wrangler 4-wheel scooter order form · 2020-02-21 · title: wrangler 4-wheel scooter order form...

of 2INFINFB4058/RevA/04JUN2019

Wrangler® 4-Wheel PMV Scooter — Quick Ship Order Form

Pride® Mobility Products Corporation182 Susquehanna Ave., Exeter, PA 18643Phone: 1-800-800-8586 | Fax: 1-800-800-1636 | Email: [email protected]

Account Number: ___________ Date: ________________

Provider Name: __________________________________

Contact: ________________________________________

Phone: ___________________ Fax: _________________

Email: __________________________________________

PO Number: _____________________________________

Marked for: _____________________________________

Ship to Address: _________________________________

City: _____________________ State: ______ Zip: ______

Desert SandPart: DGN1806199

Stone GreyPart: DGN1809142

COLORREQUIRED. Colors shown here may differ from actual product depending on monitor/printer calibration used.

SEATINGREQUIRED.

Wrangler ..........................................................................$6,999Part: MV600

This product is not a medical device and is not intended to assist, treat, diagnose, or alleviate any medical condition or disability.

Includes standard features:• Backup sensor • Variable speed control• Hand lever tiller adjustment• Hydraulic handbrake• 14.5″ pneumatic tires

• 8-amp off-board charger• Integrated XLR charger port• Integrated USB charger• Full light package

MODELREQUIRED. 350 lb. weight capacity. More details and specifications at found at pridemobility.com/scooters.

ACCESSORIESOptional.

Front Basket ................................... $54Part: ACCASMB2492

Saddle Bag (12.5″ × 9.875″) ........... $35Part: DWR1020D010

Cup Holder, Style B ....................... $20Part: ACCASMB2287

Rear View Mirror ............................ $25Part: LGTRMIR1003

Cell Phone Holder .......................... $70Part: ACC1804467

50″ Lap Belt ................................$39.90 Part: ACCBELT1000



This form is interactive when viewed in Adobe Acrobat Reader and may not function correctly if opened with applications other than Acrobat. All prices are MSRP. Prices, specifications, part numbers, and availability are subject to change without notice. Prices and part numbers as shown are only available when configured as a complete scooter. Pride Providers may contact Technical Services for accurate parts ordering.

Thank you for choosing Pride® Mobility Products!

INTRODUCTION

High Back, Black Vinyl Reclining Pillow-Top, 18.5″ × 16.5″..................................................................................................... StandardPart: SET165470With sliders

https://www.pridemobility.com/pride-mobility-scooters/outdoor-terrain-scooters

https://get.adobe.com/reader/

Air Force Patch ............................... $20Part: ACC140240

Army Patch ..................................... $20Part: ACC140241

Coast Guard Patch ........................ $20Part: ACC140239

Marines Patch ................................. $20Part: ACC140243

Navy Patch ...................................... $20Part: ACC140244

Purple Heart Patch ........................ $20Part: ACC140238

of 2INFINFB4058/RevA/04JUN2019

Pride® Mobility Products Corporation182 Susquehanna Ave., Exeter, PA 18643Phone: 1-800-800-8586 | Fax: 1-800-800-1636 | Email: [email protected]

Account Number: ___________ Date: ________________ Marked for: _____________________________________

COMMENTS

BRANCH PATCHESOptional.

© 2019 Pride Mobility Products Corp. All rights reserved.

youtube.com/pridemobility

facebook.com/PrideMobilityProductsCorp

twitter.com/pridemobility

instagram.com/PrideMobilityProducts

Air Force Patch ............................... $20Part: ACC140240

Army Patch ..................................... $20Part: ACC140241

Coast Guard Patch ........................ $20Part: ACC140239

Marines Patch ................................. $20Part: ACC140243

Navy Patch ...................................... $20Part: ACC140244

Purple Heart Patch ........................ $20Part: ACC140238

Group 24, 75 Ah .......................................................... StandardPart: BATLIQ1019

Group 27, 100 Ah .......................................................... $368 ea.Part: BATLIQ1011

BATTERIESREQUIRED. Requires two batteries.

CANE/CRUTCH HOLDEROptional. Only one cane/crutch holder can be used at a time.

Wishbone Crutch Holder .................................................... $98Part: FRMASMB2358

Quad Cane Holder ............................................................... $98Part: ACCASMB1931

Forearm Crutch Holder ....................................................... $98Part: ACCASMB1019

Single Rear Mount, 3″ ..........................................................$70Part: ACCINDV1058

Double Rear Mount, 3″ .........................................................$70Part: ACCINDV1019

Oxygen Tank Holder ...................... $98Part: ACCASMB1017

Walker Holder ................................. $98Part: ACCASMB1018

Rear Basket (15.25″ × 9.75″ × 9.5″).. $80 Part: ACCBSKT1010

BACK-MOUNTED ACCESSORIESOptional. Only one back-mounted accessory can be used at a time. Includes mounting bracket and hardware.

http://youtube.com/pridemobility

http://facebook.com/PrideMobilityProductsCorp

http://twitter.com/pridemobility

http://instagram.com/PrideMobilityProducts

wrangler 4-wheel scooter order form · 2020-02-21 · title: wrangler 4-wheel scooter order form...

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