Home Decor NM455 Order Form - Pride Mobility · INFINF34RevC10NO201 Page 1 of 1 Home Decor, NM-455,...
1
Page 1 of 1 INFINFB3794/RevC/10NOV2017 Home Decor, NM-455, Quick Ship Order Form Pride Mobility Products Corp. 182 Susquehanna Ave., Exeter, PA 18643 Phone: 800-800-8586 | Fax: 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: ______ © 2017 Pride Mobility Products Corp. All rights reserved. youtube.com/ pridemobility facebook.com/ PrideMobilityProductsCorp twitter.com/ pridemobility instagram.com/ PrideMobilityProducts LIFT NM-455 single chair order 5'4" to 6' height range, 20" seat width, and 375 lbs weight capacity. NM-455 .............................................................................$1,399 Part: NM455MODEL This is not a medical device and is not intended to assist, treat, diagnose or alleviate any medical condition or disability. See Multiple Unit Order below Full Recline Capable TV Recline Capable Select a Lexis Sta-Kleen Fabric Color Chestnut Part: FABSKC Burgundy Part: FABSKG Mushroom Part: FABSKM Black Part: FABSKB Protective Pad .................................$30 Part: ACCASMB2514 Head Pillow ......................................$50 Chestnut Part: UPSHDPL1453 Burgundy Part: UPSHDPL1452 Mushroom Part: UPSHDPL1454 Black Part: UPSHDPL1451 Wireless Remote .............................$89 Part: ELE168998 Lumbar Pillow..................................$50 Chestnut Part: UPSBOLT1584 Burgundy Part: UPSBOLT1583 Mushroom Part: UPSBOLT1585 Black Part: UPSBOLT1582 Residential ......................$39.90 ea. Cleaning Kits Part: ACCASMB2479 Multiple Unit Order Enter a quantity below and then place check marks in the field with the desired option. Residential Cleaning Kit Protective Pad NM-455 ($1,399) Chestnut Burgundy Mushroom Black QTY Upgrades and Accessories Lexis Sta-Kleen Fabrics Lumbar Pillow Head Pillow This form is interactive when viewed with 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 power lift recliner. Please contact technical service for accurate parts ordering. Thank you for choosing Pride ® Mobility Products! Introduction Wireless Remote Select upgrades and accessories for a single chair order
Transcript of Home Decor NM455 Order Form - Pride Mobility · INFINF34RevC10NO201 Page 1 of 1 Home Decor, NM-455,...
Page 1 of 1INFINFB3794/RevC/10NOV2017
Home Decor, NM-455, Quick Ship Order Form
Pride Mobility Products Corp.182 Susquehanna Ave., Exeter, PA 18643Phone: 800-800-8586 | Fax: 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: ______
© 2017 Pride Mobility Products Corp. All rights reserved.
youtube.com/pridemobility
facebook.com/PrideMobilityProductsCorp
twitter.com/pridemobility
instagram.com/PrideMobilityProducts
LIFT
NM-455 single chair order5'4" to 6' height range, 20" seat width, and 375 lbs weight capacity.
NM-455 .............................................................................$1,399Part: NM455MODELThis is not a medical device and is not intended to assist, treat, diagnose or alleviate any medical condition or disability.
See Multiple Unit Order below Full Recline Capable TV Recline Capable
Select a Lexis Sta-Kleen Fabric ColorChestnutPart: FABSKC
BurgundyPart: FABSKG
MushroomPart: FABSKM
BlackPart: FABSKB
Protective Pad .................................$30Part: ACCASMB2514
Head Pillow ......................................$50Chestnut Part: UPSHDPL1453Burgundy Part: UPSHDPL1452Mushroom Part: UPSHDPL1454Black Part: UPSHDPL1451
Wireless Remote .............................$89Part: ELE168998
Lumbar Pillow ..................................$50Chestnut Part: UPSBOLT1584Burgundy Part: UPSBOLT1583Mushroom Part: UPSBOLT1585Black Part: UPSBOLT1582
Residential ......................$39.90 ea.Cleaning KitsPart: ACCASMB2479
Multiple Unit OrderEnter a quantity below and then place check marks in the field with the desired option.
Residential Cleaning Kit
Protective Pad
NM-455 ($1,399) Chestnut Burgundy Mushroom Black
QTY Upgrades and AccessoriesLexis Sta-Kleen Fabrics
Lumbar PillowHead Pillow
This form is interactive when viewed with 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 power lift recliner. Please contact technical service for accurate parts ordering.
Thank you for choosing Pride® Mobility Products!
Introduction
Wireless Remote
Select upgrades and accessories for a single chair order
