lift - proactiv-gmbh.com · lift with mechanical seat height adjustment by the simple manual...

10
- 1 - 2017-09-19 / The prices are plus statutory value-added tax and shipping costs = Included in the basic price = Position selected Lift Rev. 05 Im Hofstätt 11 D- 72359 Dotternhausen Tel +49 (0)7427 9480-0 Fax +49 (0)7427 9480-7025 e-mail [email protected] www.proactiv-gmbh.de Quotation date: ___________ Order date: ____________ according to GTC PRO ACTIV GmbH Medical suppliers / Company address: Cust. no.: Name: Street: Postcode, city: Phone: Fax: E-mail: Contact: Shipping address: same as company address other (see below) Name: Street: Postcode, city: Customer name / commission: Name: Street: Postcode, city: Phone: Fax: E-mail: Date of birth: Paying organisation: Indication: Invoice address: same as company address Invoice address: other (see below) Cust. no.: Name: Street: Postcode, city: Phone: Fax: E-mail: Contact: LIFT with mechanical seat height adjustment By the simple manual adjustment of the seat height, the desired working height can be achieved with the help of gas springs. With just a little muscle power the seat lifts up to 30 cm. Approved up to 120 kg user load capacity 9060100000 6,190.00

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Page 1: LIFT - proactiv-gmbh.com · LIFT with mechanical seat height adjustment By the simple manual adjustment of the seat height, the desired working height can be achieved with the help

- 1 - 2017-09-19 / The prices are plus statutory value-added tax and shipping costs = Included in the basic price = Position selected Lift Rev. 05

Im Hofstätt 11 D- 72359 Dotternhausen Tel +49 (0)7427 9480-0 Fax +49 (0)7427 9480-7025 e-mail [email protected] www.proactiv-gmbh.de

Quotation date: ___________

Order date: ____________

according to GTC PRO ACTIV GmbH

Medical suppliers / Company address:

Cust. no.:

Name:

Street:

Postcode, city:

Phone:

Fax:

E-mail:

Contact:

Shipping address: same as company address

other (see below)

Name:

Street:

Postcode, city:

Customer name / commission:

Name:

Street:

Postcode, city:

Phone:

Fax:

E-mail:

Date of birth:

Paying

organisation:

Indication:

Invoice address: same as company address

Invoice address: other (see below)

Cust. no.:

Name:

Street:

Postcode, city:

Phone:

Fax:

E-mail:

Contact:

LIFT with mechanical seat height adjustment By the simple manual adjustment of the seat height, the desired

working height can be achieved with the help of gas springs. With

just a little muscle power the seat lifts up to 30 cm.

Approved up to 120 kg user load capacity

9060100000 € 6,190.00

Page 2: LIFT - proactiv-gmbh.com · LIFT with mechanical seat height adjustment By the simple manual adjustment of the seat height, the desired working height can be achieved with the help

- 2 - 2017-09-19 / The prices are plus statutory value-added tax and shipping costs = Included in the basic price = Position selected Lift Rev. 05

Basic size

Body size:

Body size: __________ cm

Weight: __________ kg

Lower leg length: __________ cm

(anatomic dimension: hollow of the knee to the foot sole)

Wheel chair dimensions:

Seat width SB 35 36 37 38 39 40

41 42 43 44 45 46

Seat depth ST: Frame size 1

35 36

37 38

Frame size 2

39 40 41

42 43

Frame size 3

44 45 46

47 48

Back height RH 20 21 22 23 24 25 26 27 28 29

30 31 32 33 34 35 36 37 38 39

40 41 42 43 44 45 46 47 48

Lower leg length USL 30 31 32 33 34 35 36 37 38 39 40

41 42 43 44 45 46 47 48 49 50

Please cross on the appropriate dimension (all dimensions are specified in cm).

Underlined values are standard settings.

The values SHh and SHv may deviate from the specified values depending on the

wheel size and wheel camber! Special dimensions possible upon request.

