Purchase Order Chemist in Israel Jerusalem –Free Word Template Download with AI

Purchase Order No.: PO-JER-2025-04782

Date of Issue: 15 June 2025

Required Delivery Date: 29 June 2025

Payment Terms: Net 30 Days

Currency: Israeli New Shekel (ILS)

Incoterms: DDP Jerusalem

SUPPLIER / CHEMIST DETAILS

Chemist Name:	Herzliya Chemist & Pharmaceutical Distribution Co.
Address:	45 Ben-Gurion Avenue, Herzliya, Israel 46100
Contact Person:	Dr. Miriam Levi, Head of Chemist Operations
Phone:	+972-3-512-8890
Email:	[email protected]
Chemist License:	Ministry of Health Israel – Chemist License No. MOH-CHM-2023-1147
VAT No.:	51-987-654-3

BILL-TO / DELIVERY ADDRESS – ISRAEL JERUSALEM

Company:	Jerusalem Medical Supplies Ltd.
Delivery Address:	12 King David Street, Old City District, Israel Jerusalem 97100
Receiving Contact:	Mr. David Cohen, Warehouse Manager
Phone:	+972-2-623-4568
Delivery Window:	Monday – Friday, 08:00 – 16:00 (Israel Standard Time)

ITEMIZED PURCHASE ORDER – CHEMIST SUPPLIES

Item No.	Description	Chemist Ref. Code	Qty	Unit	Unit Price (ILS)	Line Total (ILS)
1	Amoxicillin 500mg Capsules – 28-count blister packs (Prescription Chemist Stock)	CHM-AMX-500-28	500	Boxes	42.50	21,250.00
2	Ibuprofen 400mg Tablets – 100-count bottles (OTC Chemist Supply)	CHM-IBU-400-100	300	Bottles	28.75	8,625.00
3	Sterile Gauze Pads 10x10cm – 100-pack (Chemist Wound Care Line)	CHM-GAU-1010-100	200	Packs	18.90	3,780.00
4	Normal Saline 0.9% IV Bags 500ml (Chemist Infusion Supplies)	CHM-SAL-09-500	400	Bags	12.30	4,920.00
5	Nitrile Examination Gloves – Medium, Box of 100 (Chemist PPE)	CHM-GLV-NIT-M-100	150	Boxes	35.00	5,250.00
6	Metformin 850mg Tablets – 60-count (Prescription Chemist Stock)	CHM-MET-850-60	250	Boxes	55.20	13,800.00
7	Digital Thermometers – Clinical Grade (Chemist Diagnostic Tools)	CHM-THM-DIG-CLN	80	Units	67.40	5,392.00
8	Hand Sanitizer 70% Alcohol – 500ml Pump Bottles (Chemist Hygiene)	CHM-SAN-70-500	100	Bottles	22.10	2,210.00
9	Insulin Glargine 100IU/ml Pens – 5-pack (Prescription Chemist Stock)	CHM-INS-GLA-100-5	120	Packs	185.00	22,200.00
10	Adhesive Bandages Assorted – 200-count (Chemist First Aid)	CHM-BND-ASS-200	180	Packs	14.60	2,628.00

Subtotal: ILS 90,055.00

VAT (18% – Israel Standard Rate): ILS 16,209.90

GRAND TOTAL: ILS 106,264.90

NOTE: All items listed in this Purchase Order must comply with the Israeli Ministry of Health regulations for Chemist and pharmaceutical distribution. The Chemist supplier is required to provide valid batch numbers, expiration dates, and Israeli regulatory approval documentation (MOH registration) for every pharmaceutical product included in this order. Delivery to Israel Jerusalem must be completed within the specified window and all cold-chain items (Item 9) must be transported at 2°C–8°C with temperature logging. TERMS AND CONDITIONS

This Purchase Order is issued by Jerusalem Medical Supplies Ltd. and constitutes a binding request for the Chemist supplier to fulfill the listed items in accordance with Israeli commercial law and the Ministry of Health Chemist licensing regulations.
The Chemist supplier shall deliver all goods to the specified Israel Jerusalem address no later than the Required Delivery Date stated above. Late delivery beyond five (5) business days entitles the buyer to cancel this Purchase Order without penalty.
All pharmaceutical products must be in original, unopened packaging with a minimum remaining shelf life of eighteen (18) months from the date of delivery to Israel Jerusalem.
Payment shall be made via bank transfer to the Chemist supplier's designated Israeli bank account within thirty (30) calendar days of receipt of a valid tax invoice (Faskal) and confirmed delivery at the Israel Jerusalem warehouse.
The Chemist supplier warrants that all products are genuine, properly stored, and fully compliant with Israeli pharmaceutical standards. Any non-conforming goods will be rejected at the Israel Jerusalem receiving dock and must be replaced within five (5) business days at the Chemist supplier's expense.
This Purchase Order is subject to the general terms of the Israeli Consumer Protection Law and the specific provisions of the Israeli Pharmacy and Chemist Practice Regulations (2023 Amendment).
Any amendments to this Purchase Order must be made in writing and signed by both parties. Verbal modifications are not valid under this agreement.
Disputes arising from this Purchase Order shall be resolved under the jurisdiction of the competent courts in Israel Jerusalem, in accordance with Israeli law.

AUTHORIZATION AND SIGNATURES

For and on behalf of the Buyer:

Jerusalem Medical Supplies Ltd.

Name: Mr. David Cohen
Title: Warehouse Manager / Authorized Signatory
Signature: _________________________
Date: 15 June 2025

For and on behalf of the Chemist Supplier:

Herzliya Chemist & Pharmaceutical Distribution Co.

Name: Dr. Miriam Levi
Title: Head of Chemist Operations
Signature: _________________________
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX

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