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SERIAL NO: _ ______________
PROD DATE: _______ / _____
Customer Contact Details
Customer Name: Ship to Customer Address:
Advisor: Shipping Name:
Address: Shipping Address:
Phone: Phone:
Email: Email:
Additional Information
Notes: Current Wheelchair:
Customer Weight:
Customer Height:
Customer Disability:
Other
I declare that I am chronically sick or disabled by reason of:
I would like to be contacted by RGK:
Signature: Date: Signature: Date:
VAT Excemption Declaration (UK Only): RGK Contact Authorisation:
and that I am receiving from RGK Wheelchairs Ltd, the wheelchair specified
herein and I claim relief from Value Added Tax under group 12 of schedule 8 to
Value Added Tax Act 1994.
From time to time, RGK would like to send you exclusive information, news and
offers on everything RGK, by email or post. We will not pass any of your details
to any third party.
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SERIAL NO: ________________
PROD DATE: _______ / _______
Guide:
Base product Required option Optional Extra Critical Information Information Needed
TGAXZ011 TIGA
XA070
XA080
TGAXA085 Crash tested upgrade
Max User Weight 125kg (275lbs)XA070 - Open design XA080 - Closed design
Yes, I am within the max user weight
XW010 CAD drawing for approval XW011 CAD drawing for approval in 48 hours
XY010
XY020
XY030 Extra Seat Length (Provides additional leg support & hand grip)
XY050
XY060
XY070
(Min = XY020 + XY030 + 140mm)
XY072
Optimise measurements TX Forward Castor Position
XA020 Ergonomic seat
Specify length(Standard = 120mm)
PRODUCT STYLE
CAD APPROVAL
Seat length
Front frame height
mm(Max - 500mm)
mm
$3,848.00
KEY MEASUREMENTS
mm(Max - 500mm)
Seat width (Inside to inside of sideguards)
Closed design
Open design
mm
mm
$66.00
Castor position
mm
(Max - 550mm)(Min - 360mm)
Frame length
mm
Rear frame height
$146.00
$135.00 $203.00
mm(Max - 550mm)(Min - 380mm)
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RGK_TIGA_2021_V1_USD
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SERIAL NO: ________________
PROD DATE: _______ / _______
XY080 Seat taper design XY091 Parallel taper design
Specify width Specify width
XY100 Round design XY105 Square design
XB200 XB200
XY115 Front footrest height
XY120 Rear footrest height
(Std = 20mm lower than front height)
XY125 Footrest length
(Std = 100mm)
(160mm and over requires heavy duty upgrade XB150)
XB010 XB030
(Height adjustable)
XB070 XB150
(Angle/height adjustable) (Height adjustable, for Freewheel use)
TGAXB080
(No height adjustment)
XB050 Carbon fibre cover XB170 Aluminium cover
(Not with XB070 & XB030) (Not with XB070 & XB030)
XB040 Plastic Cover XB165 Rubber grip tape
(Not with XB070 & XB030) (3M Safety walk) - (not with XB030)
(When combined with
XY080 , dimensions must be
smaller by 20mm)
Footrest Design (Choose One)
(When combined with
XY091 , dimension is
inbetween the centre of the
main bends)
Castor
Size3" 135mm
Castor
Size
Max
Height115mm
With
XB200165mm
Max
Height
With
XB2003" 185mm
FRONT FRAME AND FOOTRESTFront Frame Options
mm mm
Heavy duty tubular footrestAngle adjustable aluminium footrest
mm
mm
Footrest Style (Choose One)
$222.00Tubular aluminium footrest Flip up plastic footrest
(Angle/height adjustable, with closed frame only)
185mm 5"135mm
$105.00
$31.00$57.00
$93.00
$110.00 $57.00
Tubular footrest welded into frame
Footrest Cover
$117.00
4"5"
145mm 195mm4"125mm 175mm
Footrest Individual Measurements
mm
155mm 205mm
$117.00 $117.00High level footrest (Only with XB010, XB080 & XB150)
High level footrest (Only with
XB010, XB080 & XB150)
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SERIAL NO: ________________
PROD DATE: _______ / _______
XC150 Aluminium centre 3"x1.4" (Silver hub and black urethane tyre)
XC060 Soft roll 4"x1.3"(Black)
XC110 Aluminium centre 4"x1" (Silver hub and black urethane tyre)
XC130 Aluminium centre 4"x1.4" (choose colour below)
Silver hub & black tyre (Std) Black hub & blue tyre Purple hub & black tyre Silver hub & blue tyre
