Purchase Order Nurse in United States San Francisco –Free Word Template Download with AI
Bay Area Healthcare Staffing Solutions, Inc.
1200 Market Street, Suite 4500, San Francisco, California 94102, United States
Phone: (415) 555-0187 | Email: [email protected] | Tax ID: 94-2847561
Golden Gate Nursing & Medical Supply Co.845 Harrison Street, San Francisco, California 94105, United States
Contact: Robert Tanaka, Sales Director
Phone: (415) 555-0342 | Email: [email protected]
Vendor ID: V-2024-0091 | W-9 on File: Yes Bill To: Bay Area Healthcare Staffing Solutions, Inc.
1200 Market Street, Suite 4500, San Francisco, CA 94102, United States
Attn: Accounts Payable Department
Ship To: Bay Area Healthcare Staffing Solutions – San Francisco Central Clinic
2200 Fillmore Street, San Francisco, CA 94115, United States
Attn: Nurse Coordinator, Floor 3 – Nursing Operations
| Item # | Description | Qty | Unit | Unit Price (USD) | Extended Price (USD) |
|---|---|---|---|---|---|
| 1 | Registered Nurse (RN) – Acute Care, Full-Time Contract (40 hrs/week), 12-month term, San Francisco Central Clinic | 1 | Position | $148,000.00 | $148,000.00 |
| 2 | Registered Nurse (RN) – Pediatric Ward, Full-Time Contract (40 hrs/week), 12-month term, San Francisco Central Clinic | 2 | Position | $142,500.00 | $285,000.00 |
| 3 | Practical Nurse (LPN) – Geriatric Care Unit, Part-Time (24 hrs/week), 12-month term, San Francisco Central Clinic | 3 | Position | $89,200.00 | $267,600.00 |
| 4 | Nurse Uniform Set (Scrub Top, Bottom, ID Badge Holder, Non-Slip Shoes) – Per Nurse Assignment | 6 | Set | $185.00 | $1,110.00 |
| 5 | Certified Nurse Training Program – BLS/ACLS Recertification, San Francisco Medical Training Center | 6 | Enrollment | $425.00 | $2,550.00 |
| 6 | Nurse Electronic Health Record (EHR) Software License – Annual Subscription, San Francisco Regional Network | 6 | License | $1,200.00 | $7,200.00 |
| 7 | Personal Protective Equipment (PPE) Annual Supply Kit – Per Nurse | 6 | Kit | $310.00 | $1,860.00 |
| 8 | Nurse Liability Insurance – Professional Indemnity, Annual Policy, State of California Coverage | 6 | Policy | $1,850.00 | $11,100.00 |
| Subtotal: | $724,420.00 | ||||
| California Sales Tax (8.5%): | $61,575.70 | ||||
| Grand Total (USD): | $785,995.70 | ||||
- This Purchase Order constitutes a binding agreement between Bay Area Healthcare Staffing Solutions, Inc. (hereinafter "Buyer") and Golden Gate Nursing & Medical Supply Co. (hereinafter "Vendor") for the provision of Nurse staffing services and associated medical supplies within the jurisdiction of San Francisco, California, United States.
- All Nurse personnel assigned under this Purchase Order must hold a valid California Board of Registered Nursing (BRN) license in good standing and must complete a background check as required by the State of California and the City and County of San Francisco.
- The Vendor shall ensure that every Nurse deployed to the San Francisco Central Clinic location meets the minimum competency standards established by the Joint Commission and the California Department of Public Health.
- Payment shall be made within thirty (30) calendar days of receipt of a valid invoice. Late payments shall accrue interest at a rate of 1.5% per month, in accordance with California Commercial Code Section 2910.
- All Nurse services rendered under this Purchase Order shall comply with the Health Insurance Portability and Accountability Act (HIPAA), the California Confidentiality of Medical Information Act (CMIA), and all applicable federal and state regulations governing patient care in the United States.
- The Vendor is responsible for workers' compensation insurance, unemployment insurance, and all payroll tax obligations for each Nurse engaged under this Purchase Order, in compliance with California Labor Code and Internal Revenue Service (IRS) requirements.
- Delivery of all physical supplies (uniforms, PPE kits, training materials) shall be made to the San Francisco Central Clinic address listed above no later than the Required Delivery Date. The Buyer reserves the right to reject non-conforming items within five (5) business days of delivery.
- This Purchase Order may be amended only by written agreement signed by both parties. Any modification to Nurse staffing levels, shift schedules, or service locations within San Francisco must be documented in a formal amendment to this Purchase Order.
- Disputes arising from this Purchase Order shall be resolved through binding arbitration in San Francisco, California, United States, in accordance with the rules of the American Arbitration Association.
- This Purchase Order is governed by the laws of the State of California and the federal laws of the United States of America. The exclusive venue for any legal proceedings shall be the Superior Court of California, County of San Francisco.
The Buyer requests that all Nurse assignments be coordinated with the San Francisco Central Clinic Nursing Operations team at least fourteen (14) days prior to the start date. The Vendor shall provide a detailed Nurse roster, including credentials, specialty certifications, and shift availability, to the Buyer's Nurse Coordinator no later than June 25, 2025. All Nurse personnel must complete the facility-specific orientation program at the San Francisco Central Clinic within their first three (3) working days. The Vendor acknowledges that this Purchase Order is subject to the Buyer's internal budget approval cycle and may be subject to modification if the San Francisco municipal healthcare funding allocation for fiscal year 2025–2026 is adjusted by the City and County of San Francisco Board of Supervisors.
Authorized Signature – BuyerDr. Margaret Chen, VP of Operations
Bay Area Healthcare Staffing Solutions, Inc.
Date: _______________ Authorized Signature – Vendor
Robert Tanaka, Sales Director
Golden Gate Nursing & Medical Supply Co.
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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