Purchase Order Doctor General Practitioner in Sri Lanka Colombo –Free Word Template Download with AI
Medical Services & General Practitioner Procurement Document
Issued for use in Sri Lanka Colombo
Purchasing Entity| Organization: Colombo Metropolitan Health Services Authority | Address: 42, Galle Road, Colombo 03, Sri Lanka |
| Contact Person: Dr. Nimal Perera, Procurement Officer | Telephone: +94 11 234 5678 |
| Email: [email protected] | Tax ID (TIN): 700123456-0000 |
| Provider Name: Dr. Anusha Fernando, Doctor General Practitioner | License No.: SL/MD/2019/00452 |
| Practice Address: 18, Temple Road, Colombo 10, Sri Lanka Colombo | Telephone: +94 77 890 1234 |
| Specialization: General Medicine, Family Health, Preventive Care | Email: [email protected] |
| Item No. | Description | Quantity | Unit | Unit Price (LKR) | Total (LKR) |
|---|---|---|---|---|---|
| 01 | General Practitioner Consultation – Outpatient Services (per patient visit, including history, examination, and prescription) | 1,200 | Visits | 3,500.00 | 4,200,000.00 |
| 02 | Doctor General Practitioner – Home Visit Service for elderly and immobile patients within Colombo District | 350 | Visits | 6,000.00 | 2,100,000.00 |
| 03 | Preventive Health Screening Program – Annual check-ups administered by the Doctor General Practitioner (blood pressure, blood sugar, BMI, ECG) | 800 | Packages | 5,500.00 | 4,400,000.00 |
| 04 | Chronic Disease Management – Ongoing care for diabetes, hypertension, and asthma patients supervised by the Doctor General Practitioner | 600 | Patients | 4,800.00 | 2,880,000.00 |
| 05 | Medical Reports and Referral Letters – Written documentation prepared by the Doctor General Practitioner for specialist referrals | 450 | Reports | 1,200.00 | 540,000.00 |
| 06 | Community Health Education Sessions – Conducted by the Doctor General Practitioner in Colombo community centers | 24 | Sessions | 15,000.00 | 360,000.00 |
| 07 | Emergency Triage and Initial Stabilization – On-call availability of the Doctor General Practitioner for urgent cases in Sri Lanka Colombo | 12 | Months | 85,000.00 | 1,020,000.00 |
| GRAND TOTAL (Inclusive of 18% VAT) | 15,500,000.00 | ||||
- This Purchase Order is issued by the Colombo Metropolitan Health Services Authority and governs the engagement of Dr. Anusha Fernando, a registered Doctor General Practitioner, to deliver the medical services and supplies outlined above within the Colombo District of Sri Lanka Colombo.
- The Doctor General Practitioner shall maintain a valid medical license issued by the Medical Secretariat of Sri Lanka throughout the duration of this Purchase Order. Any lapse in licensure shall render this Purchase Order void at the discretion of the purchasing entity.
- All services shall be rendered in accordance with the standards set by the Sri Lankan Medical Association and the Ministry of Health, Sri Lanka. The Doctor General Practitioner is expected to adhere to the ethical code of conduct for general practitioners operating in Sri Lanka Colombo.
- Payment shall be made within thirty (30) calendar days of receipt of a valid invoice from the Doctor General Practitioner. Payment will be processed via bank transfer to the account specified on the invoice. The currency of this Purchase Order is the Sri Lankan Rupee (LKR).
- The Doctor General Practitioner shall submit monthly service reports detailing the number of patients seen, procedures performed, and any referrals made. These reports are a mandatory condition of this Purchase Order and must be submitted by the 5th of the following month.
- Confidentiality of all patient records is strictly enforced under the Sri Lankan Data Protection Act. The Doctor General Practitioner shall not disclose any patient information to third parties without written consent, in compliance with this Purchase Order and applicable Sri Lankan law.
- This Purchase Order is valid for a period of twelve (12) months from the date of issue, unless terminated earlier by mutual written agreement or in the event of material breach by either party.
- Any amendments, additions, or modifications to this Purchase Order must be documented in a written addendum signed by both the Colombo Metropolitan Health Services Authority and the Doctor General Practitioner. Verbal agreements shall not be recognized under this Purchase Order.
- Disputes arising from this Purchase Order shall be resolved through mediation in Sri Lanka Colombo in accordance with the Arbitration Act of Sri Lanka. The jurisdiction of the courts of Colombo, Sri Lanka shall apply.
- The Doctor General Practitioner shall maintain adequate professional indemnity insurance coverage of no less than LKR 10,000,000 for the duration of this Purchase Order and shall provide a certificate of insurance upon request.
| Bank Name: Commercial Bank of Ceylon PLC | Branch: Colombo Head Office, Galle Road |
| Account Name: Colombo Metropolitan Health Services Authority | Account No.: 1010-0045-8872-1 |
| SWIFT Code: CMBKLKLX | Payment Terms: Net 30 days from invoice date |
Dr. Nimal Perera, Procurement Officer
Colombo Metropolitan Health Services Authority
Date: _______________ Accepted By – Doctor General Practitioner
Dr. Anusha Fernando
License No. SL/MD/2019/00452
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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