Kimba Neo. with MPS Seating. Order Form. Order Quote Only. Account Information. Ship To
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1 Account Information Date Bill To Account Number Kimba Neo with MPS Seating Order Form Phone Number Fax Number Effective Date 2/1/16 Address Buyer P.O. Number Physician/Therapist Ship To Name All specifications and pricing are subject to change without notice Ottobock HealthCare LP _1R 2/1/16 Address City State/Zip Code Phone Number Please complete this form and return to Rehabmart by fax OR . Order Quote Only Notes: Kimba Neo Mobility Base Includes: Foot-operated positive wheel locks Knob operated tilt-in-space Tension shock absorption Adjustable easy-to-use folding levers Powder coated scratch resistant frame Under-seat storage bag Ergonomic height-adjustable pushbar Page 1/5
2 I. Mobility Base Kimba Neo Mobility Base (choose one) Kimba Neo frame Size 1, Silver 470G71= $2,201 E1234 Size 1, Black 470G71= $2,201 E1234 Size 2, Silver 470G71= $2,201 E1234 Size 2, Black 470G71= $2,201 E1234 Size 2 Kimba 470G71= $2,201 E1234 base with size 1 seat adapter, Silver Size 2 Kimba 470G71= $2,201 E1234 base with size 1 seat adapter, Black Size 2 Seat 471A71=SK175 $425 adapter for size 2 base retrofit Transit Option r3 Fits Size 1 or 2 471X00=ST007 $51 II. Additional Mobility Bases Home Underframe- Multi-use therapy base (dark grey) Size 1 HR $1,181 Size 2 HR $1,181 Leckey Hi/Lo Size 1 415A89=SK030 $1,636 Size 2 415A88=SK030 $1,636 Adapter 415C88=SK110 $188 Twin Tandem- accommodates 2, seating units (silver) Size 1 HR $2,714 Cross- outdoor mobility base (silver) Kimba Cross base HR $2,660 Note: Requires size 1 or size 2 seat adapter Size 1 seat adapter HR $200 Size 2 seat adapter HR $200 Cycle Trailer* HR $400 Swivel Caster Wheel (12") HR $287 Storage Bag HR $105 III. Seating System Upholstery Options Kimba Adjustable Seating System Includes: Height and angle adjustable armrests Height adjustable backrest Articulating, elevating legrest Contoured seat with medial knee support and incontinent resistant foam Depth adjustable seat with width adjustable hip guides Height adjustable footplate with dorsi/plantar flexion adjustment Free Basic Canopy 471S71=SK505 $N/C K0108 Black Sun/Rain Canopy, 471S71=SK054 $403 K0108 Complete, black/pink Sun/Rain Canopy, 471S71=SK056 $403 K0108 Complete, black/blue Sun/Rain Canopy, 471S71=SK301 $403 K0108 Complete, grey/black * Must be ordered when ordering a size 2 Kimba Mobility Base with a Size 1 seating system. Cannot be used with Home Underframe, Spider, Twin Tandem or Cross Mobility Bases. ** Select color option Kimba MPS Seating System: Seat and Back must be ordered together, in same size and upholstery color. Seat and Back are an integrated seating system. Size 1 Seat PS10=SB-344 $840 E2294 Seat for 5 Pt Harness PS10=SH-344 $840 E2294 Back, fixed PS10=RB-* $840 E2293 Back, reclining, must PS10=RC-* $840 E2293 be ordered with the PS00A=BR Reclining mechanism** PS00A=BR $492 E1014 Size 2 Seat PS20=SB-344 $865 E2294 Seat for 5 Pt Harness PS20=SH-344 $865 E2294 Back, fixed PS20=RB-* $865 E2293 Back, reclining, must PS20=RC-* $865 E2293 be ordered with the PS00A=BR Reclining mechanism** PS00A=BR $492 E1014 **Must be installed by manufacturer Page 2/5
3 IV. Postural Supports All postural supports will be selected to match upholstery chosen in Section II. Headrest and Adjustable Hardware Note: Attachment hardware (481A00=1515) must be ordered with all headrests Contoured headrest, Size 1 PS00A=H1-* $287 E0955 Contoured headrest, Size 2 PS00A=H2-* $287 E Fixed wing headrest, Size 1 PS00A=HW-* $368 E Fixed wing headrest, Size 2 PS00A=HW2-* $384 E0955 Adjustable winged headrest, Size 1 PS00A=HA-* $474 E0955 Adjustable winged headrest, Size 2 PS00A=HA2-* $474 E0955 Attachment hardware, removable, piece 481A00=1515 $119 Padded Adjustable Lateral Supports Laterals, fixed angle (per pair)* Size 1 PS10A=L-* $253 E0956x2 Size 2 PS20A=L-* $253 E0956x2 Curved Swing-Away Laterals (per pair)* (grey only) Note: Curved laterals must be ordered with Attachment Hardware 481A00=1516 Size 1 or 2 PS00A=LS-344 $265 E0956x2 Attachment hardware, swing-away 481A00=1516 $237 x2 Positioning Belts, Padded Adjustable Pelvic Positioning Belt * (grey) Size 1 PS00A=PB $71 E0978 Size 2 PS00A=PB $71 E0978 Anterior Trunk Support Note: must select seat compatible with