UL

(front side rear tube to axis middle drive wheel)

Page 3: LIFT - proactiv-gmbh.com · LIFT with mechanical seat height adjustment By the simple manual adjustment of the seat height, the desired working height can be achieved with the help

- 3 - 2017-09-25 / The prices are plus statutory value-added tax and shipping costs = Included in the basic price = Position selected

Colours Lift Rev. 02

Frame colour - One-colour design Rahmenfarbe - Einfarbdesign Information on current colour designs and example images under: www.proactiv-gmbh.de/farben.php

White RAL 9016

gloss 9000100170-023 matt 9000100170-123 € 33.30

Brilliant Silver

glanz 9000100170-011

Anthracite RAL 7016

gloss 9000100170-001 matt 9000100170-101 € 33.30

Black RAL 9005

gloss 9000100170-003 matt 9000100170-019 € 33.30

Deep black, silver effect

gloss 9000100170-007

Pure orange RAL 2004

glanz 9000100170-022

Fire Red

gloss 9000100170-018 matt 9000100170-118 € 33.30

Pink magenta RAL 4010

gloss 9000100170-037 matt 9000100170-137 € 33.30

Sky blue

gloss 9000100170-017

Pastel blue RAL 5024

gloss 9000100170-036 matt 9000100170-136 € 33.30

Navy blue

gloss 9000100170-045 matt 9000100170-145 € 33.30

Apple green

gloss 9000100170-014 matt 9000100170-114 € 33.30

Lemon green

gloss 9000100170-005 matt 9000100170-105 € 33.30

Purple

gloss 9000100170-044

Yellow RAL 1023

gloss 9000100170-046 matt 9000100170-146 € 33.30

Red RAL 3001

gloss 9000100170-047 matt 9000100170-147 € 33.30

Colour - Attachment parts Farbe - Anbauteile

Drive wheel1

Aluminium rim and hub

Caster fork and

bearing block

black 9000100171-003 9000100173-003

The attachment parts are always mounted in black.

Attachment parts colour design according to customer desires:

Drive wheel1

Aluminium rim and hub 5" Aluminium rim

2

3 spoke design

Orange

RAL 2004 € 144.901

9000100171-022

€ 30.702 9000100174-022

white

RAL 9016 € 144.901

9000100171-023

€ 30.702 9000100174-023

in frame

colour € 176.101

9000100171-999

€ 51.502 9000100174-999

Selection

from single

colour

design

deviating

from the

frame colour

€ 206.201 9000100171-998

€ 60.802 9000100174-998

Please enter the last 3 digits of the desired colour

(single colour design):

9000100170-

9000100170-

Frame colour - Two colour designs

Information on current colour designs and example images under:

www.proactiv-gmbh.de/farben.php

Note: Frames with two clolour designs in gloss level of the design colour

Two-colour design

comprising one basic colour (on the back of the frame) and one design colour (on the front of the frame)

€ 205.90

Please select from the following colours:

Base colour (on the rear frame):

Design colour (on the front frame):

White 9000100170-200

Silver 9000100170-201

Anthracite 9000100170-202

Black 9000100170-203

Pastel blue 9000100170-206

Lemon green 9000100170-207

Yellow 9000100170-208

Yellow

gloss 9000100170-261

matt 9000100170-262

Lemon green

gloss 9000100170-250

matt 9000100170-251

Blue

gloss 9000100170-252

matt 9000100170-263

Chili

gloss 9000100170-253

matt 9000100170-254

Pure Orange

gloss 9000100170-255

matt 9000100170-256

Cappuccino

gloss 9000100170-257

matt 9000100170-258

Black

gloss 9000100170-259

matt 9000100170-260

Special colour requests (frame or attachment parts)

Frame colour single procurement

Frame from RAL range of colours

Surface coating: gloss matt

9000100170-100 € 317.20

Colour details with RAL number:

Note: Attachment parts not possible in design colours 1 Only in combination with aluminium rim drive wheel

9000203000-9000203300 2 Only in combination with caster wheel 5" Aluminium rim 3-spoke design easy running 9000501200 or 5" aluminium rim 3-spoke design good shock absorption 9000501210

Page 4: LIFT - proactiv-gmbh.com · LIFT with mechanical seat height adjustment By the simple manual adjustment of the seat height, the desired working height can be achieved with the help

- 4 - 2017-09-19 / The prices are plus statutory value-added tax and shipping costs = Included in the basic price = Position selected Lift Rev. 05

Frames Note: Footrest area with V-shape x =SB-(0,25 x USL + 6cm)

Straight Front End

9060100010

Knee angle 105°

Front end V-shape

9060100020

Knee angle 105°

Individual production On request and after checking

Seat width 30 - 34 cm

9060601001 € 956.80

with chassis width 35cm and/or Seat depth 25-34cm with backrest shift to the front

