Pride Mobility Victory 10 Owner's manual

Page 1 of 3INFINFB3737/RevE/08APR2020

Victory

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

Pride

Mobility Products Corporation

401 York Avenue, Duryea, PA 18642

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.

MODEL

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

Victory 10 3-Wheel. ......................................................... $2,669

Part: SC610. HCPCS: K0801 — Heavy Duty/Group 1.

Victory 10 4-Wheel.......................................................... $2,819

Part: SC710. HCPCS: K0801 — Heavy Duty/Group 1.

Standard Features

• Two U-1 batteries

• 3.5-amp o-board charger

• Front basket

• Foldable seat with sliders (18″W × 17″D)

OPTIONAL SEATING

The Victory 10 comes standard with a foldable 18″W × 17″D seat with sliders. Another seat type may be selected below or on Page 2.

Deluxe Contour, 18″W × 18″D, no Sliders ........................ $600

Part: SETASMB2156

Deluxe Contour, 18″W × 20″D, no Sliders ........................ $600

Part: SETASMB2375

Deluxe Contour, 20″W × 20″D, no Sliders ....................... $600

Part: SETASMB2168

Deluxe Contour, 22″W × 20″D, no Sliders........................ $600

Part: SETASMB2382

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

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 Service for accurate

parts ordering.

Thank you for choosing Pride Mobility Products!

INTRODUCTION

Deluxe Contour, High Back, Black Vinyl

Candy Apple Red, 3-Wheel

Part: SHDASMB5258

Candy Apple Red, 4-Wheel

Part: SHDASMB5246

Viper Blue, 3-Wheel

Part: SHDASMB5261

Viper Blue, 4-Wheel

Part: SHDASMB5253

Page 2 of 3INFINFB3737/RevE/08APR2020

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 ( 1 5 . 2 5 ″ × 9 . 7 5″ × 9 . 5 ″ ) .. $80

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

Medium Black Weather Cover .... $158

Part: ACCCOVR1019

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

Part: ACCCOVR1018

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

and 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

XLR USB Charger .......................... $38

Part: ACC1704791

BACK-MOUNTED ACCESSORIES

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

BATTERIES

The Victory 10 comes standard with U-1 batteries. Another battery type may be selected below.

40Ah Batteries .................................................................................................................................................................................$350 ea.

Par t: BATLIQ1002

Includes a 5-amp o-board charger

OPTIONAL SEATING Continued

The Victory 10 comes standard with a foldable 18″W × 17″D seat with sliders. Another seat type may be selected below or on Page 1.

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

Part: SET1800951

High Back, Black Vinyl

Limited Recline, High Back with Sliders, 18″W × 18″D .. $300

Part: SET147133

Limited Recline, High Back, no Sliders, 22″W × 18″D ... $350

Part: SET151622

Limited Recline, High Back, Black Vinyl

Foldable Seat

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

Part: SET1800793