Purchase Order Nurse in United States New York City –Free Word Template Download with AI
Nurse Services Procurement — United States New York City
Official Document PO Number: NYC-PO-2025-04872 | Date of Issue: June 12, 2025 | Status: Pending Approval
Buyer (Purchasing Entity)
Manhattan General Medical Center
450 West 57th Street, Suite 1200
New York, New York 10019
United States
Phone: (212) 555-0147
Email: [email protected]
Tax ID (EIN): 13-4829105
Seller (Service Provider)
Empire State Nursing Solutions, LLC
88 Park Avenue South, Floor 22
New York, New York 10003
United States
Phone: (212) 555-0392
Email: [email protected]
Tax ID (EIN): 84-7712346
NYC Business License: #NYC-2019-44821
Order Details
PO Number: NYC-PO-2025-04872
Effective Date: July 1, 2025
Expiration Date: December 31, 2025
Delivery Location: Manhattan General Medical Center, New York, NY 10019
Payment Terms: Net 30 Days
Currency: USD (United States Dollar)
| Item # | Description of Nurse Service | Specialty / Certification | Shift Pattern | Duration | Unit Rate (USD) | Quantity (Hours) | Extended Amount (USD) |
|---|---|---|---|---|---|---|---|
| 001 | Registered Nurse (RN) — Intensive Care Unit (ICU) Patient Care | BSN, RN, CCRN Certified | 12-hour shifts, 3 days/week | 6 months | $68.50 | 1,248 | $85,488.00 |
| 002 | Registered Nurse (RN) — Emergency Department Triage & Treatment | BSN, RN, CEN Certified | 12-hour shifts, 4 days/week | 6 months | $72.00 | 1,664 | $119,808.00 |
| 003 | Practical Nurse (LPN) — Post-Operative Ward Monitoring | ADN, LPN Licensed (NY State) | 8-hour shifts, 5 days/week | 6 months | $42.75 | 1,560 | $66,690.00 |
| 004 | Charge Nurse (RN) — Medical-Surgical Unit Supervision | MSN, RN, CENP Certified | 12-hour shifts, 4 days/week | 6 months | $85.00 | 1,664 | $141,440.00 |
| 005 | Nurse Practitioner (NP) — Outpatient Clinic Consultations | MSN, APRN, FNP-BC | 8-hour shifts, 3 days/week | 6 months | $95.00 | 996 | $94,620.00 |
| Subtotal | $508,046.00 |
| NYC Sales & Service Tax (8.875%) | $45,089.08 |
| NY State Withholding & Compliance Surcharge | $12,701.15 |
| Administrative & Onboarding Fee | $3,500.00 |
| Grand Total (USD) | $569,336.23 |
Terms and Conditions
- Scope of Services: This Purchase Order authorizes Empire State Nursing Solutions, LLC to supply qualified, licensed Nurse personnel to Manhattan General Medical Center located in United States New York City. All Nurse staff must hold valid New York State nursing licenses issued by the New York State Education Department, Office of the Professions, and must maintain current certifications relevant to their assigned specialty.
- Compliance with NYC Regulations: All Nurse personnel deployed under this Purchase Order shall comply with all applicable regulations of the New York City Department of Health and Mental Hygiene, the New York City Human Rights Law, and the New York State Labor Law. The Seller warrants that all Nurse employees are properly registered with the New York City Department of Consumer and Worker Protection.
- Background Checks and Credentialing: Prior to commencing any shift, each Nurse must complete a comprehensive background check, fingerprint clearance through the New York State Division of Criminal Justice Services, and facility-specific credentialing as mandated by Manhattan General Medical Center's medical staff bylaws.
- Payment Schedule: Invoices shall be submitted bi-weekly on the 15th and last day of each month. Payment is due within thirty (30) calendar days of invoice receipt. Late payments shall accrue interest at a rate of 1.5% per month in accordance with New York State Commercial Law.
- Substitution and Replacement: The Seller reserves the right to substitute a Nurse of equal or greater qualification with forty-eight (48) hours' written notice. The Buyer may request the removal of any Nurse for cause, and the Seller shall provide a replacement within twenty-four (24) hours.
- Insurance and Liability: The Seller shall maintain professional liability insurance of no less than $2,000,000 per occurrence and $5,000,000 aggregate, as well as workers' compensation coverage compliant with New York State requirements. The Seller shall indemnify and hold harmless the Buyer against any claims arising from the negligence or malpractice of any Nurse furnished under this Purchase Order.
- Termination: Either party may terminate this Purchase Order with thirty (30) days' written notice. In the event of material breach, termination may be effective immediately upon written notice. All accrued and unpaid obligations shall survive termination.
- Governing Law: This Purchase Order shall be governed by and construed in accordance with the laws of the State of New York, United States, and the local ordinances of New York City. Any disputes shall be resolved in the state or federal courts located in New York County, New York City.
- Confidentiality: All Nurse personnel shall be bound by the Health Insurance Portability and Accountability Act (HIPAA) and the New York State Public Health Law regarding patient confidentiality. The Seller shall ensure that all Nurse staff sign facility-specific confidentiality agreements prior to accessing any patient information.
- Anti-Discrimination: In accordance with New York City's Local Law 1 (Human Rights Law) and federal civil rights statutes, the Seller shall ensure that all Nurse recruitment, placement, and employment practices are free from discrimination on the basis of race, color, religion, sex, national origin, age, disability, or any other protected characteristic.
Authorized Buyer Representative
Manhattan General Medical Center
Name: Dr. Eleanor V. Whitfield, Chief Operating Officer
Signature: ___________________________
Date: ___________________________
Authorized Seller Representative
Empire State Nursing Solutions, LLC
Name: Marcus J. Delgado, Director of Contracts
Signature: ___________________________
Date: ___________________________
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