Black hub & black tyre Red hub & black tyre Gold hub & black tyre Silver hub & red tyre
Black hub & red tyre Blue hub & black tyre Green hub & black tyre
XC070 Soft roll 5"x1.3" XC120 Aluminium centre 5"x1" (Black) (Silver hub and black urethane tyre)
XC100 Pneumatic Aluminium centre 5"x1" XC140 Aluminium centre 5"x1.4" (Grey) (Silver hub and black urethane tyre)
XC080 Soft roll 6"x1.3" XC145 Aluminium centre 6"x1.4"
(Silver hub and black urethane tyre)
XC185 Pneumatic offroad 8"x2"
XC190 XC210 Froglegs suspension castor fork
Note: Colour follows accent Black Silver
XY330 Castor pin width
XD020 Underseat Scissor XD050 Push to lock
XD030 Compact scissor XD046 Out Front push to lock
XD035 Compact scissor with lightweight fixing(Only with fixed centre of gravity)
XD045 Out Front Compact scissor XD010 Omit wheel locks
$105.00
$384.00
$143.00
200mm (8")
(only with TX Forward castor position)
CASTOR WHEELS, FORKS & WHEEL LOCKSCastor Wheels
$105.00
$105.00
$105.00
100mm (4")
$143.00
$98.00
$83.00
$105.00
75mm (3")
Wheel Lock Options (choose one)
$118.00
Optimise measurements
Castor Pin Width
mm
Castor Forks
Low ride castor fork(Std when no option selected)
150mm (6")
125mm (5")
$105.00
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SERIAL NO: ________________
PROD DATE: _______ / _______
XE030 XE040 Screw on aluminium with fender
XE080 XE090 Lift out aluminium with fender
TGAXE130 TGAXE140 Fold flat aluminium with fender
XE180 XE190 Flip back aluminium with fender
TGAXE220
TGAXE230
(Extra strong) XE060 Screw on carbon fibre with fender
XE110 Lift out carbon fibre with fenderXE050
TGAXE160 Fold flat carbon fibre with fenderXE100
XE210TGAXE150
XE200
10mm above tyre XE070 (Standard)
XE120 Individual above tyre
(Min = 10mm)TGAXE170
XF010 Centre of tyre (Standard if no option selected)
XF020
Height (Top of seatrail to top of armrest)
Outside of tyre
25mm above tyre(Follow tyre)
Individual above tyre
(Follow tyre)
Level with tyre(Follow tyre)
Sideguard length
Sideguard height
SIDEGUARDS AND ARMRESTS
$456.00
$473.00
mm
$376.00
Optimised measurements
Fold flat aluminium
$146.00
$337.00Lift out aluminium
Screw on carbon fibre
$365.00
$175.00Screw on aluminium
Sideguard Sideguard with FenderAluminium Options Aluminium Options
$531.00
$321.00
Lift out carbon fibre
Welded aluminium sport
$175.00 $203.00Flip back aluminium
Welded with 6mm bead
$311.00$429.00Carbon Fibre Options
$222.00 Carbon Fibre Options
$575.00
Fender position
mm
$327.00
$292.00
Flip back carbon fibre with fenderFold flat carbon fibre $429.00
Fold flat ABS plastic
$292.00
Flip back carbon fibre Sideguard MeasurementsFender Height$354.00
$146.00
$219.00
ABS Plastic Options
Screw on ABS plastic
Lift out ABS plastic
mm
Armrest Options
$376.00
Sideguard Measurements
mm
Lift out armrest with plastic sideguard
(Indicate fixed height)
Lift out armrest with Aluminium sideguard
(Indicate fixed height)
mm
Individual measurements
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SERIAL NO: ________________
PROD DATE: _______ / _______
BACKREST
XY230 Fixed height backrest XY245 Adjustable height backrest
(+/-25mm)
Specify height Specify height
XG010 Fixed backrest TGAXG020 Folding backrest
(Non-folding) (with 2 position snap lock and angle adjust ± 5 Deg)
XY360 Backrest angle XG100
-5 -3 0
Individual
XG110 Inward taper XG120
(inside of backrest posts)
Specify width or per side
XG070 Screw in push handles XG090 Stroller push handles height adjustable
(N/A with XY245)
XG080 Flip down push handles (N/A with XY245) Optimise
(1000mm from floor)
XG085 Flip down push handles height adjustable XG097 Integrated push handle(N/A with XY245) (Quickie design)
XG040 Heavy duty backrest upgrade XG130 Extra deep Square brace bar(Recommended for hand cycling) (Not with XY245) (Recommended for JAY backs) (Std - 90mm)
XG140 Integrated lateral support
A - Left A - Right
B - Left B - Right
C - Left C - Right
D - Left D - Right
$66.00 $66.00
mm
Outward flare
Specify width or per side
(inside of backrest posts)
Ergonomic Options
Ergonomic backrest
$66.00
(Max -10/+20 Deg)
mm
Rearward position
