Purchase Order Dietitian in United States Los Angeles –Free Word Template Download with AI
PO Number: PO-LA-2025-004872
Date of Issue: June 15, 2025
Valid Until: July 15, 2025
Purchasing Party (Buyer)
Company: Pacific Wellness Group, LLC
Address: 4500 Wilshire Boulevard, Suite 1200
City/State/ZIP: United States Los Angeles, CA 90010
Contact: Margaret Chen, Procurement Director
Email: [email protected]
Phone: (213) 555-0147
Tax ID (EIN): 82-4471903
Supplier / Service Provider
Company: Angel City Nutrition & Dietetics, Inc.
Address: 1200 S. Grand Avenue, Floor 3
City/State/ZIP: United States Los Angeles, CA 90015
Contact: Dr. Sarah Okafor, R.D., L.D.
Email: [email protected]
Phone: (323) 555-0892
License No.: CA-DSN-2019-44871
This Purchase Order is issued by Pacific Wellness Group, LLC, a corporation registered in the State of California, to formally request and authorize the procurement of professional Dietitian services to be rendered within the metropolitan area of United States Los Angeles. This document constitutes a binding agreement upon acceptance by both parties and governs all terms, conditions, deliverables, and payment obligations associated with the engagement of the Dietitian professional services described herein.
Line Items – Dietitian Services| Item # | Description of Dietitian Service | Qty | Unit | Unit Price (USD) | Extended Price (USD) |
|---|---|---|---|---|---|
| 001 | Comprehensive Nutritional Assessment and Individualized Meal Planning by a Licensed Dietitian – Initial Consultation (90 minutes) | 120 | Sessions | $185.00 | $22,200.00 |
| 002 | Ongoing Dietitian Follow-Up Consultations and Dietary Progress Monitoring (45 minutes per session) | 360 | Sessions | $120.00 | $43,200.00 |
| 003 | Corporate Wellness Workshop Series – Dietitian-Led Group Nutrition Education (2-hour sessions, up to 50 participants) | 8 | Workshops | $1,500.00 | $12,000.00 |
| 004 | Customized Dietary Program Development for Employee Assistance Program (EAP) – United States Los Angeles Office | 1 | Project | $8,500.00 | $8,500.00 |
| 005 | Monthly Nutritional Audit and Reporting by the Dietitian – Compliance with California Board of Registered Dietitians Standards | 6 | Months | $2,200.00 | $13,200.00 |
| 006 | Emergency Dietitian On-Call Availability – 24/7 Coverage for United States Los Angeles Facility (Monthly Retainer) | 6 | Months | $1,800.00 | $10,800.00 |
| Subtotal: | $110,000.00 | ||||
| California Sales Tax (8.75%): | $9,625.00 | ||||
| TOTAL AMOUNT DUE (USD): | $119,625.00 | ||||
- Scope of Services: The Dietitian engaged under this Purchase Order shall provide all nutritional counseling, meal planning, dietary assessments, and wellness education services in full compliance with the California Code of Regulations, Title 16, Section 1470 et seq., and the standards established by the California Board of Registered Dietitians. All services shall be performed at the purchasing party's facility located in United States Los Angeles, California, or at such other locations within the City of Los Angeles as mutually agreed upon in writing.
- Qualifications: The Dietitian providing services under this Purchase Order must hold a current California Registered Dietitian License (R.D., L.D.) and maintain a minimum of five (5) years of post-licensure clinical experience. Proof of licensure, professional liability insurance (minimum $2,000,000 per occurrence), and a current Certificate of Good Standing from the California Board of Registered Dietitians must be submitted prior to the commencement of services.
- Payment Terms: Payment for all services rendered under this Purchase Order shall be made via ACH transfer or certified check within thirty (30) days of receipt of a valid invoice. Invoices shall be submitted on a monthly basis by the 5th business day of the following month. Late payments shall accrue interest at a rate of 1.5% per month or the maximum rate permitted under California law, whichever is less.
- Service Period: The Dietitian services authorized by this Purchase Order shall commence on July 1, 2025, and shall continue through December 31, 2025, unless terminated earlier in accordance with the cancellation provisions herein. All services shall be scheduled and delivered within the United States Los Angeles metropolitan area during standard business hours (Monday through Friday, 8:00 AM to 6:00 PM Pacific Time), unless otherwise specified for the on-call retainer service.
- Confidentiality and HIPAA Compliance: The Dietitian and all associated staff shall adhere strictly to the Health Insurance Portability and Accountability Act (HIPAA) and the California Confidentiality of Medical Information Act (CMIA). All client nutritional records, dietary assessments, and personal health information collected during the performance of services under this Purchase Order shall be maintained in strict confidence and shall not be disclosed to any third party without written consent, except as required by law.
- Termination: Either party may terminate this Purchase Order with thirty (30) days' written notice. In the event of termination, the purchasing party shall be obligated to pay for all Dietitian services rendered up to the effective date of termination. The supplier shall deliver all completed reports, dietary plans, and documentation within fifteen (15) days of the termination date.
- Governing Law: This Purchase Order shall be governed by and construed in accordance with the laws of the State of California. Any disputes arising from or related to this Purchase Order shall be resolved through binding arbitration in United States Los Angeles, California, in accordance with the rules of the American Arbitration Association.
- Force Majeure: Neither party shall be liable for failure to perform obligations under this Purchase Order due to events beyond reasonable control, including but not limited to natural disasters, pandemics, government mandates affecting operations in United States Los Angeles, or acts of war, provided that the affected party gives prompt written notice to the other party.
- Warranty of Services: The Dietitian warrants that all services provided under this Purchase Order shall be performed in a professional, competent, and workmanlike manner consistent with the accepted standards of the dietetics profession in the State of California. Any services found to be deficient shall be re-performed at no additional cost to the purchasing party within ten (10) business days of written notice.
- Entire Agreement: This Purchase Order, together with any attached exhibits, schedules, or amendments executed in writing, constitutes the entire agreement between the parties with respect to the Dietitian services described herein and supersedes all prior negotiations, representations, or agreements relating to the subject matter of this document.
By signing below, both parties acknowledge that they have read, understood, and agree to be bound by all terms and conditions set forth in this Purchase Order for the engagement of Dietitian services in United States Los Angeles, California. This Purchase Order shall become effective upon execution by both authorized representatives.
For: Pacific Wellness Group, LLC (Buyer)
Name: ______________________________
Title: Procurement Director
Signature: ______________________________
Date: ______________________________
For: Angel City Nutrition & Dietetics, Inc. (Supplier)
Name: ______________________________
Title: Lead Dietitian / Principal
Signature: ______________________________
Date: ______________________________
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