Purchase Order Dentist in Indonesia Jakarta –Free Word Template Download with AI
PO Number: PO-JKT-DNT-2025-00487
Date of Issue: 14 June 2025
Country of Operation: Indonesia — Jakarta
This Purchase Order is issued by PT Senyum Sehat Dental Clinic, a licensed Dentist practice operating in Indonesia Jakarta, to PT Medika Dental Supply Indonesia for the procurement of dental equipment, instruments, and consumable supplies. This document serves as a binding commercial agreement between the Buyer and the Seller for the goods and services described herein, in full compliance with the regulations of the Ministry of Health of the Republic of Indonesia and the local health authority of the Special Capital Region of Jakarta (DKI Jakarta).
LINE ITEMS — DENTAL EQUIPMENT AND SUPPLIES| Item No. | Description | Specification / Model | Qty | Unit Price (IDR) | Subtotal (IDR) |
|---|---|---|---|---|---|
| 01 | Dental Chair Unit with Integrated Light | A-dec 500 Series, CE & BPOM Certified | 4 | 185,000,000 | 740,000,000 |
| 02 | Digital Intraoral X-Ray System | Sirona OptraSensor, 2D Imaging | 2 | 92,500,000 | 185,000,000 |
| 03 | Dental Handpiece (High-Speed & Low-Speed) | NSK W101 / W201, Autoclavable | 12 | 8,750,000 | 105,000,000 |
| 04 | Composite Resin Filling Material (Assorted Shades) | 3M Z350 XT, 4g syringes, A1–A4 | 200 | 425,000 | 85,000,000 |
| 05 | Dental Burs (Diamond & Carbide Assortment) | KG Sorensen, 100-piece kit | 10 | 2,850,000 | 28,500,000 |
| 06 | Autoclave Sterilizer (Class B, 24L) | Tuttnauer 3830EA, BPOM Registered | 2 | 45,000,000 | 90,000,000 |
| 07 | Dental Dam & Accessories (Rolls, Forceps, Clamps) | Assorted, 500 rolls + 20 forceps | 1 | 12,500,000 | 12,500,000 |
| 08 | Patient Examination Gloves (Nitrile, S/M/L) | Medline, 100 boxes (100 pcs/box) | 100 | 185,000 | 18,500,000 |
| 09 | Dental Mirror & Explorer Set (Stainless Steel) | Whaledent, 50 sets | 50 | 320,000 | 16,000,000 |
| 10 | LED Curing Light (Wireless) | Woodpecker W26, 1200 mW/cm² | 6 | 6,250,000 | 37,500,000 |
| Subtotal (IDR): | 1,418,000,000 | ||||
| VAT (PPN) 11% — Indonesia: | 155,980,000 | ||||
| GRAND TOTAL (IDR): | 1,573,980,000 | ||||
| Grand Total in Words: | One Billion Five Hundred Seventy-Three Million Nine Hundred Eighty Thousand Indonesian Rupiah | ||||
- Delivery Location: All goods shall be delivered to the Buyer's premises at Jl. Jend. Sudirman Kav. 52-53, SCBD, South Jakarta, Indonesia. The Seller is responsible for all logistics, customs clearance (if applicable for imported components), and last-mile delivery within the Jakarta metropolitan area.
- Delivery Timeline: The Seller shall deliver all items listed in this Purchase Order within thirty (30) calendar days from the date of this Purchase Order, i.e., no later than 14 July 2025. Partial deliveries are permitted provided the Buyer is notified in writing at least five (5) business days in advance.
- Payment Terms: Payment shall be made via bank transfer (transfer bank) to the Seller's designated account in Indonesian Rupiah (IDR). A 40% down payment is due upon signing of this Purchase Order, and the remaining 60% is due within fourteen (14) days of confirmed delivery and acceptance of goods at the Jakarta clinic site.
- Warranty: All dental equipment and instruments shall carry a minimum warranty of twenty-four (24) months from the date of delivery, in accordance with the Consumer Protection Law of the Republic of Indonesia (UU No. 8 Tahun 1999). The Seller shall provide on-site repair or replacement within Jakarta at no additional cost to the Buyer during the warranty period.
- Regulatory Compliance: All products must hold valid registration with the National Agency of Drug and Food Control (BPOM) of Indonesia. The Seller warrants that all items comply with the Indonesian Dental Association (PDGI) standards and the operational licensing requirements of the DKI Jakarta Health Office (Dinas Kesehatan DKI Jakarta).
- Acceptance and Inspection: The Buyer's designated Dentist supervisor and procurement officer shall inspect all delivered goods within five (5) business days of arrival at the Jakarta facility. Any defects, shortages, or non-conformities must be reported in writing to the Seller within this period.
- Installation and Training: The Seller shall provide professional installation of all major equipment (dental chairs, X-ray systems, autoclaves) at the Buyer's Jakarta clinic. Additionally, the Seller shall conduct a minimum of eight (8) hours of hands-on training for the Buyer's dental staff, including dentists, dental assistants, and hygienists, on the proper operation and maintenance of the delivered equipment.
- Force Majeure: Neither party shall be liable for delays caused by events beyond reasonable control, including but not limited to natural disasters, government-mandated closures in Jakarta, or national public health emergencies as declared by the Indonesian government.
- Governing Law: This Purchase Order shall be governed by and construed in accordance with the laws of the Republic of Indonesia. Any disputes arising from this Purchase Order shall be resolved through the Commercial Court (Pengadilan Niaga) in South Jakarta, Indonesia.
- Confidentiality: Both parties agree to maintain the confidentiality of all commercial terms, pricing, and operational details contained in this Purchase Order. This obligation shall survive the termination of this agreement for a period of three (3) years.
The Buyer, PT Senyum Sehat Dental Clinic, is a multi-chair Dentist practice serving the greater Indonesia Jakarta metropolitan population. This Purchase Order represents a quarterly restocking and capital equipment upgrade to ensure the clinic maintains the highest standards of patient care in line with Indonesian dental practice regulations. All imported components must be accompanied by valid import permits (API) and customs documentation processed through the Jakarta Customs Office (Kantor Bea Cukai Jakarta). The Seller is reminded that the clinic operates under a valid Izin Praktik (Practice License) issued by the DKI Jakarta Health Office, and all equipment must be registered accordingly to maintain the clinic's operational compliance. The Buyer reserves the right to adjust quantities by up to 10% without reissuing this Purchase Order, provided the adjustment is communicated in writing at least ten (10) business days before the scheduled delivery date.
For and on behalf of the BUYER:
PT Senyum Sehat Dental Clinic
Name: drg. Andi Wijaya, M.Kes.
Title: Lead Dentist & Clinic Director
Signature: ___________________________
Date: 14 June 2025
For and on behalf of the SELLER:
PT Medika Dental Supply Indonesia
Name: Budi Santoso, S.E.
Title: Sales & Account Manager
Signature: ___________________________
Date: 14 June 2025
⬇️ Download as DOCX Edit online as DOCXCreate your own Word template with our GoGPT AI prompt:
GoGPT