Purchase Order Doctor General Practitioner in United States Miami –Free Word Template Download with AI
| Field | Details |
|---|---|
| Purchase Order Number | MIA-GP-2025-04872 |
| Date of Issue | June 12, 2025 |
| Required Delivery Date | July 15, 2025 |
| Currency | United States Dollars (USD) |
| Payment Terms | Net 30 Days from Invoice Date |
| Shipping Method | Freight Prepaid – Ground Delivery |
| Incoterms | DDP (Delivered Duty Paid) – United States Miami |
Castellanos Family Medicine & Primary Care
2847 Brickell Avenue, Suite 412
United States Miami, Florida 33133
Telephone: (305) 555-0192
Email: [email protected]
Florida Medical License No.: ME48291
NPI: 1730482915
Tax ID (EIN): 82-4471903 MedSupply Solutions of Florida, Inc.
1450 NW 42nd Street, Building C
United States Miami, Florida 33142
Telephone: (305) 555-7743
Email: [email protected]
Florida Business License No.: FL-2019-88342
Tax ID (EIN): 59-2210487
| Item # | Description | Qty | Unit | Unit Price (USD) | Total (USD) |
|---|---|---|---|---|---|
| 001 | Electronic Blood Pressure Monitor, Clinical Grade (Omron HBP-1320) | 4 | Each | $189.99 | $759.96 |
| 002 | Digital Thermometer, Infrared Forehead (Braun ThermoScan 7) | 6 | Each | $74.50 | $447.00 |
| 003 | Pulse Oximeter, Fingertip (Nonin 3250) | 8 | Each | $42.00 | $336.00 |
| 004 | Stethoscope, Dual Head, Clinical (Littmann Classic III) | 3 | Each | $129.95 | $389.85 |
| 005 | Examination Table, Adjustable with Paper Roll Holder | 2 | Each | $1,245.00 | $2,490.00 |
| 006 | Disposable Nitrile Exam Gloves, Box of 100 (Medium) | 50 | Box | $12.75 | $637.50 |
| 007 | Isopropyl Alcohol 70%, 1 Gallon Jug | 20 | Gallon | $18.99 | $379.80 |
| 008 | Surgical Mask, 3-Ply, Box of 50 (N95 Certified) | 30 | Box | $34.00 | $1,020.00 |
| 009 | Electronic Patient Scale with Height Measure | 2 | Each | $312.00 | $624.00 |
| 010 | Sharps Disposal Container, 3.5 Gallon, Autoclavable | 10 | Each | $28.50 | $285.00 |
| Subtotal | $7,769.11 | ||||
| Florida Sales Tax (7.0%) | $543.84 | ||||
| Shipping & Handling (United States Miami Delivery) | $185.00 | ||||
| TOTAL AMOUNT DUE (USD) | $8,497.95 | ||||
- This Purchase Order is issued by Dr. Elena M. Castellanos, a licensed Doctor General Practitioner operating a primary care clinic in United States Miami, Florida, and constitutes a binding offer to purchase the goods and services described herein upon acceptance by the Supplier.
- All items listed in this Purchase Order must be new, unused, and in their original manufacturer packaging. Any item found to be defective, damaged, or not conforming to the specifications stated in this document shall be returned at the Supplier's expense within fourteen (14) calendar days of delivery.
- Delivery shall be made to the Doctor General Practitioner practice location at 2847 Brickell Avenue, Suite 412, United States Miami, Florida 33133. The Supplier is responsible for all transportation costs, insurance, and risk of loss until the goods are received and signed for by the Buyer's authorized representative in United States Miami.
- Payment shall be remitted via ACH bank transfer or certified check within thirty (30) days of the date of the Supplier's invoice, provided that all goods have been received in satisfactory condition. Late payments shall accrue interest at a rate of 1.5% per month or the maximum rate permitted under Florida state law, whichever is lower.
- The Supplier warrants that all medical equipment and supplies provided under this Purchase Order comply with all applicable Federal Drug Administration (FDA) regulations, Occupational Safety and Health Administration (OSHA) standards, and Florida Department of Health requirements for use in a Doctor General Practitioner clinical setting.
- This Purchase Order is governed by and shall be construed in accordance with the laws of the State of Florida, United States. Any disputes arising from or related to this Purchase Order shall be resolved through binding arbitration in United States Miami, Florida, in accordance with the rules of the American Arbitration Association.
- The Supplier shall maintain adequate product liability insurance with a minimum coverage of $2,000,000 per occurrence for all goods delivered under this Purchase Order. A certificate of insurance shall be provided to the Buyer prior to the first delivery.
- Neither party shall be liable for failure to perform obligations under this Purchase Order to the extent such failure is caused by acts of God, natural disasters (including hurricanes common to the United States Miami region), government actions, or other events beyond the reasonable control of the affected party.
- This Purchase Order may not be modified, amended, or supplemented except by a written instrument signed by authorized representatives of both the Doctor General Practitioner (Buyer) and the Supplier.
- All intellectual property rights, trademarks, and proprietary information associated with the products listed herein remain the property of the respective manufacturers. This Purchase Order does not grant any license or right beyond the purchase and use of the goods for clinical practice purposes.
Delivery of all items under this Purchase Order must be scheduled between the hours of 8:00 AM and 4:00 PM, Monday through Friday, to accommodate the Doctor General Practitioner's clinical schedule. The delivery driver must present a valid government-issued photo identification and a copy of this Purchase Order (PO No. MIA-GP-2025-04872) upon arrival at the United States Miami clinic address. The receiving staff member will verify quantities and inspect items for visible damage before signing the delivery manifest. Any discrepancies must be noted on the manifest at the time of delivery and reported to the Supplier within twenty-four (24) hours.
Authorized by (Buyer):
Dr. Elena M. Castellanos, M.D.Doctor General Practitioner
Castellanos Family Medicine & Primary Care
United States Miami, Florida
Date: ______________________
Accepted by (Supplier):
________________________________Authorized Representative
MedSupply Solutions of Florida, Inc.
United States Miami, Florida
Date: ______________________ ⬇️ Download as DOCX Edit online as DOCX
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