Purchase Order Nurse in United States Houston –Free Word Template Download with AI
Procurement of Licensed Nurse Services — United States Houston, Texas 77002
Buyer (Issuing Entity)
Organization: Houston Regional Medical Partners, LLC
Address: 1200 Medical Center Drive, Suite 450, United States Houston, TX 77030
Contact: Procurement Department, Attn: Ms. Linda Vasquez
Phone: (713) 555-0192
Email: [email protected]
Tax ID (EIN): 74-2839105
Supplier (Service Provider)
Organization: Gulf Coast Nursing Staffing Solutions, Inc.
Address: 8450 Westheimer Road, Floor 3, United States Houston, TX 77063
Contact: Account Manager, Mr. David Okafor
Phone: (281) 555-7743
Email: [email protected]
Tax ID (EIN): 75-9102847
Order Details
Purchase Order Date: June 12, 2025
Required Delivery/Start Date: July 1, 2025
Service Location: United States Houston, TX 77030 (Primary Facility)
Contract Duration: 12 Months (Renewable)
Payment Terms: Net 30 Days from Invoice Date
Reference Information
RFP Reference: RFP-HRM-2025-0031
Approved By: Dr. Margaret Chen, Chief Medical Officer
Department: Inpatient Care & Critical Care Units
Cost Center: CC-4471-Nursing
Classification: Professional Medical Services
| Item # | Description of Nurse Services | Specialization | Shift | Qty (FTE) | Rate (Monthly) | Amount (Monthly) |
|---|---|---|---|---|---|---|
| 001 | Registered Nurse (RN) — Intensive Care Unit, 24/7 coverage | Critical Care / ICU | Day & Night | 6 | $8,450.00 | $50,700.00 |
| 002 | Registered Nurse (RN) — Emergency Department, triage and acute care | Emergency Medicine | Rotating | 8 | $7,900.00 | $63,200.00 |
| 003 | Registered Nurse (RN) — Surgical Recovery & Post-Operative Ward | Perioperative Nursing | Day | 5 | $7,650.00 | $38,250.00 |
| 004 | Licensed Practical Nurse (LPN) — General Inpatient Floor Support | General Medical-Surgical | Rotating | 10 | $5,200.00 | $52,000.00 |
| 005 | Charge Nurse (RN) — Unit Supervision & Administrative Coordination | Nursing Management | Day & Night | 4 | $9,800.00 | $39,200.00 |
| 006 | Travel Nurse (RN) — Temporary Coverage for Maternity/Leave Absences | Multi-Specialty | As Needed | 3 | $8,100.00 | $24,300.00 |
| Subtotal (Monthly) | $267,650.00 |
| Applicable Texas Sales Tax (0% — Professional Services Exempt) | $0.00 |
| Annual Contract Value (12 Months) | $3,211,800.00 |
| Total Purchase Order Value | $3,211,800.00 |
- Scope of Nurse Services: The Supplier shall provide qualified, licensed Nurse personnel as specified in the line items above. All Nurse candidates must hold a valid Texas Board of Nursing license and maintain current BLS/ACLS certifications. The Supplier guarantees that each Nurse assigned to the United States Houston facility will complete a facility-specific orientation within the first 72 hours of assignment.
- Compliance and Licensing: All Nurse personnel must comply with the Texas Occupations Code, Title 41, and all applicable federal regulations under the Centers for Medicare & Medicaid Services (CMS). The Supplier shall maintain malpractice insurance coverage of no less than $2,000,000 per occurrence for every Nurse deployed at the United States Houston site.
- Delivery and Onboarding: The Supplier shall ensure that all Nurse positions listed in this Purchase Order are filled and personnel are on-site at the United States Houston facility no later than July 1, 2025. A penalty of $500 per Nurse position per day of delay shall apply beyond the stated start date.
- Payment Schedule: Invoices shall be submitted monthly by the 5th business day for services rendered in the preceding month. Payment is due Net 30 days from the date of invoice receipt. Late payments shall accrue interest at 1.5% per month as permitted under Texas Business & Commerce Code Section 2412.
- Substitution and Replacement: The Buyer reserves the right to request the replacement of any Nurse who fails to meet performance standards, violates facility policy, or whose conduct is deemed unsatisfactory. The Supplier shall provide a qualified replacement Nurse within 5 business days at no additional cost to the Buyer.
- Confidentiality and HIPAA: All Nurse personnel shall execute a HIPAA-compliant confidentiality agreement prior to accessing patient records. The Supplier acknowledges that all patient information handled at the United States Houston facility is protected under the Health Insurance Portability and Accountability Act of 1996.
- Termination: Either party may terminate this Purchase Order with 60 days written notice. In the event of material breach, the non-breaching party may terminate with 15 days notice. Upon termination, the Supplier shall ensure an orderly transition of all Nurse assignments to avoid disruption of patient care.
- Governing Law: This Purchase Order shall be governed by and construed in accordance with the laws of the State of Texas, United States. Any disputes arising hereunder shall be resolved through binding arbitration in United States Houston, Harris County, in accordance with the Texas Arbitration Act.
- Insurance Requirements: The Supplier shall maintain general liability insurance of $1,000,000, professional liability (Nurse malpractice) insurance of $2,000,000, and workers' compensation insurance as required by Texas law. Certificates of insurance shall be provided prior to the commencement of services.
- Non-Collusion and Anti-Kickback: The Supplier certifies that the pricing in this Purchase Order is not the result of any collusive agreement and that no kickbacks, rebates, or improper inducements have been offered or accepted in connection with this Nurse services procurement.
Authorized Signature — Buyer
Name: Linda Vasquez
Title: Director of Procurement, Houston Regional Medical Partners, LLC
Date: ______________________
Authorized Signature — Supplier
Name: David Okafor
Title: VP of Contracts, Gulf Coast Nursing Staffing Solutions, Inc.
Date: ______________________
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