This form must be opened in Adobe Acrobat. The Submit Form button will not work from most browser windows. Canada Company: Account Number: Date: q Quote q PO Number: RTS: Ship To: Address: City: State: Zip: Phone: Marked For: Email/Fax: Select if chair quote has: q Additional Ki Products with Different Quote/Order Number Quote/Order Number: Ethos $4395 Effective 03/25/2019 Ethos Standard Frame. 275 lb weight capacity. Frame Seat Width / Seat Depth Select box corresponding to desired Seat Width and Depth. See references A and B on page 9. Seat Depth Seat Width 12 13 14 15 16 17 18 19 20 Price N/C N/C N/C N/C N/C N/C N/C N/C $275 14 N/C q q q q q q q q q 15 N/C q q q q q q q q q 16 N/C q q q q q q q q q 17 N/C q q q q q q q q q 18 N/C q q q q q q q q q 19 N/C q q q q q q q q q 20 $275 q q q q q q q q q Transit Option Cannot be retrofitted q Transit System $399 Sling Position In Performance Position (0 ), sling is at front of frame. The 1 or 2 sling position extends the frame in front of the sling by that amount. See reference C on page 9. q 0 (Performance) N/C q 1 N/C q 2 (Classic) N/C Adjustable Depth Adds the capability to grow seat in depth q No Rear Adjustment N/C q 1/2 N/C q 1 $165 q 1 1/2 $165 q 2 $165 Seat Pan q Solid Seat Pan $265 Front Frame Bend Angle between front seat tube and ground. See reference D on page 9. q 90º $185 q 85º N/C q 80º N/C q 75º N/C q 70º N/C Polymer Setup Setup determines characteristics of ride experience. For more information visit www.kimobility.com. If no selection is made Standard Setup will be used. Setup by Ki Std A series of intelligent calculations using data below and chair configuration to determine optimal polymer setup based on desired ride experience User Weight Range (lbs) q 120 or less q 121-165 q 166-209 q 210-275 Ride Experience q Firmer q Softer q Standard Setup N/C Polymer configuration calculated by using chair size and CG setup. No additional information required. q Custom Setup N/C Select from chart below Polymer Gauge and Recommended Max Weight Capacity Ultra Soft Soft Mid Rigid (<120 lbs) (<150 lbs) (<250 lbs) (<275 lbs) Front ISO Tower q q q q Rear ISO Tower q q q q DCN0387.0 Pricing and specifications subject to change without notice Page 1 of 10
Backrest Back Post / Height Range / Back Height Select Back Height in row corresponding to desired Back Post and Height Range. Back Post Price Height Range Back Height Height Adjustable N/C Short q 11 2 q 12 q 13 q 14 Medium q 13 q 14 q 15 q 16 q 17 Tall q 17 q 18 q 19 q 20 q 9 2 q 10 2 q 11 2 q 12 q 13 q 14 q 15 q 16 q 17 q 18 Fixed Height 1 N/C 1 Not available with back upholstery 2 Not available with Fold Down Push Handle Push Handle q Omit Push Handle N/C q Standard Push Handle N/C q Low Profile Push Handle $55 2 shorter than standard push handles q Fold Down Push Handle $145 q Bolt-On Push Handle $170 Handles will be 1-2 above back height Stroller Handle Stroller Handles are removable and height adjustable q Single Stroller Handle $206 q Double Stroller Handle $395 Not available with Push Handles Rigidizer Bar q Adjustable Height Rigidizer Bar $94 Seat Back Angle Standard is 90º (perpendicular to floor). Minus (-º) closes back angle. Plus (+º) opens back angle. q Standard q +3º q +6º q +9º q -3º q -6º q -9º q -12º Back Upholstery Padded Velcro Adjustable q Standard Cover Std q Air Mesh Breathable Cover $75 Tension Adjustable q Standard Cover $385 q Air Mesh Breathable Cover $450 q Omit Back Upholstery -$10 DCN0387.0 Pricing and specifications subject to change without notice Page 2 of 10