Vertical height
+3 +5
mm
Backrest Height
$110.00
Backrest Design
$275.00
mmmm
ILSA Backrest Options
$346.00
mm
$118.00 $66.00
Depth
mm
mm
mm
mm
mm
mm
mm
mm
mm
Backrest Options
$218.00
mm
Push handle Options
$198.00
$228.00$129.00
mm
$218.00
Height from floor to top of handles
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SERIAL NO: ________________
PROD DATE: _______ / _______
XH110 Square back adjustable centre of gravity TGAXH100 Single post fixed centre of gravity(25-150mm)
(Not with Crash test option)
Specify measurement Specify measurement
XH120 Round back adjustable centre of gravity TGAXH090 V-style fixed centre of gravity(60-150mm) (25-125mm)
Specify measurement Specify measurement
XY390 XY390 Camber angle
0 1 2 3 5 0 1 2 3 5
XH040 Handbike camber bar fixed XH040 Handbike camber bar fixed
Camber angle (Handbike camber bar) Camber angle (Handbike camber bar)0 5 0 5
Castor height from floor for handbike fitting Castor height from floor for handbike fitting(Standard 30mm if not indicated)
XH030 Froglegs suspension camber bar
XJ010 XJ100 Single sport anti tip(centre mounted)
XJ020
CAMBER BAR
$275.00
Adjustable Centre of Gravity Fixed Centre of Gravity
(25-125mm) (Open frame only)
mm
$275.00
mm
$118.00
Anti-Tip Options
Swingaway anti tip LEFT side (Only with square
back frame. Not with XH040)$118.00 $365.00
Swingaway anti tip RIGHT side (Only with square
back frame. Not with XH040)
mm
mm
Camber Bar Options Camber Bar Options
$555.00
$231.00
Camber angle
Specify Camber Angle Specify Camber Angle
$231.00
30 50
(Standard 30mm if not indicated)
30 50
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SERIAL NO: ________________
PROD DATE: _______ / _______
XY420
XY460
Individual
XK010 XK320
XK050 XK060
XK150 XK070(Black hub only) (Black hub only)
Spinergy Colour Options:
XK180 Individual spoke design(Specify colour)
Inside:
Outside:
Spinergy Anodise Options
XK190 XK200 XK201 XK204
(std option) (n/a with BLXL/CLX) (LX, XLX & BLXL only) Select colour:
XK202 XK203 XK204
(LX, XLX & BLXL only) (LX, XLX & BLXL only) (LX, XLX & BLXL only)
XK040 Supply without Wheels Wheel Type: Tyre Type:
XY480 XY485 Wide set handrim
XL090
XL010 XL040 Titanium 6 tab
XL160 XL050 Stainless steel 6 tab(replacement for Surge)
XL020 XL140 Ergo gripp 6 tab wide
XL100
XM010 Kenda Red
XM130 Kenda black
XM020 Schwalbe Marathon Plus XM060 Schwalbe One (24",25" only)
XM040 Shox solid airless XM050 Kenda K885 mountain bike tyre(Black only) (24",25" only)
XY500 Schraeder inner tube valve XY490 Presta inner tube valve(Standard if no option selected)
XK220 XK300
XK240 Quad release axle nuts (pair) XK310
$1,241.00
Individual:
$203.00
Blue hub/rims
$154.00
Red hub/rims
$154.00
Gold hub/rims
$203.00
REAR WHEELS
Rear Wheel Options
Rear Wheel Gap
Rear wheel gap
15 20 25
mm
Rear Wheel Size
26" Wheels24" Wheels XY430 25" Wheels XY440
$93.00
$15.00
$281.00
Wheel Accessories
$537.00$94.00Titanium 130mm quick release axle pins (pair)
(N/A with XK010 & XK070)Offroad wheel set 22" with handrim, MTB tyre and
axle pins (Replaces 24" wheel with XM010)
$57.00 $79.00
Elipse 6 tab
Para grip 6 tab
Tetra grip 6 tab
Narrow set handrim
Handrim Styles
$84.00
$657.00
-$161.00
$146.00White spokes
Blue spokes
Green spokesOrange spokes
Black spokes
Red spokes
Yellow spokes
Pink spokes
Purple spokes
$154.00
Silver hub
$76.00
Spinergy XLX 12 spoke
Spinergy SPOX 18 spoke
Spinergy CLX 18 carbon blade spoke
Handrim Position / Options
$624.00
(cross/radial spoked)$657.00
Spinergy LX 12 spoke$470.00
Spinergy BLXL 18 blade spoke
(Silver Hub, black spokes)Fusion 16 spoke
Supply Without Wheels
Black hub
Purple hub/rims
$129.00 $537.00Offroad wheel set 24" with handrim, MTB tyre and
axle pins (Replaces 25" wheel with XM010)
Aluminium hard anodised 6 tab
Remove excess mounting tabs(recommended for small wheel gaps)
BlueGrey (std)
Tyre Options
$236.00
$236.00
$200.00
$110.00
$245.00
Inner Tube Valve Options
$22.00
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SERIAL NO: ________________
PROD DATE: _______ / _______
XN010 XN150
Frame Comp. Frame Comp. Frame Comp.
