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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.
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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
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