This form is designed to be filled out using Adobe Acrobat. E-Mail completed form to [email protected] 5720 Arville St. Suite 105 Las Vegas, Nevada 89118 ATH-FSe Order Form Date: Shipping Phone: Shipping Notes: E-mail: Price Quote Only I’d Like to Place an Order Frame Style Lasher Sport ATH-FSe - All Terrain eHandcycle with Pedal Assist and Throttle H00FS1 Three wheel independent suspension, recumbent style. * Max rider weight 250 pounds (113 Kg) * A 50% deposit is required at time of order. The Balance is due when the handcycle is ready to ship. Frame Dimensions Seat Width / Rear Wheel Width Seat Depth Seat Width is measured from inside of seat rails. Measure from front of backrest post to front edge of seat sling. Seat Width- 16” (40.6cm), Rear Wheel Width- 33.75” (85.7cm) Back Height Backrest Angle Measured from seat base to top of backrest. Angle measured from floor plane to back plane. Footrest Style Upholstery Seat: Tension Strap Back: Tension Strap with 1.25” (3.2cm) foam padding Adjustable with padded ankle slings and Velcro ankle restraints. Crank Arms Width by crank extenders- Standard H02CAE Lasher Sport CNC Machined ‘Bull Horn’- $695 H02CABH * Anodized Black. Crank Handles Lasher Sport Ergo Max Grips, Standard H03CHE Quad Grips, Optional- +$795 H03CHQ

Options and Accessories Components * Components below may be substituted for equal or greater value components depending on availability. Front Wheel Shock- Fox Float DPS Performance Rear Wheel Shocks- Fox Float DPS Performance Front Wheel Brake- TRP Quadiem Rear Brakes- TEKTRO Auriga Twin+ Chain- KMC 12 speed Click Strap Seat Belt Headset- Cane Creek 40 Seat Cushion - Contoured Foam * Standard handcycle includes back rest cushion Power Option 1000watt Electric Power System, mid-mount - $0 H07P1000 Select Battery CapacityBattery- 17Ah (870 Wh) at 52V- $0 Upgrade- Battery 24Ah (1250 Wh) at 52V-...

Accessories Rear Mount Platform Rack- +$495 H08APR * Powder Coated to match frame, or request color (requested color may add additional cost). Flag Mount included Wheelchair Carrier Attachment- +$395 * Requires Rear Mount Platform Rack. Powder Coated black, or request color (requested color may add additional cost). Rear Mount Basket Style Rack- +$995 H08ABR * Powder Coated to match frame, or request color (requested color may add additional cost). Flag Mount included * Powder Coated to match frame, or request color (requested color may add additional cost). Crash and Damage Policy In the event...

Frame Finish- Color Options *Powder coat is a baked on finish. *Colors and shades can look different than the samples below. Standard Powder Coat Finish, Single Color- Included H09PCSC * Select a color from the two columns below. Premium Powder Coat Finish- +$595 H09PCSCI * Select a color from the two columns below. Powder Coat Finish, Two Tone- +$995 H09PCTT * Select any two colors from this page and list at right. Main Frame ColorSuspension ColorPremium Powder Coat Colors Standard Powder Coat Colors Gloss White PSS-5690 Neon Yellow Shattered Glass Pastel Blue Prismatic Universe Illusion Pacific...