XN200 Individual paint colour (State Colour/RAL code)
Frame Comp
TGAXN030 XN160 Brushed components(All parts black unless XN160 chosen)
TGAXN050 XN170 Polished components(All parts black unless XN170 chosen)
Silver accent XN250 Individual Accent Colour
Blue accent
Carbon accent (Castor caps only, black for rest)
XP040 Seat sling adjustable tension with straps XR050 Carbon fibre seat plate
XP050 XP070(Black)
Black Blue Individual:
Light blue Purple
Individual:
XP110 Backrest with zip pocket XP170 Individual backrest embroidery(Provide .jpeg file and positioning)
Dark blue gloss 151
Royal blue gloss 154
Purple gloss 157
Blue gloss 174
Duckegg blue gloss 141
Pink gloss 188
Orange gloss 180
$143.00
Silver
Backrest Stitching Options
Note: Accent colour includes, forks, clamps & castor caps.
Airtech backrest strap adjustable Backrest upgrade to leather corners$100.00
$143.00
Red
Green Blue
$74.00 $113.00
White (Std)
Backrest RGK Logo Colour
Light blue Purple
Backrest Accessories
Red
Brushed frame
Backrest Upholstery
Black accent
Red accent
Purple accent
UPHOLSTERYSeat Upholstery
$281.00
Accent Colour
$80.00$199.00
$510.00 $135.00Polished frame
Forest green gloss 143 White sandpaper 200
Green gloss 107
Grey gloss 132 Grey matt 131
Cream gloss 135 Light grey matt 133
Red gloss 108 Navy blue matt 152
Yellow gloss 120
Metallic black matt 104
Metallic grey matt 130
Black sandpaper 201
Grey sandpaper 202
Black gloss 103 Black matt 105 Chrome Mirror 300
White gloss 100 White matt 101 Sparkle silver 170
FINISH OPTIONSFrame & Component Finish
Powder coated frame
Gloss Matt Special
Powder coated components (Frame colour if not specified)
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SERIAL NO: ________________
PROD DATE: _______ / _______
XP080 Cushion foam
(select density and size below)
Soft (CMS040) Medium (CMS050) Hard (9lb recon)
50mm 75mm 100mm
XP081 Nylon cushion cover(Black)
XP090 Air Lite cushion cover(Black)
XP100 Leather cushion cover(Black)
JAY Cushion Jay Order form attached Notes:
(Price dependant on size / option)
JAY Backrest Jay Order form attached
(Price dependant on size / option)
JAY Whitmyer Headrest Jay Order form attached
(Price dependant on size / option)
XR060 Welded calf strap mounting loops(To locate calf strap on front frame)
Specify height from floor
Optimise measurements
XR080 Frontwheel assembly (Only with Tubular style footrest)
XP120 Frame protectors Neoprene zip fasten with TIGA logo(Black)
XP420 Frame protectors Nylon velcro fasten(Black)
XR010 Seat pouch velcro attach(Black)
XR200 Rucksack with RGK logo(Black)
XR020 Underseat large storage bag(Black)
XA020 Tool kit
XS060 Calf strap
FRAME OPTIONS
$84.00
CUSHION
$69.00
Cushion foam options
Cushion Cover Upgrades
Jay Products
$54.00
$176.00
ACCESSORIES
$60.00
$31.00
$74.00
$53.00
$606.00
$40.00
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SERIAL NO: ________________
PROD DATE: _______ / _______
NOTES
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