Seat width 47 - 50 cm

9060100050 € 942.00

Lenght of front frame USL 20 - 29 cm

9060601000 € 182.00

(only for continuous foot brackets)

Push handles

Back tubes with integrated handles

9016401051 € 99.90 € 92,40

Straight tubes, also possible with lordosis bend:

1cm

2cm

3cm

Aluminium push handles fixed in back tube

9060401050 € 99.90

min. back height RH 23cm

Safety push handles with continuous height adjustment

9060401060 € 166.00

Mount in the back tube from RH 30 cm with belt cover from RH 43 cm with back shell

Safety push handles back-positioned length 45 cm

9060401075 € 285.50

continuous height adjustment, Safety push handle holder mounted on the back cross bar Up to a SB of 42 cm or a body weight of 95 kg cannot be swung back in combination with the armrest!

Push handles, horizontally screwed in back tube

9060401076 € 185.10

Can be unscrewed

Backrest

Folding backrest

9060400010

7-way inclination adjustment with integrated plastic coated aluminium side parts

Back tubes with lordosis bend

9000400005 € 88.00 € 110,00

1cm

2cm

3cm

Back equipment

Adaptable back with back padding

9060802010

Colour: black Equipment with back cross bar

Raised back + 3 - 5 cm

9060802100 € 119.60

(for the nominal back height dimension) Only in combination with continuous height adjustable push handles Art no. 9061401060!

Equipment without back upholstery and back padding or back system

9000802011 € - 50.00

Equipment with back cross bar

Further back systems e.g. ergonomic back shell see separate dimension sheet: "PRO ACTIV seat and back systems"

Seat upholstery

Body Contour

9060801025

Open belt system

9060801010 € 58.80

Page 5: LIFT - proactiv-gmbh.com · LIFT with mechanical seat height adjustment By the simple manual adjustment of the seat height, the desired working height can be achieved with the help

- 5 - 2017-09-19 / The prices are plus statutory value-added tax and shipping costs = Included in the basic price = Position selected Lift Rev. 05

Equipment without seat upholstery

9000801050

Seat cushion

rectangluar contour radius contour

cover:

black, breathable, open fabric surface

black, closed fabric surface

If no specification is given, the cover material "black breathable, open surface" will be delivered.

Further seat cushions, e.g., "Anti-Decubitus" see separate dimension sheet: "PRO ACTIV "Seat and back systems"

Lift mechanism Mechanical seat height adjustment up to 30cm

9060100500

By 2 gas pressure springs up to 2x1200N (body weight < 100 kg)

Mechanical seat height adjustment up to 30cm

9060100510 € 754.00

By 4 gas pressure springs up to 4x900N (body weight > 100kg)

Armrests

Armrest with aluminium handle bar and release mechanism

release right 9060403040-001

release left 9060403040-002

Note: the release mechanism can be mounted only on the left OR on the right side!

Armrest pads, length 25cm

9060403340 € 126.90

Armrest pads, length 38 cm

9060403350 € 150.80

Handle extension for release mechanism with swing away handle

9060403440 € 134.20

Release mechanism, equipped with pressure plate

9060403450 € 244.40

power assist for the fingers (armrest pads not available)

Axle plates Standard equipment with 12mm Buchsen/Achsen

Standard Axle plate

9060201100

Sitzhöhe hinten ca. 45cm (bei 24" Rad)

Axle plate lowered

9060201120 € 199.70

Rear seat height approx. 42cm (for 24" wheel)

Extended axle plate

9060201110 € 223.60

Wheelbase extension by 7.5 cm

Wheel camber *Total width with tight-mounted handrim

1° drive wheel camber

9060202000

Total width = approx. SB + 20 cm

E-adoptions

Preparation for "e-motion" mounting

9060201200 € 275.60

Equipment: e-motion torque support, 1/2" axle and socket length 50.8 mm (2")

Preparation for "e-fix" mounting

9060201220 € 306.80

Equipment: 1/2" axle, socket length 50.8 mm (2") and e-fix torque support. According to the guide line of company Alber, the assembly of an additional safety switch is necessary. For that reason, we recommend the assembly of the e-fix by company Alber GmbH.

