/rims Blue hub/rims Gold hub/rims
$154.00 $154.00 $203.00
Supply Without Wheels
-$161.00
Wide set handrim
Handrim Position / Options
$57.00 $79.00
Handrim Styles
$236.00 $245.00
$236.00
$200.00
$281.00 $110.00
Grey (std) Blue
$15.00
Quad release axle nuts (pair) Offroad wheel set 24" rim with handrim, MTB tyre and
axle pins (Replaces 25" wheel with XM010)$129.00 $537.00
Schraeder inner tube valve Presta inner tube valve(Standard if no option selected)
Titanium 130mm quick release axle pins (pair)
(N/A with XK010 & XK070)Offroad wheel set 22" rim with handrim, MTB tyre and
axle pins (Replaces 24" wheel with XM010)
Wheel Accessories
$94.00 $537.00
[email protected] Page 8RGK_MAXLITE_2021_V1_USD
ENGLISH
SERIAL NO: _ ______________
PROD DATE: _______ / _____
XN010 Powder coated frame XN150 Powder coated components (Frame colour if not specified)
Frame Comp. Gloss Frame Comp. Matt Frame Comp. Special
XN200 Individual paint colour -State Colour/RAL code
TMLXN030 Bead blast frame XN165 Bead blast components(All parts black unless XN160 chosen)
TMLXN050 Polished frame XN170 Polished components(All parts black unless XN170 chosen)
Note: Accent colour includes, forks, castor caps, decals.
Black accent Silver accent XN250 Individual Accent Colour
Red accent Blue accent
Purple accent
XP040 Seat sling adjustable tension with straps XR050 Carbon fibre seat plate
XP050 Airtech backrest strap adjustable XP070 Backrest upgrade to leather corners (Black)
(not with flip down push handles)
Silver Black Blue Individual:
Red Light blue Purple
White (Std) Green Blue Individual:
Red Light blue Purple
XP110 XP170 Individual backrest embroidery
(Please provide .jpeg file and positioning)$74.00 $113.00
Backrest Accessories
Backrest with zip pocket
Backrest RGK Logo Colour
$510.00
Accent Colour
Orange gloss 180
Purple gloss 157
$199.00 $80.00
$135.00
Frame Comp
Royal blue gloss 154
Blue gloss 174
Duckegg blue gloss 141
Pink gloss 188
Green gloss 107
Dark blue gloss 151
$143.00
FINISH OPTIONSFrame & Component Finish
Cream gloss 135 Light grey matt 133 Metallic grey matt 130
Black gloss 103 Black matt 105 Chrome Mirror 300
White gloss 100 White matt 101 Sparkle silver 170
Grey gloss 132 Grey matt 131 Metallic black matt 104
Navy blue matt 152 Black sandpaper 201
Yellow gloss 120 Grey sandpaper 202
Forest green gloss 143 White sandpaper 200
Red gloss 108
$143.00
Backrest Upholstery
UPHOLSTERYSeat Upholstery
Backrest Stitching Options
$281.00
$100.00
[email protected] Page 9RGK_MAXLITE_2021_V1_USD
ENGLISH
SERIAL NO: _ ______________
PROD DATE: _______ / _____
XP080 Cushion foam
(select density and size below)
Soft (CMS040) Medium (CMS050) Hard (9lb recon)
50mm 75mm 100mm
XP081 Nylon cushion cover
(Black)
XP090 Air Lite cushion cover
(Black)
XP100 Leather cushion cover
(Black)
Jay Order form attached Notes:
(Price dependant on size / option)
Jay Order form attached
(Price dependant on size / option)
JAY Whitmyer Headrest Jay Order form attached
(Price dependant on size / option)
XR060
Specify height from floor
XR080 Frontwheel assembly
(Only with Tubular style footrest)
XP120 Frame protectors Neoprene zip fasten with TIGA logo
(Back)
XP420 Frame protectors Nylon velcro fasten
(Black)
XR010 Seat pouch velcro attach
(Back)
XR200 Rucksack with RGK logo
(Back)
XR020 Underseat large storage bag
(Back)
XA020 Tool kit
XS060 Calf strap
CUSHION
$69.00
Optimise measurements
ACCESSORIES
FRAME OPTIONS
Welded calf strap mounting loops
$74.00
Cushion foam options
Cushion Cover Upgrades
$54.00
$176.00
Jay Products
JAY Cushion
$60.00
$40.00
$31.00
$606.00
JAY Backrest
$84.00 (To locate calf strap on front frame)
$53.00
[email protected] Page 10RGK_MAXLITE_2021_V1_USD
ENGLISH
SERIAL NO: ________________
PROD DATE: _______ / _______
NOTES
[email protected] Page 11RGK_MAXLITE_2021_V1_USD
ENGLISH