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Purchase Order Doctor General Practitioner in Senegal Dakar –Free Word Template Download with AI

Medical Services & Supplies Procurement Document

Issued for the Engagement of a Doctor General Practitioner in Senegal Dakar

Purchase Order No.: PO-SD-2025-04871
Date of Issue: 15 June 2025
Valid Until: 15 September 2025
Issuing Authority:
Clinique Médicale de Dakar
Avenue Cheikh Anta Diop
Plateau, Dakar, Senegal
Tel: +221 33 820 45 67
Email: [email protected]
1. Supplier / Service Provider Information
Field Details
Provider Name Dr. Awa Ndiaye, Doctor General Practitioner
Professional License No. OMPS-2019-0342 (Ordre des Médecins du Sénégal)
Specialization General Practice / Family Medicine
Practice Address Cabinet Médical Ndiaye, Rue Félix Faure, Almadies, Senegal Dakar
Contact Telephone +221 77 654 32 10
Email [email protected]
Bank Account (for payment) Bank: BICEF Senegal | IBAN: SN09 1005 6000 0123 4567 8901 234
2. Scope of Purchase Order

This Purchase Order is issued by Clinique Médicale de Dakar to formally engage the services of Dr. Awa Ndiaye, a licensed Doctor General Practitioner, for the provision of comprehensive primary healthcare services, diagnostic consultations, and related medical supplies within the city of Senegal Dakar. This document constitutes a binding procurement agreement between the issuing clinic and the named practitioner for the duration specified herein. The engagement covers outpatient consultations, preventive health screenings, chronic disease management, and the procurement of associated medical consumables as itemized below.

3. Itemized Services and Supplies
Ref. Description of Service / Item Quantity Unit Unit Price (XOF) Total (XOF)
01 General Practitioner outpatient consultation sessions (adult and pediatric) provided by the Doctor General Practitioner at the Almadies clinic in Senegal Dakar 500 Session 25,000 12,500,000
02 Preventive health screening packages (blood pressure, blood glucose, lipid profile, BMI assessment) administered by the Doctor General Practitioner 200 Package 45,000 9,000,000
03 Chronic disease management follow-up visits (hypertension, diabetes, asthma) conducted by the Doctor General Practitioner 300 Visit 30,000 9,000,000
04 Medical consumables: sterile examination gloves, gauze, antiseptic solutions, and single-use diagnostic kits for the Doctor General Practitioner's practice in Senegal Dakar 1 Lot 3,500,000 3,500,000
05 Prescription medication stock (essential medicines per Senegalese national formulary) for dispensing by the Doctor General Practitioner 1 Lot 7,200,000 7,200,000
06 Home-visit consultation services by the Doctor General Practitioner for elderly and immobile patients in the Dakar metropolitan area 80 Visit 50,000 4,000,000
07 Health education workshops on maternal and child health delivered by the Doctor General Practitioner to community groups in Senegal Dakar 12 Workshop 150,000 1,800,000
GRAND TOTAL (XOF) 47,000,000
4. Terms and Conditions
  1. This Purchase Order is governed by the laws of the Republic of Senegal and the regulatory framework established by the Ordre des Médecins du Sénégal. All services rendered by the Doctor General Practitioner must comply with the professional standards and ethical codes applicable in Senegal Dakar.
  2. The Doctor General Practitioner shall provide all services listed in Section 3 within the contractual period of 15 June 2025 to 15 September 2025, unless otherwise extended by mutual written agreement between both parties.
  3. Payment shall be made in CFA Francs (XOF) via bank transfer to the account specified in Section 1. Invoices are due within thirty (30) calendar days of receipt of a valid invoice from the Doctor General Practitioner.
  4. The Doctor General Practitioner is required to maintain valid professional liability insurance coverage throughout the duration of this Purchase Order. A certificate of insurance must be provided to the issuing clinic prior to the commencement of services.
  5. All patient records, medical files, and diagnostic data generated during the engagement of the Doctor General Practitioner shall remain the property of Clinique Médicale de Dakar and must be stored in accordance with Senegalese data protection regulations.
  6. The Doctor General Practitioner shall not subcontract any portion of the services outlined in this Purchase Order without prior written consent from the issuing authority in Senegal Dakar.
  7. In the event of non-performance, partial performance, or breach of professional standards, the issuing clinic reserves the right to terminate this Purchase Order with fourteen (14) days written notice, and the Doctor General Practitioner shall be liable for any resulting damages.
  8. Any disputes arising from this Purchase Order shall be resolved through mediation in Dakar, Senegal, before escalation to the competent courts of Senegal Dakar.
  9. All medical supplies and consumables procured under this Purchase Order must meet the quality standards set by the Agence Nationale de Régulation de la Santé (ANRS) of Senegal.
5. Acceptance and Authorization

By signing below, both parties acknowledge and accept the terms, conditions, and scope of work defined in this Purchase Order. The Doctor General Practitioner confirms availability to deliver all services as specified for the duration of the engagement in Senegal Dakar.

For and on behalf of Clinique Médicale de Dakar:

Name: Dr. Mamadou Diallo
Title: Director of Procurement & Operations
Signature: _________________________
Date: 15 June 2025

For and on behalf of the Doctor General Practitioner:

Name: Dr. Awa Ndiaye
Title: Doctor General Practitioner
Signature: _________________________
Date: 15 June 2025

This Purchase Order (PO-SD-2025-04871) is a controlled document issued by Clinique Médicale de Dakar, Plateau, Senegal Dakar. Unauthorized reproduction or distribution is prohibited. For inquiries, contact the Procurement Department at [email protected] or +221 33 820 45 67.

Document Classification: Confidential | Page 1 of 1

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