Front Seat Height and Casters Caster Size / Footrest Taper / Front Seat Height Select Front Seat Height in row corresponding to Footrest Taper and Caster Size. 6 casters not available with 85º and 90º Front Frame Bend. Footrest Taper indicates bend of front frame creating footrest width. 2 Taper not available with seat widths less than 16. V-Front not available with seat widths less than 14. V-Front results in 4 reduction from seat width to footrest width. Taper is measured from outside of seat frame to outside of front tube. See reference E on page 9. Front Seat Height is measured from floor to top of seat tube at front of seat sling. Minimum adjustment is +/- 1/2. See reference F on page 9. Footrest Taper Straight Price Caster Size N/C Front Seat Height 3 q13.5 q 14 q14.5 q 15 q15.5 q 16 q16.5 q 17 q17.5 q 18 q18.5 q 19 q19.5 q 20 q20.5 4 q 14 q14.5 q 15 q15.5 q 16 q16.5 q 17 q17.5 q 18 q18.5 q 19 q19.5 q 20 q20.5 5 q14.5 q 15 q15.5 q 16 q16.5 q 17 q17.5 q 18 q18.5 q 19 q19.5 q 20 q20.5 6 q 15 q15.5 q 16 q16.5 q 17 q17.5 q 18 q18.5 q 19 q19.5 q 20 q20.5 1 Taper N/C 2 Taper N/C V-Front $295 3 q16.5 q 17 q17.5 q 18 q18.5 q 19 q19.5 q 20 q20.5 4 q 17 q17.5 q 18 q18.5 q 19 q19.5 q 20 q20.5 5 q17.5 q 18 q18.5 q 19 q19.5 q 20 q20.5 6 q 18 q18.5 q 19 q19.5 q 20 q20.5 3 q16.5 q 17 q17.5 q 18 q18.5 q 19 q19.5 q 20 q20.5 4 q 17 q17.5 q 18 q18.5 q 19 q19.5 q 20 q20.5 5 q17.5 q 18 q18.5 q 19 q19.5 q 20 q20.5 6 q 18 q18.5 q 19 q19.5 q 20 q20.5 3 q16.5 q 17 q17.5 q 18 q18.5 q 19 q19.5 q 20 q20.5 4 q 17 q17.5 q 18 q18.5 q 19 q19.5 q 20 q20.5 5 q17.5 q 18 q18.5 q 19 q19.5 q 20 q20.5 6 q 18 q18.5 q 19 q19.5 q 20 q20.5 Caster Type q.75 Rollerblade N/C Available only with 3 and 4 Caster Sizes q.75 Lighted Rollerblade $85 Available only with 3 and 4 Caster Sizes q 1 Poly N/C Not available with 3 Caster Size q 1 Poly Aluminum $120 Available only with 4 and 5 Caster Sizes q 1 Pneumatic $120 Available only with 6 Caster Size q 1.5 Poly $85 Not available with 3 Caster Size q 1.5 Soft Roll Aluminum $190 Caster Position q Optimized Std Caster placement relative to seat frame has been set to maximize adjustability and minimize the footprint of the chair q Expanded Width N/C Caster arm is positioned approximately.75 wider than Optimized position Fork Options q Standard Fork Std q Single Sided Fork $156 q Frog Legs Ultra-Sport Fork - Black $545 Not included in Colored Anodizing Package End User Weight Required: lbs q Frog Legs PHASE 2 Carbon Fork $545 Lightweight shock absorbing fork. Not included in Colored Anodizing Package. DCN0387.0 Pricing and specifications subject to change without notice Page 3 of 10
Footrest Footplate q Tubular Open Footplate Std Not available with V-Front Taper q Tubular Footplate with ABS Cover $38 Not available with V-Front Taper or footrest widths greater than 15.5. See Reference G on page 9. q Aluminum Angle Adjustable $95 Not available with V-Front Taper q Hybrid Angle Adjustable $95 q Hybrid Angle Adjustable with Wings $125 Raised sides aid in foot positioning q Angle Adjustable Flip Under $230 Not available with V-Front Taper or footrest widths less than 9.5. See Reference G on page 9. Rear Seat Height and Wheels Seat to Footrest Length Measured from front edge of seat sling to top, rear of footrest. Footrest length at least 2.5 shorter than Front Seat Height recommended. See reference H on page 9. Taper Seat to Footrest Length q 9 q 9.5 q 10 q10.5 q 11 q11.5 Straight q 12 q12.5 q 13 q13.5 q 14 q14.5 and V-Front q 15 q15.5 q 16 q16.5 q 17 q17.5 q 18 q18.5 q 19 q19.5 1 Taper and 2 