Purchase Order Dentist in United States Los Angeles –Free Word Template Download with AI
SmileCare Dental Group, LLC
4520 Wilshire Boulevard, Suite 310, Los Angeles, California 90010, United States
Phone: (213) 555-0187 | Email: [email protected]
California Dental Board License No. D-48291 | EIN: 82-4471903
BUYER INFORMATION (Dentist Practice)| Company Name: | SmileCare Dental Group, LLC – A Licensed Dentist Practice in Los Angeles |
| Address: | 4520 Wilshire Boulevard, Suite 310, Los Angeles, California 90010, United States |
| Authorized Buyer: | Dr. Margaret Chen, DDS, MS – Lead Dentist & Practice Owner |
| Procurement Contact: | James Rodriguez, Office Manager – (213) 555-0187 ext. 4 |
| State Registration: | California Department of Consumer Affairs, Dental Board of California |
| Supplier Name: | Pacific Dental Supply Co., Inc. |
| Address: | 1200 Industrial Avenue, Long Beach, California 90810, United States |
| Contact Person: | Sarah Kim, Regional Sales Director – (562) 555-0342 |
| Supplier License: | California Medical Device Distributor License No. MDD-2019-7743 |
| Item # | Description | SKU / Part No. | Qty | Unit Price (USD) | Extended Price (USD) |
|---|---|---|---|---|---|
| 1 | Digital Intraoral Camera System – 5MP Resolution, Compatible with Dentist Chair Integration (Los Angeles Clinic Standard) | DI-5MP-2025 | 2 | $4,850.00 | $9,700.00 |
| 2 | LED Curing Light, 1200 mW, Cordless – For Composite Restorations in General Dentist Practice | CL-1200-C | 4 | $620.00 | $2,480.00 |
| 3 | Autoclave Sterilizer, 24L Capacity, Class B – Required for All Dentist Offices in United States Los Angeles per CDC Guidelines | AC-24L-B | 1 | $3,200.00 | $3,200.00 |
| 4 | Nitrile Examination Gloves, Size M, Box of 100 (Case of 10 Boxes) – For Dentist Patient Care | NG-M-1000 | 20 | $48.00 | $960.00 |
| 5 | Composite Resin Kit, Universal Shade, 50g Syringes (Set of 12) – For Dentist Restorative Procedures | CR-U-50-12 | 6 | $310.00 | $1,860.00 |
| 6 | Patient Dental Chair, Hydraulic, with Integrated Suction and Light – For New Dentist Treatment Room in Los Angeles | DC-HYD-2025 | 1 | $12,500.00 | $12,500.00 |
| 7 | Portable X-Ray Unit, Digital Sensor, 70kV – For In-Office Dentist Diagnostic Imaging | XR-70K-D | 1 | $18,900.00 | $18,900.00 |
| 8 | Disposable Dental Burs, Carbide, Assorted (Pack of 200) – For Dentist Operative Dentistry | DB-CARB-200 | 15 | $85.00 | $1,275.00 |
| 9 | Antiseptic Mouthwash, Chlorhexidine 0.12%, 1L Bottles (Case of 12) – Post-Procedure Care for Dentist Patients | AM-CHX-1L | 10 | $95.00 | $950.00 |
| 10 | Dental Impression Material, Polyvinyl Siloxane, Medium Viscosity (Kit of 20) – For Dentist Prosthodontic Work | IM-PVS-M20 | 8 | $145.00 | $1,160.00 |
| Subtotal: | $53,985.00 | ||||
| California Sales Tax (7.25% – Los Angeles County): | $3,913.91 | ||||
| Freight & Installation (Los Angeles Metro): | $1,250.00 | ||||
| TOTAL PURCHASE ORDER AMOUNT (USD): | $59,148.91 | ||||
- Scope of Purchase Order: This Purchase Order is issued by SmileCare Dental Group, LLC, a licensed Dentist practice operating in Los Angeles, California, United States, for the procurement of dental equipment, instruments, and consumable supplies as itemized above. All items must comply with the FDA (U.S. Food and Drug Administration) regulations and the standards set forth by the Dental Board of California.
- Delivery: All goods shall be delivered to the Dentist practice location at 4520 Wilshire Boulevard, Suite 310, Los Angeles, CA 90010, United States, no later than July 1, 2025. Delivery must be made between the hours of 8:00 AM and 4:00 PM Pacific Time on a business day. The supplier is responsible for all freight charges, insurance, and risk of loss until the goods are received and signed for at the Dentist office in Los Angeles.
- Quality and Compliance: All dental equipment and supplies must be new, unused, and in original manufacturer packaging. The supplier warrants that all items meet or exceed the quality standards expected of a professional Dentist practice in the United States. Any item found to be defective, expired, or non-compliant with California health and safety regulations shall be replaced at the supplier's sole expense within five (5) business days.
- Payment: Payment of the full Purchase Order amount of $59,148.91 shall be made via ACH bank transfer within thirty (30) calendar days of the date of receipt and acceptance of all goods at the Dentist practice in Los Angeles. Late payments shall accrue interest at a rate of 1.5% per month. The Dentist practice reserves the right to withhold payment for any disputed line items until resolution is reached.
- Installation and Training: The supplier shall provide on-site installation of the dental chair, portable X-ray unit, and autoclave sterilizer at the Dentist office in Los Angeles. A minimum of two (2) hours of hands-on training for the Dentist staff shall be included at no additional charge. Installation must be completed within five (5) business days of delivery.
- Warranty: All capital equipment (Items 1, 3, 6, and 7) shall carry a minimum manufacturer warranty of two (2) years from the date of installation. Consumable supplies (Items 2, 4, 5, 8, 9, and 10) are warranted to be free from defects at the time of delivery. The Dentist practice in Los Angeles shall notify the supplier in writing of any warranty claims within the applicable warranty period.
- Regulatory Compliance: The supplier acknowledges that the buyer is a regulated Dentist practice in the United States, specifically in the city of Los Angeles, and that all supplied items must comply with the California Health and Safety Code, Title 17, and all applicable Los Angeles County Department of Public Health regulations regarding dental office operations.
- Confidentiality: The supplier agrees to maintain strict confidentiality regarding the Dentist practice's patient records, operational procedures, and business information that may be disclosed during the fulfillment of this Purchase Order. This obligation shall survive the termination of this agreement for a period of three (3) years.
- Governing Law: This Purchase Order shall be governed by and construed in accordance with the laws of the State of California, United States, without regard to its conflict of law principles. Any disputes arising under this Purchase Order shall be subject to the exclusive jurisdiction of the state or federal courts located in Los Angeles County, California.
- Force Majeure: Neither party shall be liable for delays or failures in performance resulting from causes beyond their reasonable control, including but not limited to natural disasters, acts of government, or supply chain disruptions affecting the Los Angeles, United States region. The affected party shall notify the other party in writing within forty-eight (48) hours of the occurrence.
- Amendments: No modification or amendment to this Purchase Order shall be valid unless made in writing and signed by both the authorized representative of the Dentist practice and the supplier. Verbal agreements or email communications shall not constitute a valid amendment to this document.
For the Buyer (Dentist Practice):
SmileCare Dental Group, LLC
Los Angeles, California, United States
Dr. Margaret Chen, DDS, MS
Lead Dentist & Practice Owner
Date: ______________________
For the Supplier:
Pacific Dental Supply Co., Inc.
Long Beach, California, United States
Sarah Kim
Regional Sales Director
Date: ______________________
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