Pride Mobility Victory 10.2 Owner's manual

Page 1 of 3INFINFB3928/RevC/03FEB2020

Victory

10.2 Order Form — 3-Wheel and 4-Wheel Scooters

Pride

Mobility Products Corporation

182 Susquehanna Ave., Exeter, PA 18643

Phone: 1-800-800-8586 | Fax: 1-800-800-1636 | Email: prideorders@pridemobility.com

Account Number: ___________ Date: ________________

Provider Name: __________________________________

Contact: ________________________________________

Phone: ___________________ Fax: _________________

Email: __________________________________________

PO Number: _____________________________________

Marked for: _____________________________________

Ship to Address: _________________________________

City: _____________________ State: ______ Zip: ______

COLOR

REQUIRED. Colors shown here may dier from actual product depending on monitor/printer calibration.

Candy Apple Red

S6102 part: DGN1800060

S7102 part: DGN1713218

Ocean Blue

S6102 part: DGN1800407

S7102 part: DGN1800401

MODEL

REQUIRED. Weight capacity: 400 lbs. Find more specications at pridemobility.com/victory-10-2-3-wheel or pridemobility.com/victory-10-2- 4-wheel.

Victory 10.2 3-Wheel ...................................................... $2,859

Part: S6102. HCPCS: K0801 - Heavy Duty/Group 1.

Victory 10.2 4-Wheel ...................................................... $2,959

Part: S7102. HCPCS: K0801 - Heavy Duty/Group 1.

Standard Features

• Two U-1 batteries

• 3.5-amp o-board charger

• Front basket

• LED headlight

• Integrated USB charger

• Cup holder — tiller/storage

• Integrated XLR charger port

Black Vinyl, High Back, no Sliders, 20″W × 20″D .............................................................................................................................. $300

Part: SET1800951

SEATING

Optional. Select one seat. See Page 2 for other seating options.

High Back, Black Vinyl

This form is interactive when viewed in Adobe Acrobat Reader and may not function correctly if opened with applications other than Acrobat.

HCPCS codes provided should not be considered as legal advice and do not guarantee reimbursement. DME providers are responsible for determining

the appropriate billing codes when submitting for insurance reimbursement. Payer coding, coverage, and bundling guidelines may apply. All prices are

MSRP. Prices, specications, part numbers, and availability are subject to change without notice. Prices and part numbers as shown are only available

when congured as a complete scooter. Pride Providers may contact Technical Services for accurate parts ordering.

Thank you for choosing Pride Mobility Products!

INTRODUCTION

Foldable Seat with Sliders, 18″W × 17″D ................. Standard

Part: SET1800464

Foldable Seat with Sliders, 20″W × 18″D ..........................$100

Part: SET1800793

Foldable Seat

Page 2 of 3INFINFB3928/RevC/03FEB2020

Account Number: ___________ Date: ________________ Marked for: _____________________________________

CANE/CRUTCH HOLDER

Optional. Only one cane/crutch holder can be used at a time.

LAP BELTS

Optional.

50″ Lap Belt ............................... $39.90

Part: ACCBELT1000

60″ Lap Belt ............................... $39.90

Part: ACCBELT1002

70″ Lap Belt ................................ $39.90

Part: ACCBELT1003

Rear Basket .................................... $80

(1 5 . 2 5 ″ × 9 . 7 5 ″ × 9 . 5 ″ )

Part: ACCBSKT1010

Oxygen Tank Holder ...................... $98

Part: ACCASMB1017

Walker Holder ................................. $98

Part: ACCASMB1018

ACCESSORIES

Optional.

Wishbone Crutch Holder .................................................... $98

Part: FRMASMB2358

Quad Cane Holder ............................................................... $98

Part: ACCASMB1931

Forearm Crutch Holder ....................................................... $98

Part: ACCASMB1019

Single Rear Mount, 3″...........................................................$70

Part: ACCINDV1058

Double Rear Mount, 3″ .........................................................$70

Part: ACCINDV1019

Cane Clip Attachment (Quantity of 2 Required) .......... $8 ea.

For standard foldable seat only

Part: ACCINDV1074

Cell Phone Holder .......................... $70

Part: ACC145549

Rearview Mirror .............................. $25

Part: LGTRMIR1003

Saddle Bag (12.5″ × 9.875″) ............ $35

Part: DWR1020D010

Safety Flag ...................................... $38

Part: ACCASMB2079

Cup Holder, Style B ....................... $20

Used on SET151622 & all Deluxe Contour Seats

Part: ACCASMB2287

Cup Holder, Style C ....................... $20

Used on Foldable Seats

Part: ACCASMB2288

Cup Holder, Style D ....................... $20

Used on SET147133 Seat only

Part: ACC120041

Back-Mounted Accessories

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

Weather Covers

Large Black Weather Cover .............................................. $202

Part: ACCCOVR1018

Medium Black Weather Cover ...........................................$158

Part: ACCCOVR1019

40Ah Batteries, with 5-Amp O-board Charger ......................................................................................................................... $175 ea.

Par t: BATLIQ1002

ADDITIONAL BATTERIES

Optional.

SEATING Continued

Optional. Select one seat. See Page 1 for other seating options.

Black Vinyl, High Back with Sliders, 18″W × 18″D ......... $300

Part: SET147133