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
SUPPLIER / CHEMIST DETAILSChemist 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 DETAILSBuyer: 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 | |||||
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
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: _______________
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