Taper q13.5 q 14 q14.5 q 15 q15.5 q 16 q16.5 q 17 q17.5 q 18 q18.5 q 19 q19.5 Footrest Protector q Footrest Protector N/C Not available with Angle Adjustable Flip Under Footplate Wheel Size / Rear Seat Height Select Rear Seat Height in row corresponding to desired Wheel Size. For proper setup, selection is required when omitting rear wheels. Measured from floor to top of seat tube at front of back post. Rear Seat Height is custom to needs. See reference I on page 9. Wheel Size Rear Seat Height 22 q 13.5 q 14 q 14.5 q 15 q 15.5 q 16 q 16.5 q 17 q 17.5 q 18 q 18.5 q 19 q 19.5 q 20 24 q 14.5 q 15 q 15.5 q 16 q 16.5 q 17 q 17.5 q 18 q 18.5 q 19 q 19.5 q 20 25 q 14.5 q 15 q 15.5 q 16 q 16.5 q 17 q 17.5 q 18 q 18.5 q 19 q 19.5 q 20 26 q 15.5 q 16 q 16.5 q 17 q 17.5 q 18 q 18.5 q 19 q 19.5 q 20 Rear Wheel Type q MAXX Performance Spoke N/C Not available in 25 or 26 wheel sizes q Spoke N/C q Mag N/C Not available in 25 or 26 wheel sizes q Superlight Spoke $305 Available only in 24 and 25 wheel sizes. 25 wheel size available only with Superlight and Plastic Coated Handrims. Spinergy Spox $820 Color: q Black q Red q White q Blue q Yellow Handrim: q Short Tab q Long Tab Available only with Aluminum Anodized and Plastic Coated Handrims Spinergy LX $1025 Color: q Black q Red q White q Blue q Yellow q Pink q Green q Orange q Purple Handrim: q Short Tab q Long Tab Available only with Aluminum Anodized and Plastic Coated Handrims q Omit Rear Wheel and Tire -$45 No axles will be provided Rear Tire Type Full Profile q Street Pneumatic 1 3/8 Std Not available on 25 wheel size q Full Poly 1 3/8 N/C Not available on Superlight wheel or 25 or 26 wheel sizes q Pneumatic with Airless Insert 1 3/8 $200 Not available on Superlight wheel or 25 wheel size q Schwalbe HS-127 1 3/8 $119 Available only on 24 wheel size. Not available on Mag wheel. q Euro Trek Knobby 1 3/8 $119 Available only on 24 wheel size q Mountain 2 Black $119 Available only on 22, 24 and 25 Spoke and Spinergy wheels Low Profile q Low Poly 1 N/C Not available on Superlight wheel, 25 or 26 wheel sizes q Sentinel Solid Tire 1 $120 Not available on Superlight wheel or 22 Mag wheel q High Pressure 1 $100 Not available on Mag wheel q Schwalbe One 1 $135 Available only on 24 and 25 wheel sizes. Not available on Mag wheel. q Schwalbe Marathon Plus Evolution 1 $145 Not available on Mag wheel or 22 wheel size DCN0387.0 Pricing and specifications subject to change without notice Page 4 of 10
Rear Seat Height and Wheels continued Handrim Standard Handrims q Aluminum Anodized Std q Superlight Aluminum Anodized $63 Available only on 24 and 25 wheel sizes. Available only on MAXX Performance, Superlight or Spinergy wheels. q Plastic Coated $129 q Projection (8 Vertical Projections) $395 Available only with full profile tires in combination with MAXX Performance, Spoke, or 24 Mag wheel q Spinergy Flex Rim $795 Available only on 24 and 25 Spinergy LX wheels q Omit Handrim N/C Natural Fit Handrims Not available on 22 Mag wheel. Not recommended with Mag wheel. q Natural Fit LT Regular Grip $445 q Natural Fit Standard Regular Grip $445 q Natural Fit LT Super Grip $495 q Natural Fit Standard Super Grip $495 q Natural Fit LT Omit Grip $375 q Natural Fit Standard Omit Grip $375 Handrim Option q 3M Micro Grip $81 Not available on Plastic Coated or Projection Handrims Axle q Quick Release Std q Quad Quick Release $219 Not available with Mag or Spinergy wheels Wheel Locks Wheel Lock q Push to Lock Std q Push to Lock Flush Mount N/C Not available with Mountain tires q Pull to Lock Std q Low Profile Scissor Lock $25 Not available with Low Poly, Full Poly or Sentinel Solid tires q Short Thro Scissor Lock $133 q Omit Wheel Locks N/C Rear Wheel Camber q 0º q 2º q 4º q 6º q 8º Rear Wheel Spacing Measured from outside of back to inside of rear tire. 1.75 minimum Rear Wheel Spacing with Height Adjustable Armrests. 