Bowhead RX™ Quote Form Price starts at $16,999.00 USD. Subject to customizations. Please note that components are subject to change based on availability, but overall bike performance is not a:ected. Contact Information Individual Customer/Rider First Name: Last Name: Age: T-shirt size: Extra Large Phone Number: Email: Reseller (For approved Bowhead Resellers only) Resellers, please fill out ALL your company’s information and customer details for EVERY quote submitted! Company Name: Rep’s First Name: Rep’s Last Name: Phone Number: Email: Adaptive Program Organization’s Name: Rep’s First Name: Rep’s Last Name: Phone Number: Email: Ship To: Street Address: City: State/Province: Country: Postal/Zip Code: Shipping Information Reseller Program General Rider’s Information Details will help Bowhead build a bike suitable for your specific rider requirements. Your responses below may initiate a call from one of our team members. What is the reason for purchasing a Bowhead Bike: What is your previous biking experience: How did you hear about Bowhead and our bikes? Website Friend or Word of Mouth Social Media (Facebook, Instagram) Cycling Event (Sea Otter, Crankworks, Dunbar, etc.) Adaptive Foundation (RMA, KASA, Teton, etc.) Reseller Abilities Expo Other Program Options & Accessories Only applicable if you are an adaptive program that will use bike for multiple riders or for programming purposes. Additional Harness & Frame Assembly. This allows programs to change harnesses depending on rider size and preference: Is this a program bike? Select “Yes” if this bike will be used for multiple riders or for programming purposes. Please fill out the “Program Options & Accessories” below: Small Harness & Frame Assembly ($799.00 USD) Medium Harness & Frame Assembly ($799.00 USD) Large Harness & Frame Assembly ($799.00 USD) Extra Large Harness & Frame Assembly

Anatomic Information Height (include units of measure): Weight (include units of measure): Type of Injury: If injury is a SCI, include level: Quadriplegic Information If you are a quadriplegic, our quad bar can help you control the brakes and throttle in a variety of ways depending on the level of your injury. RX Quad Option None (Standard) QuadGrips with wrist braking and Wireless SRAM Blip Shifters (Upgrade $1,299.00 USD) Your right-hand grip strength and mobility on a scale from 1 to 10 (Low strength, minimal mobility = 1 / High strength, Lots of mobility = 10): 1 2 3 4 5 6 7 8 9 10 Use this...

Fiberglass (Standard) Battery Quantity. Carbon Fiber (Upgrade $599.00 USD) Note: Bosch 500 PowerTubes are regular $999. We oZer a discounted rate at time of purchase to help you get the most range out of your new ride! $799 for a second, and $699 for a third. 0 Batteries (International) 1 Battery (Standard with purchase, NC) 2 Batteries (Upgrade, $799.00 USD) 3 Batteries (Upgrade, $1498.00 USD) Pro Bolt Kit No (Standard) Yes (Upgrade $179.00 USD) Please select ONE color: Red Blue Orange Purple Gold Cerakote Custom Color Upgrade – add some flare to your Bowhead Reach! Color selection will be determined...