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Purchase Order Dentist in Canada Vancouver –Free Word Template Download with AI

North Shore Dental Associates Inc.

4820 West Broadway, Suite 310, Vancouver, British Columbia, Canada V5X 4E8

Phone: (604) 555-0172  |  Email: [email protected]  |  BC Business Licence: #8012345-6

Purchase Order No.: PO-2025-0487
Date of Issue: June 12, 2025
Required Delivery Date: June 27, 2025
Vendor: Pacific Dental Supply Co. Ltd.
Vendor Address: 1200 Granville Street, Vancouver, BC, Canada V6Z 2V1
Vendor Contact: Mr. David Chen, Sales Manager
Payment Terms: Net 30 Days
Currency: Canadian Dollars (CAD)
Shipping Method: Ground Freight – Vancouver Metro
Item # Description SKU / Part No. Qty Unit Price (CAD) Line Total (CAD)
1 Digital Dental X-Ray Sensor (Intraoral, 2.0 MP) – for use in Vancouver clinic radiography suite DXS-2000-CA 2 $4,850.00 $9,700.00
2 LED Dental Operating Light, 50,000 Lux, with UV Sterilization Module LED-50K-VX 1 $3,200.00 $3,200.00
3 Composite Resin Kit, Universal Shade Range (A1–A4, B1–B4), 24 syringes per kit CRU-24-STD 10 $185.00 $1,850.00
4 Disposable Dental Gloves, Nitrile, Medium, Box of 100 (Class II Medical Device, Health Canada approved) DGL-NIT-M-100 200 $12.50 $2,500.00
5 Autoclave Sterilizer, 23L Capacity, Class B, with Digital Cycle Monitoring – compliant with BC College of Denturists regulations ACL-23B-DC 1 $6,400.00 $6,400.00
6 Prophy Paste, Fluoride 1.1%, Strawberry, 120g tubes PPF-110-ST 50 $8.75 $437.50
7 Dental Impression Material, Polyvinyl Siloxane (PVS), Medium Viscosity, 350ml cartridges PVS-MED-350 40 $22.00 $880.00
8 Local Anesthetic Cartridges, Lidocaine 2% with Epinephrine 1:100,000, 1.8ml (Health Canada NPN listed) LID-2-EP-18 300 $3.20 $960.00
9 Patient Dental Chair, Hydraulic, with Headrest and Armrest Adjustment, ANSI/ADA compliant CHY-HYD-ADA 1 $12,500.00 $12,500.00
10 Suction System, High-Volume and Saliva Ejector, with Anti-Backflow Valves SUC-HV-ABF 2 $1,150.00 $2,300.00
Subtotal: $40,727.50
GST (5% – Federal, Canada): $2,036.38
PST (7% – British Columbia, Canada Vancouver): $2,850.93
TOTAL AMOUNT DUE (CAD): $45,614.81

All items listed in this Purchase Order must be delivered to the North Shore Dental Associates Inc. facility located at 4820 West Broadway, Suite 310, Vancouver, British Columbia, Canada V5X 4E8. The delivery address falls within the City of Vancouver municipal boundary in the Lower Mainland region of British Columbia. The vendor is required to coordinate delivery with the practice's front-office staff between the hours of 8:00 AM and 4:30 PM Pacific Daylight Time (PDT). All dental equipment must be packaged in accordance with Health Canada transport regulations for medical devices. Fragile items, including the digital X-ray sensors and the LED operating light, must be shipped with appropriate shock-absorbing materials and clearly labelled "FRAGILE – DENTAL EQUIPMENT – VANCOUR, BC." The vendor shall provide a Bill of Lading and a Certificate of Conformance for all Class II medical devices prior to delivery.

1. Acceptance: This Purchase Order constitutes a binding agreement between North Shore Dental Associates Inc. (the "Dentist" or "Buyer") and Pacific Dental Supply Co. Ltd. (the "Vendor") upon written acceptance by both parties. The Dentist reserves the right to inspect all delivered goods within five (5) business days of receipt at the Vancouver clinic location. Any items found to be defective, damaged in transit, or non-conforming to the specifications outlined in this Purchase Order must be reported in writing to the Vendor within the inspection period. 2. Payment: Payment of the total amount of CAD $45,614.81 shall be made via Electronic Funds Transfer (EFT) to the Vendor's designated Canadian bank account within thirty (30) calendar days of the date of invoice. Late payments shall accrue interest at the rate of 1.5% per month, in accordance with the British Columbia Interest Act. All payments are denominated in Canadian Dollars. 3. Warranty: The Vendor warrants that all dental equipment and supplies supplied under this Purchase Order are new, unused, and free from defects in materials and workmanship. The dental chair and autoclave carry a minimum two-year manufacturer's warranty. The digital X-ray sensors carry a three-year warranty. All warranties are valid within the jurisdiction of Canada and specifically the Province of British Columbia. 4. Regulatory Compliance: All products must comply with the Food and Drugs Act and Regulations of Canada, as administered by Health Canada. All medical devices must hold a valid Medical Device License (MDL) or Medical Device Establishment License (MDEL) issued by Health Canada. The Dentist, operating under the College of Dentists of British Columbia, requires that all sterilization and radiographic equipment meet the standards set forth by the Canadian Standards Association (CSA) and the British Columbia College of Denturists. 5. Intellectual Property and Confidentiality: The terms of this Purchase Order, including pricing and product specifications, are confidential and shall not be disclosed to third parties without the written consent of the Dentist. 6. Governing Law: This Purchase Order shall be governed by and construed in accordance with the laws of the Province of British Columbia and the federal laws of Canada applicable therein. Any disputes arising from this Purchase Order shall be resolved through mediation in Vancouver, British Columbia, before resorting to litigation in the Supreme Court of British Columbia. 7. Force Majeure: Neither party shall be liable for delays caused by events beyond reasonable control, including but not limited to natural disasters, pandemics, or government-mandated closures affecting the Vancouver metropolitan area.

For and on behalf of the Dentist (Buyer):

North Shore Dental Associates Inc.

Dr. Sarah Mitchell, DDS, FICOI
Principal Dentist & Practice Owner
Date: ______________________

For and on behalf of the Vendor:

Pacific Dental Supply Co. Ltd.

David Chen
Sales Manager
Date: ______________________

This Purchase Order was prepared for a licensed dental practice operating in Vancouver, British Columbia, Canada. All transactions are subject to Canadian federal and provincial tax regulations. Document Reference: PO-2025-0487 | Page 1 of 1

© 2025 North Shore Dental Associates Inc. – Vancouver, BC, Canada. All rights reserved.

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