1 minimum Rear Wheel Spacing with side guards. See reference K on page 9. q.75 q 1 q 1.25 q 1.5 q 1.75 Center of Gravity Setup Measured from front of back post to center of rear axle. 0 indicates axle will be directly under back post. See reference J on page 9. Amputee Positions q -1.5 q -1.25 q -1 q -.75 q -.5 q -.25 Standard Positions q 0 q.25 q.5 q.75 q 1 q 1.25 q 1.5 q 1.75 q 2 q 2.25 q 2.5 q 2.75 q 3 q 3.25 q 3.5 q 3.75 q 4 q 4.25 q Other CG Range N/C If this option is not selected, then the default range in chart below will be used. If this option is selected, then see the Center of Gravity matrix on page 8. Not available with amputee positions. Default Center of Gravity Range CG Preset Default Range 0 to 1.5 +3 to -1 1.75 to 3 +2 to -2 3.25 to 4.25 +1 to -3 Wheel Lock Options q Extension Handles $70 Available only with Push to Lock or Pull to Lock Wheel Locks q Grade Aids $187 Available only with Push to Lock Wheel Locks and Pneumatic or Pneumatic with Airless Insert tires DCN0387.0 Pricing and specifications subject to change without notice Page 5 of 10
Armrests Armrest Please select Arm Pad option q Height Adjustable T-Arm (8.5-13.5 ) $365 Arm Pad Not available with Swing Away Armrests q Desk q Full Side Guards Not available with Height Adjustable T-Arm or Swing Away with Side Guard Armrests Armrest continued Swing Away Not available with Arm Pads. Certain configurations may dictate selection. q Short (8.5-10.5 ) $215 q Tall (10.5-12.5 ) $215 Swing Away with Side Guard Includes Composite Side Guards. Not available with Arm Pads. Certain configurations may dictate selection. q Short (8.5-10.5 ) $375 q Tall (10.5-12.5 ) $375 q Omit Armrests N/C Clamp-On Mount q Composite Side Guards $150 Aluminum Straight q Black Matte $355 q Match Seat Frame Color $405 Not available with Hydrographics q Match Base Frame Color $405 Aluminum Adjustable Fender q Black Matte $385 q Match Seat Frame Color $435 Not available with Hydrographics q Match Base Frame Color $435 q Carbon Fiber Adjustable Fender $595 Accessories Anti-Tip q Rear Anti-Tips $110 User Activated q Pair $450 q Single - Left $225 q Single - Right $225 Calf Strap Mounting hardware included with Calf Straps q Velcro Adjustable $50 q Padded Velcro Adjustable $85 q Bodypoint Padded AeroMesh $123 q Calf Strap Mounting Hardware (Extra) $35 Fabric Side Guard Not available when omitting Back Upholstery q Fabric Side Guards $85 Belt Mounting Kit q Ki Mobility Belt Mounting Clamp $50 Other Accessories q Tool Kit $60 q Removable Underseat Pouch $75 q Ki Mobility Backpack $90 q Luggage Carrier $120 q Under Chair Carrier and Removable Bag $85 Not available with Seat Widths less than 14 q Clear Spoke Guards $144 Not available with Mag wheel q Black Spoke Guards $144 Not available with Mag wheel Positioning Belt q 1 1/2 Auto Buckle $80 q 1 1/2 Padded Auto Buckle $170 q 1 Auto Buckle $80 q 1 Padded Auto Buckle $170 q 2 Airline Buckle $150 Bodypoint Evoflex - Pelvic Stabilizer $219 Size: q Small (16-24 ) q Medium (19-29 ) q Large (25-37 ) DCN0387.0 Pricing and specifications subject to change without notice Page 6 of 10
