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Purchase Order Chemist in Indonesia Jakarta –Free Word Template Download with AI

PT. Nusantara Medika Supply Co., Ltd.

Jl. Jend. Sudirman Kav. 52-53, SCBD District, Jakarta Selatan, Indonesia Jakarta 12190

Tel: +62-21-5790-4433 | Email: [email protected]

NPWP: 01.234.567.8-012.000 | Business License (NIB): 8120012345678

Purchase Order No.: PO/JKT/2025/00487

Date of Issue: 14 June 2025

Valid Until: 28 June 2025

Delivery Deadline: 25 June 2025

Payment Terms: Net 30 Days

Incoterms: DDP Jakarta

SUPPLIER / CHEMIST DETAILS

Chemist Name: PT. Apotek Sehat Nusantara (Licensed Chemist & Pharmacy Distributor)

Address: Jl. Gatot Subroto No. 88, Kebayoran Baru, Jakarta Selatan, Indonesia Jakarta 12130

Contact Person: Dr. Pharm. Andi Wijaya, M.Farm. (Head of Chemist Operations)

Phone: +62-21-7280-9911 | Email: [email protected]

BPOM Registration No.: PKM.2019.045678 | Pharmacy License (SIUP Apotek): 440/1234/DINKES/2024

Chemist License Holder: Dr. Pharm. Andi Wijaya, S.Farm., Apt. (KIA No. 1100-2019-0045)

PURCHASER / BUYER DETAILS

Buyer: PT. Nusantara Medika Supply Co., Ltd. – Central Procurement Department

Address: Jl. Jend. Sudirman Kav. 52-53, SCBD District, Jakarta Selatan, Indonesia Jakarta 12190

Authorized Signatory: Mrs. Ratna Dewi Santoso, Procurement Manager

Phone: +62-21-5790-4433 | Email: [email protected]

ITEMS ORDERED – CHEMIST PHARMACEUTICAL & MEDICAL SUPPLIES
No. Item Description BPOM Reg. No. Unit Quantity Unit Price (IDR) Total (IDR)
1 Amoxicillin 500 mg Capsules (Chemist-grade, 100 caps/box) DBL1903456789A1 Box 500 85,000 42,500,000
2 Ibuprofen 400 mg Tablets (Chemist formulation, 30 tabs/strip) DBL1903456790A2 Strip 2,000 12,500 25,000,000
3 Paracetamol 500 mg Syrup 100 ml (Pediatric Chemist product) DBL1903456791A3 Bottle 1,000 32,000 32,000,000
4 Oral Rehydration Solution (ORS) Sachets – 20 g (Chemist standard) DBL1903456792A4 Sachet 5,000 4,500 22,500,000
5 Medical Gloves (Nitrile, Powder-Free) – Box of 100 MD-2024-00891 Box 300 145,000 43,500,000
6 Disposable Syringes 5 ml with Needle (Chemist-verified sterile) MD-2024-00923 Box 200 98,000 19,600,000
7 Antiseptic Solution (Povidone-Iodine 10%) 250 ml DBL1903456793A5 Bottle 800 28,000 22,400,000
8 Chemist Refrigeration Unit (Pharmaceutical Grade, 200L) – 1 Unit EQ-2025-00341 Unit 2 18,500,000 37,000,000
SUBTOTAL 244,500,000
VAT (PPN) 11% 26,895,000
GRAND TOTAL (IDR) 271,395,000
TERMS AND CONDITIONS
  1. This Purchase Order is issued by PT. Nusantara Medika Supply Co., Ltd. and is directed to the licensed Chemist supplier identified above for the procurement of pharmaceutical products, medical consumables, and equipment for distribution across the Indonesia Jakarta metropolitan area.
  2. All pharmaceutical items listed in this Purchase Order must comply with the regulations set forth by the Badan Pengawas Obat dan Makanan (BPOM) of the Republic of Indonesia. The Chemist supplier warrants that all products carry valid BPOM registration numbers and are manufactured in Good Manufacturing Practice (GMP)-certified facilities.
  3. Delivery shall be made to the buyer's central warehouse located at Jl. Jend. Sudirman Kav. 52-53, SCBD District, Jakarta Selatan, Indonesia Jakarta 12190. The Chemist supplier is responsible for all transportation, cold-chain maintenance (where applicable), and insurance of goods until delivery is confirmed by the buyer's receiving officer.
  4. The Chemist supplier must provide a complete delivery note, invoice, and certificate of analysis (CoA) for each pharmaceutical batch upon delivery. All documents must be in Bahasa Indonesia and English.
  5. Payment shall be made via bank transfer to the Chemist supplier's designated account within thirty (30) calendar days from the date of confirmed receipt and acceptance of goods. The buyer's bank is Bank Mandiri, Jakarta branch, Indonesia Jakarta.
  6. The Chemist supplier guarantees that all products are within their shelf life (minimum 12 months remaining at the time of delivery) and are stored and transported in accordance with Indonesian pharmaceutical storage regulations.
  7. Any discrepancy in quantity, quality, or documentation must be reported by the buyer within three (3) business days of delivery. The Chemist supplier shall replace defective or non-conforming items at no additional cost within five (5) business days.
  8. This Purchase Order is governed by the laws of the Republic of Indonesia. Any disputes arising from this Purchase Order shall be resolved through the Commercial Court (Pengadilan Niaga) in Jakarta, Indonesia Jakarta.
  9. The Chemist supplier shall maintain all necessary business licenses, pharmacy operating permits (SIUP Apotek), and health facility permits (SIP) throughout the duration of this Purchase Order and any subsequent orders.
  10. This Purchase Order is valid for a period of fourteen (14) days from the date of issue. If the Chemist supplier does not confirm acceptance in writing within this period, this Purchase Order shall be considered void.
NOTES AND SPECIAL INSTRUCTIONS

1. All cold-chain pharmaceutical items (Items 1, 3, and 8) must be transported in temperature-controlled vehicles maintained between 2°C and 8°C, in compliance with BPOM cold-chain guidelines for the Indonesia Jakarta region.

2. The Chemist supplier must coordinate delivery scheduling with the buyer's logistics team at least 48 hours prior to the scheduled delivery date. Delivery windows are 08:00–16:00 WIB, Monday through Friday.

3. The Chemist supplier is required to provide a one-year warranty on the pharmaceutical refrigeration units (Item 8), including annual maintenance service visits in Indonesia Jakarta.

4. All packaging must bear the Chemist supplier's name, BPOM registration number, batch number, manufacture date, and expiry date in clear, legible print.

Prepared by (Buyer):

Mrs. Ratna Dewi Santoso

Procurement Manager

PT. Nusantara Medika Supply Co., Ltd.

Date: 14 June 2025

Accepted by (Chemist Supplier):

Dr. Pharm. Andi Wijaya, M.Farm.

Head of Chemist Operations

PT. Apotek Sehat Nusantara

Date: _______________

This Purchase Order document was generated for use in Indonesia Jakarta and is subject to all applicable Indonesian commercial and pharmaceutical regulations. Document Reference: PO/JKT/2025/00487. For inquiries, contact the Procurement Department at PT. Nusantara Medika Supply Co., Ltd., Jakarta Selatan, Indonesia Jakarta.

© 2025 PT. Nusantara Medika Supply Co., Ltd. All rights reserved.

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