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Purchase Order Doctor General Practitioner in United States Houston –Free Word Template Download with AI

Medical Equipment & Supplies Procurement for Doctor General Practitioner Practice

United States Houston, Texas 77002

Purchase Order No.: PO-HOU-2025-04872
Date of Issue: June 12, 2025
Valid Until: July 12, 2025
Payment Terms: Net 30 Days
Delivery Method: Freight Prepaid
Incoterms: DDP (Delivered Duty Paid)
BUYER INFORMATION
Practice Name: Bayou City General Practice Associates Practice Type: Doctor General Practitioner Clinic
Address: 4820 Westheimer Road, Suite 310, United States Houston, Texas 77056 Tax ID (EIN): 74-2839105
Contact Person: Dr. Margaret Ellison, M.D., F.A.C.P. Phone: (713) 555-0147
Email: [email protected] License No.: TX-MED-2019-44871
SUPPLIER INFORMATION
Supplier Name: Gulf Coast Medical Supply Co., LLC Supplier ID: GCS-2024-1198
Address: 1200 Industrial Boulevard, Building C, United States Houston, Texas 77029 Tax ID (EIN): 75-9912340
Contact Person: James Whitfield, Regional Sales Director Phone: (713) 555-0293
Email: [email protected] Account Rep: Sarah Chen, Account Manager
PURCHASE ORDER LINE ITEMS
Item # SKU Description Qty Unit Price (USD) Line Total (USD) Delivery Date
1 GP-EXAM-001 Examination Table with Adjustable Backrest and Paper Roll Holder – for Doctor General Practitioner patient consultations 4 $2,850.00 $11,400.00 Jun 28, 2025
2 GP-DIA-014 Digital Blood Pressure Monitor, Automated Cuff, FDA-Cleared – essential diagnostic tool for Doctor General Practitioner use 6 $345.00 $2,070.00 Jun 28, 2025
3 GP-OTHS-022 Otoscope with LED Illumination and Adjustable Magnification (3x, 4.5x, 6x) – for Doctor General Practitioner ear examinations 8 $189.50 $1,516.00 Jun 28, 2025
4 GP-SPHM-031 Binocular Ophthalmoscope, 20D, with 10 Diopter Adjustment – for Doctor General Practitioner eye assessments 4 $412.00 $1,648.00 Jun 28, 2025
5 GP-ECG-045 12-Lead ECG Machine with 15-inch Touchscreen Display and Built-in Printer – for Doctor General Practitioner cardiac screening 2 $7,200.00 $14,400.00 Jul 05, 2025
6 GP-PULM-053 Pneumometer with Digital Readout and Peak Flow Recording – respiratory assessment for Doctor General Practitioner practice 3 $275.00 $825.00 Jun 28, 2025
7 GP-REFR-067 Refrigerated Vaccine Storage Unit, 250L Capacity, Digital Thermometer, FDA-Compliant – for Doctor General Practitioner immunization program 2 $3,150.00 $6,300.00 Jul 05, 2025
8 GP-DESK-078 Adjustable Height Medical Workstation Desk with Cable Management, 60x30 inches – for Doctor General Practitioner consultation room 4 $1,240.00 $4,960.00 Jul 05, 2025
9 GP-CHRT-089 Electronic Health Record (EHR) Workstation, 27-inch 4K Monitor, Intel i7, 32GB RAM, 1TB SSD – for Doctor General Practitioner patient records management 6 $2,380.00 $14,280.00 Jul 05, 2025
10 GP-PPRM-094 Patient Privacy Room Partition, Sound-Insulated, 8ft x 6ft, with Integrated Lighting – for Doctor General Practitioner examination areas 4 $1,875.00 $7,500.00 Jul 10, 2025
Subtotal: $64,899.00
Texas Sales Tax (8.25%): $5,354.17
Freight & Installation (United States Houston Metro): $1,250.00
TOTAL PURCHASE ORDER AMOUNT: $71,503.17
TERMS AND CONDITIONS
  1. This Purchase Order is issued by Bayou City General Practice Associates, a Doctor General Practitioner clinic operating in United States Houston, Texas, and constitutes a binding agreement upon acceptance by the supplier.
  2. All items listed in this Purchase Order must be new, unused, and in original manufacturer packaging. Any item found defective upon delivery must be replaced within five (5) business days at no additional cost to the Doctor General Practitioner practice.
  3. Delivery shall be made to the practice address located in United States Houston, Texas 77056. The supplier is responsible for all transportation, handling, and on-site installation of equipment as specified in the line items above.
  4. Payment shall be made within thirty (30) days of the date of invoice receipt, provided that all items have been delivered, inspected, and accepted by the Doctor General Practitioner practice management. Payment will be issued via ACH transfer to the supplier's designated bank account.
  5. The supplier warrants that all medical equipment and devices listed in this Purchase Order are FDA-cleared or FDA-approved for use in a Doctor General Practitioner clinical setting in the United States. Certificates of conformity and registration numbers must accompany each shipment.
  6. Warranty terms: All equipment carries a minimum two-year manufacturer warranty from the date of installation. The supplier shall coordinate all warranty claims and provide on-site repair service within United States Houston within forty-eight (48) hours of a service request.
  7. Any changes, modifications, or cancellations to this Purchase Order must be made in writing and signed by both parties. Verbal agreements are not binding. The Doctor General Practitioner practice reserves the right to adjust quantities by up to ten percent (10%) without issuing a revised Purchase Order.
  8. This Purchase Order is governed by the laws of the State of Texas, United States. Any disputes arising from this Purchase Order shall be resolved through binding arbitration in United States Houston, Harris County, Texas, in accordance with the rules of the American Arbitration Association.
  9. The supplier acknowledges that the items procured under this Purchase Order are intended for use in a Doctor General Practitioner primary care setting serving the diverse patient population of United States Houston. All equipment must comply with HIPAA regulations, OSHA standards, and Texas Medical Board facility requirements.
  10. Force Majeure: Neither party shall be liable for delays caused by events beyond reasonable control, including but not limited to natural disasters, supply chain disruptions, or government-mandated closures affecting operations in United States Houston or elsewhere in the United States.
DELIVERY AND ACCEPTANCE

All deliveries under this Purchase Order shall be made between the hours of 8:00 AM and 4:00 PM, Monday through Friday, to the Doctor General Practitioner clinic at 4820 Westheimer Road, Suite 310, United States Houston, Texas 77056. A designated receiving manager, Mr. David Okafor, will be present to inspect and sign for all deliveries. The Doctor General Practitioner practice will have a period of seven (7) business days following delivery to inspect all items and report any discrepancies, damages, or non-conformities to the supplier in writing.

Authorized by (Buyer):

Dr. Margaret Ellison, M.D., F.A.C.P.
Doctor General Practitioner – Bayou City General Practice Associates
United States Houston, Texas

Signature: ______________________________
Date: ______________________________

Accepted by (Supplier):

James Whitfield, Regional Sales Director
Gulf Coast Medical Supply Co., LLC
United States Houston, Texas

Signature: ______________________________
Date: ______________________________

This Purchase Order (PO-HOU-2025-04872) was generated for the Doctor General Practitioner practice of Bayou City General Practice Associates, United States Houston, Texas. This document is confidential and intended solely for the named parties. Unauthorized reproduction or distribution is prohibited. For inquiries, contact the procurement department at [email protected] or (713) 555-0147.

Page 1 of 1 — Purchase Order No. PO-HOU-2025-04872 — Issued: June 12, 2025

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