Color Paint Options If there is no color preference Black is recommended Gloss Colors Matte Options Price Black Blue Skies Bubblegum Pink Candy Blue Candy Purple Candy Red Copper Granny Smith Metallic Fuchsia Metallic Orange Silver Teal Yellow Army Green Charcoal Gray Emerald Green Iridescent Burgundy Iridescent Navy Retro Red Royal Blue Shadow Black Smooth White Hydrographics 1 $795 Visit www.kimobility.com for current Hydrographic options. Note selection below. Seat Frame N/C q q q q q q q q q q q q q q q q q q q q q q Color: Base Frame 2 N/C q q q q q q q q q q q q q q q q q q q q q q Backrest Release Bar 1 Not available with Transit Option 2 Not available with Hydrographics Std q Black Anodized $35 q Paint to Match Seat Frame $35 q Paint to Match Base Frame $60 q Paint Other Color Select option below q q q q q q q q q q q q q q q q q q q q q q Additional Color Options If no selection is made, black will be used Options Highlights Discreet color highlights. See image below for parts included. Colored Anodizing Back Plate 1 Caster Fork 2 Side Guard Receiver Camber Tube 1 Not available with Transit Option 2 Available only with Standard or Single Sided Price N/C Black: N/C Color: $100 Black: N/C Color: $100 Black: N/C Color: $100 Black: N/C Color: $100 Colors Black Blue Gray Green Orange Pink Purple Red Yellow Black Blue Bright Green Gold Orange Pewter Pink Purple Red q q q q q q q q q C q q q q q q q q q q q q q q q q q q q q q q q q q q q q q q q q q q q q A C B Color Reference A Seat Frame B Base Frame C Highlights C DCN0387.0 Pricing and specifications subject to change without notice Page 7 of 10
References Center of Gravity Preset Selection required if Other CG Range is selected on page 5. Available setup options are shown in white boxes. Measured from front of back post to center of rear axle. 0 indicates axle will be directly under back post. See reference J on page 9. Depth 14 15 16 /17 / 18 19 /20 Range Center of Gravity Standard Position Setup 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2 2.25 2.5 2.75 3 3.25 3.5 3.75 4 4.25 +1 to -3 q q q q q q +2 to -2 q q q q q +3 to -1 q q q q q q +4 to 0 q +1 to -3 q q q q q q q q q +2 to -2 q q q q q q q q +3 to -1 q q q q q q q +4 to 0 q q q q q +1 to -3 q q q q q q q q q +2 to -2 q q q q q q q q q +3 to -1 q q q q q q q q q q +4 to 0 q q q q q q q +1 to -3 q q q q q q q q q +2 to -2 q q q q q q q q q q q +3 to -1 q q q q q q q q q q q +4 to 0 q q q q q q q q q - + CG Adjustment DCN0387.0 Pricing and specifications subject to change without notice Page 8 of 10
References continued A. Seat Width See Diagram 1 Measured from outside of frame tube on one side to outside of frame tube on other side. B. Seat Depth See Diagram 3 Measured from front of back posts to front edge of seat sling. Seat sling starts at beginning of bend at front of frame. Diagram 1 K A C. Sling Position See Diagram 2 In Performance Position (0 ), sling is at front of frame to keep chair shorter and more maneuverable. The 1 or 2 seat sling position extends the frame in front of the sling by that amount. Adding more frame can improve stability and provide support to aid in transfers. D. Front Frame Bend See Diagram 3 Angle between front seat tube and ground. F G E E. Footrest Taper See Diagram 1 Indicates bend of front frame creating footrest. Taper is measured from outside of seat frame to outside of front tube. F. Front Seat Height See Diagram 1 Measured from floor to top of seat tube at front of seat sling. G. Footrest Width See Diagram 1 Measured from inside of front tube to inside of front tube on other side. Footrest width is listed below for each seat width