Wheelchair delivery to

Alber GmbH

specialist dealer

Page 6: LIFT - proactiv-gmbh.com · LIFT with mechanical seat height adjustment By the simple manual adjustment of the seat height, the desired working height can be achieved with the help

- 6 - 2017-09-19 / The prices are plus statutory value-added tax and shipping costs = Included in the basic price = Position selected Lift Rev. 05

Brake system

Brake system push to lock

9060701010

rear assembly position

Brake system push to lock low assembly position

9060701015 € 119.60

Brake holding rail mounted on the axle plate, straight brake lever version

NOTE: for the assembly of both brake systems a surcharge of 180.00 € will be levied!

Double brake system push to lock

9060701020 € 286.00

One brake in the rear assembly position and a 2nd brake in the low assembly position, fixed on the axle plate with a straight, long brake lever.

Footrest

Continuous footrest

9060601010

with tubular resting bracket height adjustable +/- 3 cm for KW 105° from USL 39 cm For equipment of the foot bracket with "Rubber coated footplate", please select under "Footrest accessories".

Footrest folding back to the rear with locking mechanism

9060602005 € 220.00

with tubular resting bracket minimum USL 40cm, only compatible for frame V-shape and only for frame size 3 . For equipment of the foot bracket with "Rubber coated footplate", please select under "Footrest accessories".

Footrest folding back to the rear

9060602010 € 235.80

for KW 105° from USL 42cm with V-shape from SB 38 cm For equipment of the foot bracket with "Rubber coated footplate", please select under "Footrest accessories".

Divided Footrest

9060603200 € 303.70

with rubber coated footplate, height adjustable +/- 3cm, angle adjustment, can be pivoted outwards and folded up to the side, including frame reinforcement with V-shape from SB 40cm

Divided Footrest with pivotable front end

9060618100 € 411.80

removable, height adjustable, with rubber plate (with straight front end only)

"Swing away" footrest

9060604100 € 366.10

with rubber coated footplate, separated in the middle, can be folded to the side, removable, can be folded up, height-adjustable, angle-adjustable including frame reinforcement from USL 34 cm

Footrest accessories Rubber coated footplate

9060610000 € 96.30

bolted, angle-adjustable Depth: 14cm In combination with tubular bracket Art.-no. 9061601010 or 9061602010!

Footplate side stop

9060610080 € 46.00

adjustable Only in combination with rubber coated footplate!

Adaptations

Anti-tipping support, removable

9060300100

adjustable with a quick-pin

Caster wheels Alle caster wheels (except pneumatic tyres) are puncture-proof!

4" Caster wheel "Standard" black

9000501011-004

(82A), puncture-proof

5" Caster wheel "Standard" grey

9000501010-005

(82A), puncture-proof

5" Caster wheel "Standard" black

9000501011-005

(82A), puncture-proof

5" Lenkrad "2 components"

9000501030 € 43.00 € 39,70

puncture-proof

3" Skate wheel (80 mm)

9000501110 € 54.20 € 50,10

puncture-proof

4" Skate wheel (100mm)

9000501120 € 54.20 € 50,10

puncture-proof

Page 7: LIFT - proactiv-gmbh.com · LIFT with mechanical seat height adjustment By the simple manual adjustment of the seat height, the desired working height can be achieved with the help

- 7 - 2017-09-19 / The prices are plus statutory value-added tax and shipping costs = Included in the basic price = Position selected Lift Rev. 05

Safety light-up wheel

4" (100mm) 9000501220

€ 92.10 € 85,20

puncture-proof Safety light-up wheel

5" (125mm) 9000501221

€ 92.10 € 85,20

puncture-proof

5" Aluminium rim 3-spoke design "easy running" with replaceable rubber race 3 mm, hard, puncture-proof

silver, anodised 9000501200 € 103.80 € 97,30

black 9000501201 € 103.80 € 97,30

5" Aluminium rim 3-spoke design "good shock absorption" with replaceable rubber race 6 mm, medium hard, puncture-proof

silver, anodised 9000501210 € 103.80 € 97,30

black 9000501211 € 103.80 € 97,30

Frog Legs-Caster wheel

4" (ø100x32) 9000501230

€ 137.30 € 122,00

5" (ø125x32) 9000501232

€ 137.30

with replaceable rubber race, black, puncture proof, 3-spokes, rim: silver

6“ Caster wheel on request after checking, only with V-shape front end

Caster fork Caster fork colours, see "Component colours"

