Purchase Order Midwife in Canada Montreal –Free Word Template Download with AI
Midwifery Services Procurement Document
Province of Quebec • Canada Montreal Region
VENDOR / SERVICE PROVIDER INFORMATION| Field | Details |
|---|---|
| Provider Name: | Clinique de Sages-Femmes du Plateau, Inc. |
| Midwife Lead: | Marie-Claude Tremblay, R.M. (Registered Midwife, Ordre des sages-femmes du Québec) |
| Address: | 1287 Avenue du Mont-Royal Est, Canada Montreal, QC H2L 1C4 |
| License No.: | OSFQ-2019-44782 (Ordre des sages-femmes du Québec) |
| Business Number: | 123456789 RT0001 (Canada Revenue Agency) |
| Contact: | (514) 555-0347 • [email protected] |
| Item # | Description of Midwife Service | Qty | Unit | Unit Price (CAD) | Amount (CAD) |
|---|---|---|---|---|---|
| 1 | Comprehensive prenatal midwifery care package (12 scheduled visits) for low-risk pregnancy, including biophysical profile assessments, bloodwork coordination, and nutritional counselling. Delivered by a Registered Midwife at the Canada Montreal clinic facility. | 1 | Package | $3,200.00 | $3,200.00 |
| 2 | Intrapartum midwifery attendance and labour support services at the Centre Hospitalier de l'Université de Montréal (CHUM) birthing unit, Canada Montreal. Includes continuous one-on-one midwife presence from active labour through delivery and immediate postpartum period. | 1 | Service | $1,850.00 | $1,850.00 |
| 3 | Postpartum midwifery follow-up visits (6 visits over 12 weeks) covering newborn assessment, breastfeeding support, maternal recovery monitoring, and mental health screening. Conducted at the client's residence within the Canada Montreal metropolitan area. | 1 | Package | $1,450.00 | $1,450.00 |
| 4 | Emergency midwife on-call coverage (24/7 availability) for the duration of the contracted pregnancy term. The midwife shall respond to any urgent obstetric concern within 30 minutes within the Canada Montreal service zone. | 1 | Term | $950.00 | $950.00 |
| 5 | Midwife-led prenatal education workshop (group session, up to 10 participants) covering birth preparation, pain management techniques, and postpartum self-care. To be held at the issuing organization's facility in Canada Montreal. | 2 | Sessions | $600.00 | $1,200.00 |
| 6 | Midwifery documentation and medical record management. All midwife clinical notes, birth plans, and progress reports to be filed in accordance with Quebec health information privacy legislation (Law 25) and the Canada Montreal regional health authority standards. | 1 | Service | $450.00 | $450.00 |
| SUBTOTAL | $9,100.00 | ||||
| Quebec Provincial Sales Tax (QST) – 5% | $455.00 | ||||
| Federal Goods and Services Tax (GST) – 5% | $455.00 | ||||
| TOTAL AMOUNT DUE (CAD) | $10,010.00 | ||||
- Scope of Practice: All midwifery services rendered under this Purchase Order shall be performed exclusively by a Registered Midwife (R.M.) in good standing with the Ordre des sages-femmes du Québec. The midwife shall operate within the scope of practice defined by the Quebec Health Professions Act and the Canada Montreal regional health authority guidelines.
- Service Location: Unless otherwise specified in the line items above, all midwifery consultations, assessments, and follow-up appointments shall take place at the issuing organization's premises located in Canada Montreal, Quebec, or at the client's private residence within the Canada Montreal census metropolitan area as pre-arranged in writing.
- Payment Terms: Payment for this Purchase Order shall be made within thirty (30) calendar days of the date of invoice. Payment shall be remitted via electronic funds transfer (EFT) to the vendor's designated account. Late payments shall accrue interest at the rate of 1.5% per month as stipulated under the Quebec Civil Code.
- Insurance and Liability: The midwife and the vendor entity shall maintain professional liability insurance with a minimum coverage of $5,000,000 per occurrence, as required by the Ordre des sages-femmes du Québec and applicable Canada Montreal municipal bylaws. Certificates of insurance shall be provided upon request prior to the commencement of services.
- Confidentiality and Privacy: All patient information handled by the midwife in the course of fulfilling this Purchase Order shall be protected in accordance with the Quebec Act Respecting the Protection of Personal Information in the Private Sector (Law 25) and the Canada Health Information Protection Act. No patient records shall be transferred outside the Canada Montreal health jurisdiction without explicit written consent.
- Termination: Either party may terminate this Purchase Order with fourteen (14) days written notice. In the event of termination, the midwife shall complete all in-progress clinical documentation and transfer patient records to a successor midwife or physician as directed by the issuing organization.
- Governing Law: This Purchase Order shall be governed by and construed in accordance with the laws of the Province of Quebec and the federal laws of Canada applicable in Canada Montreal. Any disputes shall be resolved through mediation under the Quebec Mediation and Conciliation Act before proceeding to the Superior Court of Quebec, Canada Montreal judicial district.
- Compliance: The vendor warrants that the midwife services provided comply with all applicable federal, provincial, and municipal regulations in force in Canada Montreal, including but not limited to the Standards of Practice of the Ordre des sages-femmes du Québec and the public health directives issued by the Agence de la santé et des services sociaux de Montréal.
Authorized by (Issuing Organization):
Dr. François Lavoie, M.D., FRCSCDirector of Maternal & Child Health Services
Centre de Santé Communautaire de Montréal
Date: ______________________
Accepted by (Midwife / Vendor):
Marie-Claude Tremblay, R.M.Lead Midwife, Clinique de Sages-Femmes du Plateau
Canada Montreal, QC
Date: ______________________ ⬇️ Download as DOCX Edit online as DOCX
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