and taper. Seat Width Straight 1 Taper 2 Taper V-Front Outside Measurement 2 Narrower than Seat Width 4 Narrower than Seat Width 6 Narrower than Seat Width 4 Narrower than Seat Width Diagram 2 Classic Performance C 12 9.5 7.5 13 10.5 8.5 14 11.5 9.5 9.5 15 12.5 10.5 10.5 16 13.5 11.5 9.5 11.5 17 14.5 12.5 10.5 12.5 18 15.5 13.5 11.5 13.5 19 16.5 14.5 12.5 14.5 20 17.5 15.5 13.5 15.5 H. Seat to Footrest Length See Diagram 3 Measured from front edge of seat sling to top rear of footrest. Footrest length of at least 2.5 shorter than front seat height recommended. Diagram 3 B I. Rear Seat Height See Diagram 3 Measured from floor to top of seat tube at front of back post. J. Center of Gravity Preset See Diagram 3 Measured from front of back post to center of rear axle. 0 indicates axle will be directly under back post. I J H K. Rear Wheel Spacing See Diagram 1 Measured from outside of seat back to inside of rear tire. Adjustable from.75 to 1.75. D DCN0387.0 Pricing and specifications subject to change without notice Page 9 of 10
Axiom G, S and P Cushions Select size in chart at right. Weight capacity: 350 lbs. Cushions Under 22 Wide q Axiom G SE0001389 $195 q Axiom S SE0001393 $270 q Axiom P SE0001391 $575 22 Wide Cushions q Axiom G SE0001390 $275 q Axiom S SE0001394 $400 q Axiom P SE0001392 $695 Axiom G, S or P Cushion Quantity: q 1 q 2 If no selection is made, quantity 1 will be selected Depth Width 14 15 16 17 18 19 20 21 22 14 q 15 q q q 16 q q q q q q q 17 q q q q q q 18 q q q q q q q 19 q q q 20 q q q q q Cushions Under 22 Wide with Extra Outer Cover q Axiom G Cushion with Extra Outer Cover SE0001389 $290 q Axiom S Cushion with Extra Outer Cover SE0001393 $365 q Axiom P Cushion with Extra Outer Cover SE0001391 $670 Axiom G, S or P Cushion w/extra Outer Cover Quantity: q 1 q 2 If no selection is made, quantity 1 will be selected Axiom SP Cushions Select size in chart at right. Weight capacity: 350 lbs. Cushions Under 21 Wide q Axiom SP - Visco SE0001397 $640 q Axiom SP - Fluid SE0001395 $695 21 and 22 Wide Cushions q Axiom SP - Visco SE0001398 $775 q Axiom SP - Fluid SE0001396 $830 Axiom SP Cushion Quantity: q 1 q 2 If no selection is made, quantity 1 will be selected Cushions Under 21 Wide with Extra Outer Cover q Axiom SP - Visco Cushion w/extra Outer Cover SE0001389 _ $774 q Axiom SP - Fluid Cushion w/extra Outer Cover SE0001393 _ $829 22 Wide Cushions with Cover q Axiom G Cushion with Extra Outer Cover SE0001390 $370 q Axiom S Cushion with Extra Outer Cover SE0001394 $495 q Axiom P Cushion with Extra Outer Cover SE0001392 $790 Depth Width 14 15 16 17 18 19 20 21 22 14 q q q 15 q q q q q 16 q q q q q q q q 17 q q q q q q q q 18 q q q q q q q q q 19 q q q q q q q q 20 q q q q q q q q Cushions Under 21 Wide with Extra Inner Cover q Axiom SP - Visco Cushion w/extra Inner Cover SE0001389 _ $774 q Axiom SP - Fluid Cushion w/extra Inner Cover SE0001393 $829 21 and 22 Wide Cushions with Extra Outer Cover 21 and 22 Wide Cushions with Extra Inner Cover q Axiom SP - Visco Cushion w/extra Outer Cover SE0001390 _ $909 q Axiom SP - Fluid Cushion w/extra Outer Cover SE0001394 _ $964 q Axiom SP - Visco Cushion w/extra Inner Cover SE0001390 _ $909 q Axiom SP - Fluid Cushion w/extra Inner Cover SE0001394 $964 Axiom SP Cushion w/extra Outer Cover Quantity: q 1 q 2 If no selection is made, quantity 1 will be selected Axiom SP Cushion w/extra Inner Cover Quantity: q 1 q 2 If no selection is made, quantity 1 will be selected DCN0387.0 Pricing and specifications subject to change without notice Page 10 of 10