Caster fork Standard

9000500100-001

with screwed axle

9000500100-002 € 130.40 € 120,90

with quick-release axle

Caster fork "Heavy duty" for high loads Extra weight approx. 100 - 150g

9000510111-001 € 43.40 € 40,10

with screwed axle

9000510111-002 € 176.00 € 161,00

with quick-release axle

Caster fork spare wheel

9000500300 € 228.30 € 209,20

with quick-release axle Article is without caster wheel. In case a caster wheel is requested, please put a cross on a second selection in the category Caster wheels

Track distance

Caster wheel track extension

13 mm per side 9060500400

€ 56.30

Drive wheels Information on further rim types, versions and availabilities under:

www.proactiv-gmbh.de

Drive wheel, 36 spoke aluminium rim

24“ (ETRTO 540) 9000203000

with aluminium front hub, spoked radially.

Drive wheel double rim 36 spokes

24“ (ETRTO 540) 9000203100

€ 126.90

25“ (ETRTO 559) 9000203200

€ 126.90

26“ (ETRTO 590) 9000203300

€ 126.90

with aluminium front hub, spoked radially Use with higher loads and body weight > 120 kg!

Spinergy running wheel "Spox Sport" with 24 PBO spokes; rim, hub and spokes in black

24“ (ETRTO 540) 9000203550

€ 561.40

25“ (ETRTO 559) 9000201559

€ 561.40

26“ (ETRTO 590) 9000203555

€ 561.40

Handrims

x = dimension handrim attachment!

Handrim : Curve Handrim attachment: attachment:

x = 11mm x = 10mm

x = 19mm x = 18mm

If no specification is given, the handrims will be mounted wide (19mm/18mm).

Ø 20 mm stainless steel handrims

for 24" and 25" wheel 9000205010-004

for 26" wheel 9000205010-006

Ø 19 mm aluminium handrims silver anodised

for 24" and 25" wheel 9000205019-004

Page 8: LIFT - proactiv-gmbh.com · LIFT with mechanical seat height adjustment By the simple manual adjustment of the seat height, the desired working height can be achieved with the help

- 8 - 2017-09-19 / The prices are plus statutory value-added tax and shipping costs = Included in the basic price = Position selected Lift Rev. 05

Ø 19 mm aluminium handrims powder coated in the frame colour (Basic colour in two-colour design)

= surface gloss

= surface matt

Please note: coating in matt is because of the minimal Grip not recommended.

for 24" and 25" wheel 9000205020-004

€ 51.90 € 48,00

for 26" wheel 9000205020-006

€ 51.90 € 48,00

Ø 19 mm aluminium handrims polished and hard-anodised

for 24" and 25" wheel 9000205030-004

€ 124.80

for 26" wheel 9000205030-006

€ 124.80

Ø 19 mm titanium handrims

for 24" and 25" wheel 9000205040-004

€ 257.90

for 26" wheel 9000205040-006

€ 257.90

Ultra-Grip handrims "very good grip"

for 24" and 25" wheel 9000205070-004

€ 316.40 € 292,20

for 26" wheel 9000205070-006

€ 316.40 € 292,20

Ergo-Grip handrims

for 24" and 25" wheel 9000205080-004

€ 316.40

for 26" wheel 9000205080-006

€ 316.40

Resting attachment to the rim!

Dual-Grip handrims

for 24" and 25" wheel 9000205110-004

€ 178.90

for 26" wheel 9000205110-006

€ 178.90

Silicone handrim covers

for 24" hand rim 9000205100-004

€ 187.10 € 173,00

for 26" hand rim 9000205100-006

€ 187.10 € 173,00

Surface without structure, compatible with handrim Ø 19mm or Ø 20mm.

