Purchase Order Doctor General Practitioner in United States Los Angeles –Free Word Template Download with AI
PO-2025-LA-04872
Doctor General Practitioner Medical Supply & Equipment Procurement
United States Los Angeles, California 90012
BUYER INFORMATION| Practice Name: Pacific Coast General Practice, LLC | Practice Type: Doctor General Practitioner Clinic |
| Address: 1420 Wilshire Boulevard, Suite 310, Los Angeles, California 90012, United States | Phone: (213) 555-0187 |
| Primary Physician: Dr. Margaret Chen, MD – Doctor General Practitioner | Email: [email protected] |
| CA Medical Board License: CA-4829173 | Tax ID (EIN): 82-4471903 |
| Company: MedEquip West Coast Distribution, Inc. | Supplier ID: MCW-2025-0091 |
| Address: 2800 Industrial Avenue, Long Beach, California 90810, United States | Phone: (562) 555-0342 |
| Contact Person: Robert Tanaka, Regional Sales Director | Email: [email protected] |
| Item # | Description | SKU | Qty | Unit Price (USD) | Extended Price (USD) |
|---|---|---|---|---|---|
| 1 | Examination Table with Adjustable Backrest – For Doctor General Practitioner patient consultations in Los Angeles clinic | EX-TBL-4400 | 2 | $2,850.00 | $5,700.00 |
| 2 | Digital Blood Pressure Monitor (Omron HBP-272) – Standard Doctor General Practitioner diagnostic tool | BP-OMR-272 | 4 | $189.99 | $759.96 |
| 3 | Electronic Stethoscope (Littmann Cardiology IV) – For Doctor General Practitioner auscultation procedures | STH-LIT-CIV | 3 | $425.00 | $1,275.00 |
| 4 | Portable ECG Machine (12-Lead) – For Doctor General Practitioner cardiac screening in United States Los Angeles facility | ECG-12L-PRO | 1 | $4,200.00 | $4,200.00 |
| 5 | Ophthalmoscope & Otoscope Combination Set – Doctor General Practitioner head and neck examination kit | OPH-OTO-COMBO | 2 | $310.00 | $620.00 |
| 6 | Thermometer, Infrared Forehead (Non-Contact) – For Doctor General Practitioner triage in Los Angeles waiting room | THM-IRF-001 | 6 | $78.50 | $471.00 |
| 7 | Medical Examination Gloves (Nitrile, Box of 100) – 12-month supply for Doctor General Practitioner clinic operations | GLV-NIT-100 | 48 | $12.75 | $612.00 |
| 8 | Autoclave Sterilizer (Benchtop, 18L) – For Doctor General Practitioner instrument sterilization per California health code | ACL-BT-18L | 1 | $1,890.00 | $1,890.00 |
| 9 | Electronic Medical Records Software License (Annual) – Doctor General Practitioner practice management system, United States compliant | EMR-SW-ANL | 1 | $3,600.00 | $3,600.00 |
| 10 | First Aid & Emergency Response Kit (OSHA Compliant) – For Doctor General Practitioner clinic in Los Angeles, CA | FAK-OSHA-STD | 2 | $245.00 | $490.00 |
| Subtotal: | $19,617.96 |
| California Sales Tax (7.25%): | $1,422.30 |
| Shipping & Handling (Los Angeles Metro): | $385.00 |
| TOTAL AMOUNT DUE (USD): | $21,425.26 |
- This Purchase Order is issued by Pacific Coast General Practice, LLC, a Doctor General Practitioner clinic operating in United States Los Angeles, California, and constitutes a binding offer to purchase the goods and services listed herein upon acceptance by the Supplier.
- All items listed in this Purchase Order are intended for use in a Doctor General Practitioner medical practice and must comply with all applicable United States Food and Drug Administration (FDA) regulations, California Department of Public Health standards, and Los Angeles County medical facility requirements.
- Delivery shall be made to the Buyer's facility located at 1420 Wilshire Boulevard, Suite 310, Los Angeles, California 90012, United States. The Supplier is responsible for all transportation, insurance, and risk of loss until goods are received and inspected at the designated Los Angeles address.
- Payment shall be made within thirty (30) calendar days of the date of invoice receipt, via ACH transfer or certified check, to the account designated by the Buyer. Late payments shall accrue interest at a rate of 1.5% per month as permitted under California Commercial Code Section 2310.
- The Supplier warrants that all medical equipment and supplies provided under this Purchase Order are new, unused, and free from defects in materials and workmanship. A minimum two-year manufacturer's warranty is required for all capital equipment items.
- The Doctor General Practitioner practice reserves the right to inspect all delivered goods within five (5) business days of receipt. Any items found to be damaged, defective, or non-conforming to the specifications in this Purchase Order shall be returned at the Supplier's expense and replaced within ten (10) business days.
- This Purchase Order is governed by the laws of the State of California, United States. Any disputes arising from this Purchase Order shall be subject to the exclusive jurisdiction of the state or federal courts located in Los Angeles County, California.
- The Supplier shall maintain adequate professional liability insurance (minimum $2,000,000 per occurrence) throughout the term of this Purchase Order and shall provide a certificate of insurance upon request.
- All personal health information (PHI) or patient data that may be incidentally handled in connection with this Purchase Order shall be protected in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and California Confidentiality of Medical Information Act (CMIA).
- This Purchase Order may not be assigned or transferred by either party without the prior written consent of the other party. Any modifications to this Purchase Order must be made in writing and signed by authorized representatives of both the Doctor General Practitioner practice and the Supplier.
All capital equipment (Items 1, 4, and 8) must be delivered to the second floor of the Los Angeles facility and installed by certified technicians. The Doctor General Practitioner clinic will be closed on the scheduled delivery day (July 15, 2025) to accommodate installation. Please coordinate with the front desk at (213) 555-0187 at least 48 hours prior to delivery. All items must be properly labeled with the Purchase Order number PO-2025-LA-04872 for receiving verification. The EMR software license (Item 9) must be activated and configured for a Doctor General Practitioner practice with a maximum of 15 concurrent user seats, compliant with United States Los Angeles municipal health data storage regulations.
Authorized by (Buyer):
Dr. Margaret Chen, MDDoctor General Practitioner – Principal Physician
Pacific Coast General Practice, LLC
Los Angeles, California, United States
Date: ______________________
Accepted by (Supplier):
Robert TanakaRegional Sales Director
MedEquip West Coast Distribution, Inc.
Long Beach, California, United States
Date: ______________________ ⬇️ Download as DOCX Edit online as DOCX
Create your own Word template with our GoGPT AI prompt:
GoGPT