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Purchase Order Chemist in South Africa Cape Town –Free Word Template Download with AI

Pharmaceutical & Chemist Supply Procurement Document

Issued in accordance with the Medicines and Related Substances Act, 1965 (Act No. 101 of 1965) as amended, and the South African Health Products Regulatory Authority (SAHPRA) regulations applicable in South Africa Cape Town.

PO No: CT-CHM-2025-04872

Date of Issue: 14 June 2025   |   Valid Until: 14 July 2025

Purchaser (Chemist / Pharmacy)

Table Bay Chemist & Pharmacy (Pty) Ltd

12 Long Street, City Bowl

Cape Town, 8001, Western Cape

South Africa

Registration No: 2019/456789/07

SAHPRA Pharmacy Licence: WCP-2024-00891

VAT No: 4930123456

Contact: [email protected]

Telephone: +27 21 424 5567

Supplier (Distributor)

MediPharm Distribution (Pty) Ltd

Unit 7, 45 Parow Industrial Road

Parow, Cape Town, 7501, Western Cape

South Africa

Registration No: 2005/112233/07

SAHPRA Wholesale Licence: WCP-WH-2023-0045

VAT No: 4420987654

Contact: [email protected]

Telephone: +27 21 932 8890

Field Detail
Purchase Order Reference CT-CHM-2025-04872
Order Type Recurring Monthly Chemist Stock Replenishment
Delivery Location Table Bay Chemist & Pharmacy, 12 Long Street, City Bowl, Cape Town, 8001, South Africa
Required Delivery Date 21 June 2025 (before 14:00 SAST)
Delivery Method Temperature-controlled courier (2°C – 8°C for refrigerated items)
Currency South African Rand (ZAR / R)
Payment Terms Net 30 days from date of invoice, EFT to supplier account
Governing Jurisdiction Laws of the Republic of South Africa, Western Cape Division of the High Court, Cape Town
Item No. Description SAHPRA Reg. No. Unit Qty Unit Price (ZAR) Line Total (ZAR)
001 Amoxicillin 500mg Capsules (28s) – Antibiotic, Schedule 3 SAHPRA-2024-1187 Box 120 R 89.50 R 10 740.00
002 Ibuprofen 400mg Tablets (100s) – Analgesic, OTC SAHPRA-2023-0452 Box 200 R 42.00 R 8 400.00
003 Insulin Glargine 100 IU/mL Pen (5 pens) – Refrigerated SAHPRA-2024-2201 Set 40 R 1 250.00 R 50 000.00
004 Paracetamol 500mg Tablets (100s) – Analgesic, OTC SAHPRA-2022-0891 Box 300 R 28.75 R 8 625.00
005 Metformin 850mg Tablets (60s) – Antidiabetic, Schedule 3 SAHPRA-2024-1567 Box 150 R 67.20 R 10 080.00
006 Salbutamol 100mcg Inhaler (200 doses) – Bronchodilator, Schedule 3 SAHPRA-2023-3345 Unit 80 R 145.00 R 11 600.00
007 Oral Rehydration Salts (20 sachets) – OTC SAHPRA-2021-0234 Box 100 R 35.00 R 3 500.00
008 Hydrocortisone 1% Cream 30g – Topical, OTC SAHPRA-2023-1102 Tube 60 R 52.00 R 3 120.00
009 Antiseptic Solution 10% (500mL) – First Aid, OTC SAHPRA-2022-0678 Bottle 50 R 38.50 R 1 925.00
010 Disposable Nitrile Gloves (100s, M) – PPE SAHPRA-2024-0098 Box 40 R 95.00 R 3 800.00
Subtotal (excl. VAT) R 111 790.00
VAT @ 15% (South Africa) R 16 768.50
Delivery & Cold-Chain Handling Fee R 1 250.00
TOTAL AMOUNT DUE (incl. VAT) R 129 808.50

4.1 This Purchase Order is issued by Table Bay Chemist & Pharmacy (Pty) Ltd, a registered chemist and pharmacy operating in Cape Town, South Africa, and constitutes a binding request for the supply of pharmaceutical and chemist products as itemised above.

4.2 All products supplied under this Purchase Order must comply with the standards set by the South African Health Products Regulatory Authority (SAHPRA) and must be registered in South Africa. The supplier warrants that all Schedule 3 and Schedule 5 medicines are sourced from approved manufacturers and distributed in accordance with the Medicines and Related Substances Act, 1965.

4.3 Refrigerated and temperature-sensitive items (including but not limited to Insulin Glargine) must be transported in a validated cold chain at 2°C to 8°C from the supplier's warehouse in Parow, Cape Town, to the receiving chemist premises in the City Bowl, Cape Town. A temperature log must accompany each refrigerated consignment.

4.4 The supplier shall deliver all goods to the specified address in Cape Town, South Africa, no later than the required delivery date stated in Section 2. Late delivery beyond 48 hours entitles the chemist purchaser to cancel the affected line items without penalty.

4.5 Payment shall be made within thirty (30) calendar days of receipt of a valid tax invoice, via electronic funds transfer (EFT) to the supplier's designated bank account in South Africa. No payment shall be due until all goods have been inspected and accepted by the chemist's dispensing pharmacist.

4.6 The chemist purchaser reserves the right to inspect all delivered goods upon arrival. Any damaged, expired, or non-conforming items must be reported within five (5) business days and will be replaced or credited at the supplier's cost.

4.7 This Purchase Order is governed by and construed in accordance with the laws of the Republic of South Africa. Any disputes arising from this document shall be subject to the exclusive jurisdiction of the Western Cape Division of the High Court of South Africa, Cape Town.

4.8 The supplier acknowledges that the purchaser operates as a licensed chemist in Cape Town and that all Schedule 3, 4, 5, and 6 medicines must be stored and handled in compliance with the Pharmacy Council of South Africa (PCSA) regulations.

4.9 This Purchase Order may not be assigned or transferred without the prior written consent of both parties. Any amendments must be made in writing and signed by authorised representatives of both the chemist and the supplier.

4.10 The supplier shall maintain adequate product liability insurance in South Africa for the full value of goods in transit and in storage prior to delivery to the chemist.

NOTE: This Purchase Order is specific to the chemist operations of Table Bay Chemist & Pharmacy (Pty) Ltd in Cape Town, South Africa. All pharmaceutical products listed must bear valid SAHPRA registration numbers and must be within their stated shelf life (minimum 12 months remaining at point of delivery). The supplier is required to provide batch/lot numbers and certificates of analysis for all Schedule 3 and Schedule 5 items as part of the delivery documentation.

For and on behalf of the Chemist (Purchaser):

Dr. Naledi van der Merwe, MPharm
Dispensing Pharmacist / Owner
Table Bay Chemist & Pharmacy (Pty) Ltd
Date: _______________

For and on behalf of the Supplier:

Mr. Thabo Mokoena
Regional Sales Manager, Western Cape
MediPharm Distribution (Pty) Ltd
Date: _______________

This Purchase Order document was generated for use by a registered chemist in Cape Town, South Africa. It is subject to the regulations of SAHPRA, the Pharmacy Council of South Africa, and the South African National Treasury. Document Reference: CT-CHM-2025-04872 | Page 1 of 1

© 2025 Table Bay Chemist & Pharmacy (Pty) Ltd, Cape Town, South Africa. All rights reserved.

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