Curve handrim, black anodised, ergonomic handrim profile

for 24" and 25" wheel H 24mm 9000205130-004

€ 309.90

for 24" and 25" wheel H 31mm Size L 9000205140-004

€ 309.90

for 26" wheel H 31mm Size L 9000205140-006

€ 309.90

Curve handrim powder coated, ergonomic handrim profile

= frame colour (surface gloss)

= black (surface gloss)

Please note: coating in matt is because of the minimal Grip not recommended.

for 24" and 25" wheel H 24mm 9000205135-004

€ 359.80

for 24" and 25" wheel H 31mm Size L 9000205145-004

€ 359.80

for 26" wheel H 31mm Size L 9000205145-006

€ 359.80

Curve Grip handrim, Tetra-Grip coated, ergonomic handrim profile

for 24" and 25" wheel H 31mm Size L 9000205150-004

€ 395.20

Quadro handrims, Tetra-Grip "very good grip"

for 24" and 25" wheel 9000205170-004

€ 395.20

for 26" wheel 9000205170-006

€ 395.20

Gekko handrims

for 24" and 25" wheel 9000205175-004

€ 395.20

for 26" wheel 9000205175-006

€ 395.20

black anodised with strong and exchangeable rubber completely integrated in the handrim profile

Equipment without handrims

9000205990

Spoke guard

Finger- and spoke guard "transparent"

for 24" wheel 9000206300-004

€ 158.60 € 146,40

for 26" wheel 9000206300-006

€ 158.60 € 146,40

Design and spoke protection film "basket"

9000206310-001 € 110.80 € 102,40

Only in combination with finger and spoke protection!

Page 9: LIFT - proactiv-gmbh.com · LIFT with mechanical seat height adjustment By the simple manual adjustment of the seat height, the desired working height can be achieved with the help

- 9 - 2017-09-19 / The prices are plus statutory value-added tax and shipping costs = Included in the basic price = Position selected Lift Rev. 05

Design and spoke protection film "silly-bubble"

9000206310-002 € 110.80 € 102,40

Only in combination with finger and spoke protection!

Design and spoke protection film "blue-sky"

9000206310-003 € 110.80 € 102,40

Only in combination with finger and spoke protection!

Design and spoke protection film "colour-stones"

9000206310-004 € 110.80 € 102,40

Only in combination with finger and spoke protection!

Tyres

Schwalbe "RightRun" High-pressure tyre 7.5 bar

24x1“ (540-25) 9000204000-004

25x1“ (559-25) 9000204000-005

26x1“ (590-25) 9000204000-006

Schwalbe "DownTown" Tread tyre 7.5 bar

24x1“ (540-25) 9000204010-004

Schwalbe "MarathonPlus Evolution" with "smart guard" puncture protection

24x1“ (540-25) 9000204030-014 € 35.50

25x1“ (559-25) 9000204030-015 € 35.50

26x1“ (590-25) 9000204030-016

€ 35.50

Colour: black 10 bar

Schwalbe "MarathonPlus" with "smart guard" puncture protection

24x1“ (540-25) 9000204030-004

€ 35.50

Colour: grey, black wall, 10 bar

Schwalbe "Airborne"

24x1,2“ (540-20) 9000204122-004 € 70.70

Colour: black

Puncture-proof tyre "solid-rubber tyres"

24x1“ (540-25) 9000204201-004

€ 126.70 € 117,10

Not in combination with the 18 spoke drive wheel!

Puncture protection belt for pneumatic tyres

9000206100 € 42.80 € 39,40

Accessories

Lockable drive wheel axle clip "Tetra Clip"

9000206400 € 127.40 € 117,90

Not for Spinergy drive wheels!

Hand air compressor with pressure gauge up to 14 bar

9000901100 € 85.50 € 79,00

Adjustable safety belt with belt buckle

9000902100 € 61.90 € 57,00

Adjustable safety belt with hook and loop fastener

9000902110 € 49.30 € 45,40

Crutch holder with nylon cup

9000902310 € 110.40 € 101,10

flexibel

Light set

9000903270 € 82.70 € 76,50

with battery and charger

Transport bag for drive wheels

for 24" wheel 9000903530-004 Ø76cmx2cm

€ 59.50 € 54,60

for 26" wheel 9000903530-006 Ø83cmx2cm

€ 59.50 € 54,60

Accessory bag

9000903600 € 58.20 € 53,80

17cm x 13cm x 5cm

More accessories, see

www.proactiv-gmbh.de

Page 10: LIFT - proactiv-gmbh.com · LIFT with mechanical seat height adjustment By the simple manual adjustment of the seat height, the desired working height can be achieved with the help

- 10 - 2017-09-19 / The prices are plus statutory value-added tax and shipping costs = Included in the basic price = Position selected Lift Rev. 05

Your additional notes:

I herewith confirm the details listed above

____________________________________________________

Location, Date Signature (End customer)

____________________________________________________

Location, Date Signature (Dealer)