Purchase Order Dietitian in United States Chicago –Free Word Template Download with AI
Dietitian Professional Services — United States Chicago
Purchase Order No.: PO-2025-CHIC-04872Date of Issue: June 12, 2025
Valid Until: July 12, 2025 Payment Terms: Net 30 Days
Currency: USD (United States Dollar)
Incoterms: N/A (Professional Services) Buyer Information
| Company Name: Lakeview Wellness & Corporate Health, LLC | Address: 1200 N. Michigan Avenue, Suite 2400, Chicago, Illinois 60610, United States |
| Contact Person: Margaret Ellison, Director of Employee Benefits | Phone: (312) 555-0147 | Email: [email protected] |
| Tax ID (EIN): 36-4829175 | Illinois Business License: IL-BL-2024-88341 |
| Professional Name: Dr. Katherine M. Reeves, RD, LD, FAND | Practice: Reeves Nutrition & Metabolic Health, P.C. |
| Address: 845 W. Superior Street, Suite 310, Chicago, Illinois 60654, United States | Phone: (773) 555-0293 | Email: [email protected] |
| Illinois License No.: IL-DIET-2019-44782 | Registration: Registered Dietitian Nutritionist (RDN), Commission on Dietetic Registration (CDR) #12345678 |
This Purchase Order is issued by Lakeview Wellness & Corporate Health, LLC to engage the services of a licensed Dietitian operating within the city of United States Chicago, Illinois. The Dietitian shall provide comprehensive nutritional counseling, corporate wellness programming, and clinical dietary assessments as outlined below. All services shall be rendered in compliance with the Illinois Department of Financial and Professional Regulation (IDFPR) dietary practice act and applicable Chicago municipal health ordinances.
| Item # | Description of Service | Quantity | Unit | Unit Price (USD) | Extended Price (USD) |
|---|---|---|---|---|---|
| 1 | Initial corporate nutritional audit and employee dietary risk assessment for all 340 staff members at the Chicago headquarters facility | 1 | Project | $4,800.00 | $4,800.00 |
| 2 | Individual one-on-one Dietitian consultation sessions (60 minutes each) for employees referred through the corporate wellness program, covering metabolic syndrome, diabetes management, and weight optimization | 120 | Sessions | $185.00 | $22,200.00 |
| 3 | Group nutrition education workshops (90 minutes each) held at the Lakeview Wellness office in Chicago, covering topics such as Mediterranean diet protocols, portion control, and reading food labels | 12 | Workshops | $650.00 | $7,800.00 |
| 4 | Development of a 12-month customized meal planning and dietary intervention program tailored to the demographic profile of the Chicago-based workforce, including culturally diverse dietary accommodations | 1 | Program | $6,200.00 | $6,200.00 |
| 5 | Quarterly progress reporting and data analytics review with the Director of Employee Benefits, including written summaries of aggregate dietary outcomes and recommendations for program adjustment | 4 | Reports | $950.00 | $3,800.00 |
| 6 | On-site cafeteria menu consultation and nutritional labeling review for the company dining facility located at 1200 N. Michigan Avenue, Chicago, in compliance with FDA labeling standards and Chicago Department of Public Health food service regulations | 6 | Visits | $425.00 | $2,550.00 |
| Subtotal | $47,350.00 | ||||
| Illinois State Sales Tax (Professional Services Exempt) | $0.00 | ||||
| TOTAL AMOUNT DUE (USD) | $47,350.00 | ||||
- Scope of Engagement: This Purchase Order constitutes a binding agreement between the Buyer and the Dietitian for the professional services described herein. The Dietitian shall perform all duties in accordance with the standards of practice established by the Academy of Nutrition and Dietetics (AND) and the Illinois Board of Examiners for the Dietetic Profession.
- Location of Services: All services under this Purchase Order shall be performed at the Buyer's premises in United States Chicago, Illinois, or at such other locations within the City of Chicago as mutually agreed upon in writing. The Dietitian acknowledges that all clinical and counseling services will take place within the jurisdiction of Cook County and the City of Chicago.
- Licensing and Compliance: The Dietitian warrants that she holds a current, valid Illinois Dietitian license and maintains active CDR registration throughout the term of this Purchase Order. The Dietitian shall comply with all applicable federal, state, and local regulations governing the practice of dietetics in the United States, including but not limited to the Chicago Municipal Code Chapter 748 (Food Service) and the Illinois Food Code.
- Payment Schedule: Payment shall be made within thirty (30) calendar days of receipt of a valid invoice from the Dietitian. Invoices shall be submitted monthly and shall reference this Purchase Order number (PO-2025-CHIC-04872). Payment shall be made via ACH transfer to the account designated by the Dietitian.
- Confidentiality: The Dietitian shall maintain strict confidentiality of all employee health information in accordance with the Health Insurance Portability and Accountability Act (HIPAA), the Illinois Personal Information Protection Act, and all applicable privacy laws in the United States. No individual dietary data collected in Chicago shall be disclosed to third parties without written consent.
- Termination: Either party may terminate this Purchase Order with thirty (30) days written notice. Upon termination, the Buyer shall pay for all services rendered up to the date of termination. The Dietitian shall deliver all completed reports and program materials to the Buyer within fifteen (15) days of termination.
- Insurance: The Dietitian shall maintain professional liability insurance with a minimum coverage of $1,000,000 per occurrence and $2,000,000 in aggregate, naming the Buyer as an additional insured. Proof of insurance shall be provided prior to the commencement of services in United States Chicago.
- Governing Law: This Purchase Order shall be governed by and construed in accordance with the laws of the State of Illinois, United States. Any disputes arising hereunder shall be resolved through binding arbitration in Chicago, Illinois, in accordance with the rules of the American Arbitration Association.
- Independent Contractor Status: The Dietitian is engaged as an independent contractor and not as an employee of the Buyer. The Dietitian is solely responsible for all federal, state, and local tax obligations, including self-employment tax, Illinois state income tax, and Chicago municipal tax obligations applicable to self-employed professionals in the United States.
For the Buyer:
Lakeview Wellness & Corporate Health, LLC
Title: Director of Employee Benefits
Signature: _________________________
Date: _________________________
For the Vendor / Dietitian:
Reeves Nutrition & Metabolic Health, P.C.
Title: Principal Dietitian
Signature: _________________________
Date: _________________________ ⬇️ Download as DOCX Edit online as DOCX
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