harness PS10(20)=SH Point Harness 471P71=SK505 $275 E0960 Retrofit Kits (converts current MPS seat to 5 point compatible seat; includes 5 point harness, seat cushion, seat pan) 5-Point Harness, size 1 471P71=SK501 $550 K Point Harness, size 2 471P71=SK502 $600 K0108 Butterfly Harness with Snap Closure* (grey) Fits Size 1 or 2 PS00A=BH-344 $142 E0960 Armrest Pads*** (grey) (per pair) Note: Must be removed to install positioning tray Fits Size 1 or 2 PS00A=AR-344 $79 K0019x2 Elbow Pads (4" X 4") (grey) (per pair) Note: Must be installed on positioning tray Fits Size 1 or 2 PS00A=P-344 $228 E0191x2 Abduction Block** (grey) Size 1 PS10A=A-344 $170 E0957 Size 2 PS20A=A-344 $170 E0957 Undercut Seat (for tight hamstrings) Size 1 PS10A=SUC $120 K0108 Size 2 PS20A=SUC $120 K0108 Footrest r3 Angle Adj. Footrest 481A00=1914 $51 K0040 Footplate Buildup (3") (grey) Fits Size 1 or 2 PS00A=RB3 $132 K0108 Footplate Buildup Padding (1") Fits Size 1 or 2 PS00A=RBP-344 $120 K0108 Shoe Holders with Straps Size 1 PS00A=FH1 $197 K0108 Size 2 PS00A=FH3 $197 K0108 Velcro Footstraps (per pair) Fits Size 1 or 2 PS00A=FS $47 E0951x2 * Accessories installed by Ottobock. Positioning Tray Height/angle adjustable Solid Size 1 PS10A=TS $326 E0950 Solid Size 2 PS20A=TS $339 E0950 Clear Size 1 PS10A=TC $326 E0950 Clear Size 2 PS20A=TC $339 E0950 Page 3/5
4 Vent Trays and Other Medical Needs Accessories 471A71=SK029 K0108 Tip assist (get up curbs easier, sold individually) $98 471S71=ST050 K0108 Medical Necessities Storage bag, brown $ S71=ST052 K0108 Medical Necessities Storage bag, black $ S64=ST005 K0108 Medical Necessities Backpack, attaches to the push bar $78 471C49=NT-KN-O2H E2208 O2 Tank Holder side mount $ C49=NT-KN-IVP48 E0776 I.V. Pole (for enteral formulas etc) $ S71=SK060 E1029 Horizontal vent tray for miscellaneous medical equipment, for Kimba Neo size 1 $ S71=SK160 E1029 Horizontal vent tray for miscellaneous medical equipment, for Kimba Neo size 2 $ C49=NT-KNAT Undercarriage vent tray mount for Respironics Trilogy Vent or misc medical equipment (Does not limit tilt or recline of seat. Will need 90 degree circuit stem for Trilogy unit) $ C49=NT-KN-LTVM Vent mount for Pulmonetics LTV (vertical vent mount with under carriage platform for battery or misc. May limit tilt and recline) $ C49=NT-KN-WMTRI Vent mount for Respironics Trilogy (vertical vent mount with under carriage platform for battery or misc. May limit tilt and recline.) $545 Page 4/5
5 Dimensions and Weights Size 1 Base (Model 3291) Size 2 Base (Model 3293) MInimum Maximum MInimum Maximum Seat depth in. (15 cm) in. (32 cm) in. (22 cm) in. (39 cm) Seat width 6 in.(15 cm) in. (26 cm) 8 in.(20 cm) 13 in. (33 cm) Seat back height in.(24 cm) in. (43 cm) in.(29 cm) in. (52 cm) Seat back recline Seat tilt 35 Anterior 35 Posterior 35 Anterior 35 Posterior Lateral height adjustment 6 in. (15 cm) in. (37 cm) 6 in. (15 cm) 19 in. (48 cm) Lateral width adjustment in. (19 cm) in. (27 cm) 8 in. (20 cm) in.(32 cm) Armrest height adjustment in. (9 cm) in. (14 cm) in. (15 cm) in. (20 cm) Footrest vertical adjustment 9 in. (23 cm) in. (39 cm) 9 in. (23 cm) in. (39 cm) Headrest width and height in. x in. (19 cm x 17 cm) in. x in. (24 cm x 17 cm) Lateral height and depth 3 in. x in. (8 cm x 11 cm) in. x in. (9 cm x cm) Weight of standard model 36 lbs. (16 kg) 42 lbs. (19 kg) Load capacity of seat 77 lbs. (35 kg) 77 lbs. (35 kg) Load capacity of frame 121 lbs. (55 kg) 121 lbs. (55 kg) Weight of frame without seat 23 lbs. (10.5 kg) 25 lbs. (11.5 kg) Weight of seating system Approx.16 lbs. Approx.21 lbs. Front wheel diameter in. (17 cm) in. (17 cm) Rear wheel diameter in. (24 cm) in. (24 cm) Full width 23.6 in. (60 cm) in. (70 cm) Dorsi/Plantar flexion adjustment Elevating legrest angles Ventilator Tray 13 in. (33 cm) w X 10 in. (25 cm) d X 2 1/2 in. (6 cm) h 13 in. (33 cm) w X 10 in. (25 cm) d X 2 1/2 in. (6 cm) h Battery Tray 9 1/2 in. (24 cm) w X 6 3/4 in. (17 cm) d X 7 in. (18 cm) h 9 1/2 in. (24 cm) w X 6 3/4 in. (17 cm) d X 7 in. (18 cm) h O2 Holder Inside: 4 1/2 in. Outside: 5 in. w X 15 in. h Inside: 4 in. Outside: 5 in. w X 15 in. h Positioning Tray 18 in. w X 16 in. d X 2 in. h (7 in. cut out) 21 in. w X 19 in. d X 2 in. h (7 in. cut out) Shoe Holders 2 1/2 in. w X 5 1/2 in. d 3 1/2 in. w X 7 in. d Page 5/5
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