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Purchase Order Dentist in United States Miami –Free Word Template Download with AI

Confidential Business Document — Dental Practice Procurement

United States • Miami, Florida

Purchase Order Details

PO Number: PO-MIA-2025-04871

Date of Issue: June 12, 2025

Required Delivery Date: June 26, 2025

Payment Terms: Net 30 Days

Currency: USD (United States Dollar)

Incoterms: DDP — Miami, FL

Buyer (Dentist Practice)

Practice Name: Coral Gables Dental Associates, P.A.

Attending Dentist: Dr. Maria Elena Rodriguez, DDS, MS

Address: 3850 Coral Way, Suite 210, Miami, FL 33145, United States

Phone: (305) 555-0192

Email: [email protected]

Florida Dental License: FL-D-2019-44871

Vendor / Supplier

Company: SunShine Dental Supply Co., Inc.

Address: 1200 NW 42nd Street, Miami, FL 33142, United States

Phone: (305) 555-0347

Tax ID (EIN): 82-4471903

Contact: James T. Whitfield, Regional Sales Manager

Email: [email protected]

Item # Description Qty Unit Unit Price (USD) Extended Price (USD)
001 Digital Dental X-Ray Sensor (Sennight 2D) — for use in Miami dental office 2 EA $4,850.00 $9,700.00
002 Composite Resin Kit, A2/A3/B1 Shades (3M Filtek Z350) — restorative materials for dentist procedures 12 SET $385.00 $4,620.00
003 Autoclave Sterilizer, 24L Capacity (Tuttnauer 3830EA) — required for Florida dental board compliance 1 EA $7,200.00 $7,200.00
004 Nitrile Examination Gloves, Size M, Box of 100 (Hartmann) — PPE for dental team in Miami clinic 50 BOX $18.50 $925.00
005 High-Speed Handpiece with Turbine (NSK Vario 20) — for dentist operative dentistry 4 EA $1,120.00 $4,480.00
006 Intraoral Camera with 15" Monitor (Dental Wings) — patient education tool for Miami dental practice 2 EA $2,340.00 $4,680.00
007 Sodium Hypochlorite 5.25%, 1 Gallon (Dental-Grade) — endodontic irrigant for dentist root canal procedures 20 GL $22.00 $440.00
008 Dental Chair Cushion Covers, Custom Fit (Miami Blue) — replacement upholstery for dental operatory 6 EA $145.00 $870.00
009 LED Curing Light, 1000 mW/cm² (Woodpecker) — for dentist composite bonding and orthodontic work 3 EA $680.00 $2,040.00
010 Impression Material, Polyvinyl Siloxane, Medium Viscosity (3M Impregum) — for dentist prosthodontic impressions 30 CT $42.00 $1,260.00

Subtotal: $36,215.00

Florida State Sales Tax (7.0%): $2,535.05

Miami-Dade County Surcharge (1.0%): $362.15

Shipping & Handling (within Miami, FL): $285.00

Grand Total: $39,397.20

Terms and Conditions — Purchase Order for Dental Practice in Miami, United States

  1. Scope of Purchase: This Purchase Order is issued by Coral Gables Dental Associates, P.A., a licensed dental practice operating in Miami, Florida, United States, for the procurement of dental equipment, restorative materials, sterilization apparatus, and personal protective equipment necessary for the continued operation of the dentist's clinical services.
  2. Delivery: All items listed in this Purchase Order shall be delivered to the buyer's dental office located at 3850 Coral Way, Suite 210, Miami, FL 33145, United States. Delivery must be completed no later than June 26, 2025. The vendor is responsible for all transportation costs within the Miami metropolitan area. Any delay exceeding five (5) business days beyond the required delivery date shall entitle the dentist practice to a 2% discount per week on the affected line items.
  3. Quality and Compliance: All dental supplies and equipment must comply with the standards set forth by the Florida Board of Dentistry, the United States Food and Drug Administration (FDA), and applicable OSHA regulations. The vendor warrants that all items are new, unused, and free from defects. Sterilization equipment must carry valid FDA 510(k) clearance documentation, which shall be included with the shipment.
  4. Payment: Payment of the full grand total of $39,397.20 shall be made within thirty (30) calendar days of the date of invoice receipt, via ACH transfer to the vendor's designated United States bank account. Late payments shall accrue interest at a rate of 1.5% per month, in accordance with Florida Statute Chapter 668.
  5. Warranty: The vendor shall provide a minimum two-year manufacturer's warranty on all capital equipment (items 001, 003, 005, 006, and 009). Consumable materials (items 002, 004, 007, 008, and 010) are warranted to be free from manufacturing defects at the time of delivery. The dentist practice in Miami shall notify the vendor in writing within thirty (30) days of discovering any defect.
  6. Regulatory Compliance — Miami, Florida: The vendor acknowledges that the purchased items are intended for use in a dental practice regulated by the Florida Department of Health and the Florida Board of Dentistry. All hazardous materials, including sodium hypochlorite, must be shipped in compliance with United States Department of Transportation (DOT) regulations and Florida Department of Environmental Protection (FDEP) guidelines for the Miami-Dade County jurisdiction.
  7. Intellectual Property and Branding: The vendor grants the dentist practice the right to use all product names, model numbers, and technical specifications contained in this Purchase Order for internal record-keeping, insurance filings, and Florida dental board reporting purposes.
  8. Governing Law: This Purchase Order shall be governed by and construed in accordance with the laws of the State of Florida, United States, without regard to its conflict of law principles. Any disputes arising from this Purchase Order shall be resolved in the state or federal courts located in Miami-Dade County, Florida, United States.
  9. Force Majeure: Neither party shall be liable for failure to perform obligations under this Purchase Order due to acts of God, hurricanes, tropical storms, or other natural disasters affecting the Miami, Florida, United States region, provided that the affected party gives written notice within forty-eight (48) hours of the event.
  10. Entire Agreement: This Purchase Order, together with any attached specifications and the vendor's standard terms of sale, constitutes the entire agreement between the dentist practice and the vendor regarding the subject matter herein. No modification shall be valid unless made in writing and signed by both parties.

Authorized by (Buyer / Dentist Practice):

Dr. Maria Elena Rodriguez, DDS, MS
Principal Dentist, Coral Gables Dental Associates, P.A.
Miami, Florida, United States
Date: ______________________

Accepted by (Vendor / Supplier):

James T. Whitfield
Regional Sales Manager, SunShine Dental Supply Co., Inc.
Miami, Florida, United States
Date: ______________________

This Purchase Order (PO-MIA-2025-04871) is a confidential business document issued for the procurement of dental supplies and equipment for a licensed dental practice in Miami, Florida, United States. Unauthorized reproduction or distribution is prohibited. For questions regarding this Purchase Order, contact the procurement office of Coral Gables Dental Associates, P.A. at (305) 555-0192 or [email protected]. This document is subject to the laws of the State of Florida and the United States of America.

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