ECLIPSE. Seat Width is adjustable within the original range with the optional Adjustment Kit (sold separately below).

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1 C u s t o m e r a n d O r d e r I n f o r m a t i o n Purchase Order * Dealer/Provider Name * Purchaser Name and Contact Information * Billing Address * Tag v Shipping Address * * required F r a m e T y p e Eclipse Bariatric Manual Wheelchair Extended delivery lead times may apply. $ 2,995 F r a m e O p t i o n s Heavy Duty Base and Seat Frame lbs Weight Capacity lbs Weight Capacity $ 300 S e a t W i d t h Overall chair width is +8" Seat Widths Seat Width is adjustable within the original range with the optional Adjustment Kit (sold separately below) "-26" Range, Width set to $ "-32" Range, Width set to $ "-36" Range, Width set to $ 1, "-42" Range, Width set to $ 1, "-48" Range, Width set to $ 1,225 Seat Widths greater than 48" are available for Custom Chairs S e a t W i d t h A d j u s t m e n t K i t Optional Seat Width Adjustment Kit $ 750 This optional Kit is required to grow or shrink the Chair in the future (Width must remain within the original range). Kit includes Seat Pan, Back Posts, Back Upholstery, and Width Adjustment Spacers. 20"-26" Range, Width set to 26"-32" Range, Width set to 30"-36" Range, Width set to 36"-42" Range, Width set to 42"-48" Range, Width set to S e a t D e p t h Seat Depths (Adjustable) " Seat Depth " Seat Depth " Seat Depth $ " Seat Depth " Seat Depth " Seat Depth $ " Seat Depth $ 325 Custom Seat Depths " Seat Depth " Seat Depth $ 625 PDG Product Design Group Inc. 318 East Kent Ave South Vancouver BC V5X 4N6 Canada Phone info@pdgmobility.com 1 / 5

2 F r a m e C o l o u r PDG Premium Colours Tracer Red Gloss Black Silver Black Shimmer Orange Fusion Karl s Imagination Blue Shimmer Gloss White Dark Titanium Geyser Green Lollypop Blue Lollypop Red Bubble Gum Pink Berry Purple Safety Yellow Custom Colour Contact PDG for specifications. $ 300 A r m T y p e No Armrest Dual Post Fixed Height (12") Dual Post Adjustable Height $ "-14" "-16" A r m r e s t s Regular Armpads Desk Length - 2" x 10" Full Length - 2" x 14" Full Length Premium Grade - 2" x 14" $ 35 Wide Armpads May interfere with wheels in some tilt configurations. $ Desk Length - 3" x 10" Full Length - 3" x 12" Gel Armpads May interfere with wheels in some tilt configurations. $ Full Length - 2" x 12" Full Length - 3.5" x 12" Forward Guards $ " Armrest Extension - Forward $ 60 S e a t P a n Solid Seat Pan $ 120 C u s h i o n No Cushion 3" Basic Foam (Nylon Cover) Up to 28" Width $ Above 28" Width $ 605 3" Contour Foam (Nylon Cover) Up to 28" Width $ Above 28" Width $ 1,090 3" Contour Pressure Reduction (Nylon Cover) Up to 28" Width $ 1, Above 28" Width $ 1,900 Spare Cushion Cover Basic $ Contour $ 490 Cushion Size Specify Size (Width" x Depth") PDG Product Design Group Inc. 318 East Kent Ave South Vancouver BC V5X 4N6 Canada Phone info@pdgmobility.com 2 / 5

3 S e a t H e i g h t Front Seat Height Angle Adjustable Foot Plates required for 14.5" and 15" " STF Front " STF Front " STF Front " STF Front " STF Front " STF Front " STF Front $ 200 Rear Seat Height Angle Adjustable Foot Plates required for 14.5" and 15" " STF Rear " STF Rear " STF Rear " STF Rear " STF Rear " STF Rear " STF Rear $ 200 C a s t e r s " Caster With Heavy Duty Steel Fork R e a r W h e e l s " Heavy Duty Spoke A x l e T y p e Quick Release Rear Axles Fixed Rear Axles Rear Axle Position Set at 1 (Rear) Set at Set at Set at 4 (Front) R e a r T i r e s Urethane H a n d R i m s No Hand Rims Standard Plastic Coated $ 250 W h e e l L o c k s Push to Lock Pull to Lock Wheel Lock Extensions $ 60 A n t i - T i p p e r s Rear Anti-Tippers Required Safety Option. $ 60 B a c k P o s t S t y l e Push Bar Back, 8 Bend Cane Handle Back, 8 Bend Not compatible with Headrest Mounting Plate. Back Post Height Seat Pan to Handle " Height " Height PDG Product Design Group Inc. 318 East Kent Ave South Vancouver BC V5X 4N6 Canada Phone info@pdgmobility.com 3 / 5

4 B a c k O p t i o n s Seat to Back Angle Set at Set at Set at Set at " Backrest Extension $ 135 B a c k U p h o l s t e r y No Back Upholstery Standard Back height measured from Seat Pan to top of Upholstery $ Set at 18" Set at 19" Set at 20" Short (25" Back only) Back height measured from Seat Pan to top of Upholstery $ Set at 16" Set at 17" Tall (30" Back only) Back height measured from Seat Pan to top of Upholstery $ Set at 21" Set at 22" Set at 23" B a c k r e s t No Backrest T i l t / R e c l i n e O p t i o n s Reclining Backrest (Manual) $ maximum recline. Not compatible with Backrest Extension. Reclining Backrest is 1 narrower than Seat Width. Back Frame is not removable. H e a d r e s t No Headrest Headrest Mounting Plate Not required if mounting to a solid Back. $ nxt MultiFit Head Support Hardware $ 235 nxt MultiFit Head Support Pad $ Regular (9" x 5") Large (10" x 5") X-Large (14" x 5") F r o n t R i g g i n g Sector Blocks only Center Mount Front Rigging Bracket Compatible with 60 only. $ Swing Away Swing Away Elevating Legrest $ 375 F o o t P l a t e s Composite Not compatible with 14.5" and 15" STF Height Aluminum Angle Adjustable Required for 14.5 and 15 STF Height. $ One Piece Flip-up Requires selection of Composite or Aluminum Angle Adjustable. $ 395 F o o t r e s t / L e g r e s t A c c e s s o r i e s Oversized 9" x 10" Calf Pad Not compatible with Seat Width of less than 25". $ Swing Away ELR Gel Knee Pad $ Adjustable Length Heel Loops $ Bodypoint - Calf Strap $ 105 PDG Product Design Group Inc. 318 East Kent Ave South Vancouver BC V5X 4N6 Canada Phone info@pdgmobility.com 4 / 5

5 E x t e n s i o n T u b e s Regular Extension Tubes Standard (13"-17") Long (15"-19") $ 75 P o s i t i o n i n g S t r a p s Bodypoint - Hip Belts Center-Pull Auto Style $ Center-Pull Auto Style, Padded $ 155 M i s c e l l a n e o u s O p t i o n s Adhesive Back Hook Strip, 2" x 30" For Cushion mounting. $ 10 O r d e r N o t e s Please send your completed order form by to info@pdgmobility.com or by fax to Scan this code or go to pdgmobility.com/products/eclipse/ to learn more about the Eclipse Bariatric Manual Wheelchair PDG Product Design Group Inc. 318 East Kent Ave South Vancouver BC V5X 4N6 Canada Phone info@pdgmobility.com 5 / 5