Purchase Order Ophthalmologist in Brazil Brasília –Free Word Template Download with AI
| Field | Details |
|---|---|
| Provider Name | Dr. Helena Vasconcelos – Certified Ophthalmologist, CRM-DF 48.291 |
| Practice / Clinic | Clínica Ocular Brasília – Ophthalmologist Specialist Center |
| Address | SHIS QI 05, Bloco A, Sala 210, Lago Sul, Brasília – DF, 71630-000, Brazil |
| CNPJ | 12.345.678/0001-90 |
| Contact | [email protected] | +55 (61) 3344-5566 |
| Specialization | Comprehensive Ophthalmologist services including cataract surgery, retinal diagnostics, glaucoma management, and pediatric ophthalmology |
This Purchase Order is formally issued by Hospital das Clínicas de Brasília to procure the professional services of a board-certified Ophthalmologist along with associated ophthalmic diagnostic equipment and surgical supplies. The engagement is specifically designated for delivery of all services and materials within the administrative boundaries of Brazil Brasília, Federal District (Distrito Federal). The Ophthalmologist shall provide clinical consultations, surgical procedures, and post-operative follow-up care in accordance with the standards established by the Conselho Federal de Medicina (CFM) and the local regulatory authority of Brasília.
3. LINE ITEMS – SERVICES AND EQUIPMENT| Item # | Description | Qty | Unit | Unit Price (BRL) | Total (BRL) |
|---|---|---|---|---|---|
| 01 | Comprehensive Ophthalmologist consultation and diagnostic evaluation (per patient session, including visual acuity testing, tonometry, and fundus examination) | 120 | session | R$ 480,00 | R$ 57,600,00 |
| 02 | Cataract extraction surgery with intraocular lens implantation performed by the Ophthalmologist (per procedure) | 35 | procedure | R$ 8,500,00 | R$ 297,500,00 |
| 03 | Retinal laser photocoagulation treatment administered by the Ophthalmologist (per session) | 28 | session | R$ 3,200,00 | R$ 89,600,00 |
| 04 | Glaucoma monitoring program – quarterly Ophthalmologist review with OCT imaging (per patient, 4 quarters) | 60 | patient | R$ 1,800,00 | R$ 108,000,00 |
| 05 | Pediatric Ophthalmologist screening program for public schools in the Brasília district (per school visit) | 45 | visit | R$ 2,400,00 | R$ 108,000,00 |
| 06 | Ophthalmic surgical consumables pack (sutures, IOLs, viscoelastic agents, drapes) – per surgical case | 35 | pack | R$ 1,250,00 | R$ 43,750,00 |
| 07 | Optical coherence tomography (OCT) machine – 130nm spectral domain, calibrated and installed at Brasília facility | 1 | unit | R$ 185,000,00 | R$ 185,000,00 |
| 08 | Phacoemulsification surgical system with handpiece and foot pedal – delivery and installation in Brasília | 1 | unit | R$ 220,000,00 | R$ 220,000,00 |
| GRAND TOTAL (BRL) | R$ 1,109,450,00 | ||||
- Governing Jurisdiction: This Purchase Order shall be governed by and interpreted in accordance with the laws of the Federative Republic of Brazil, with specific application of the Federal District (Brasília) municipal and state regulations pertaining to healthcare service procurement.
- Service Delivery Location: All clinical services rendered by the Ophthalmologist under this Purchase Order shall be performed exclusively at the designated facility located in Brazil Brasília, or at approved satellite clinics within the Federal District as pre-authorized in writing by the issuing entity.
- Professional Qualification: The Ophthalmologist must maintain an active registration with the Conselho Regional de Medicina do Distrito Federal (CRM-DF) and hold a valid sub-specialty certification in ophthalmology. Any lapse in licensure shall constitute immediate grounds for termination of this Purchase Order.
- Payment Terms: Payment shall be made in BRL (Brazilian Real) via bank transfer (TED/DOC) within 30 (thirty) calendar days from the date of invoice submission, provided all services have been verified and accepted by the Hospital das Clínicas de Brasília procurement office.
- Equipment Delivery: All ophthalmic equipment listed in Items 07 and 08 shall be delivered, installed, and calibrated at the Brasília facility no later than 45 (forty-five) days from the date of this Purchase Order. The Ophthalmologist or their designated technical representative shall certify proper installation.
- Confidentiality and Data Protection: The Ophthalmologist and all associated personnel shall comply with the Brazilian General Data Protection Law (LGPD – Lei Geral de Proteção de Dados, Law No. 13.709/2018) regarding patient medical records and personal health information collected during the engagement in Brasília.
- Warranty: All equipment procured under this Purchase Order carries a minimum 24-month manufacturer warranty. The Ophthalmologist shall coordinate any warranty claims and ensure continuity of patient care during equipment maintenance periods.
- Termination: Either party may terminate this Purchase Order with 60 (sixty) days written notice. In the event of termination, the Ophthalmologist shall complete all in-progress surgical and diagnostic procedures for patients already scheduled in Brasília before the effective termination date.
- Compliance: The Ophthalmologist warrants that all services and materials comply with ANVISA (Agência Nacional de Vigilância Sanitária) regulations and the specific healthcare procurement standards of the Federal District of Brasília.
- Dispute Resolution: Any disputes arising from this Purchase Order shall be resolved through the competent courts of Brasília – DF, Brazil, or by arbitration under the rules of the Câmara de Comércio Internacional (ICC) if both parties agree in writing.
By signing below, both parties acknowledge and agree to all terms set forth in this Purchase Order for the engagement of the Ophthalmologist and procurement of ophthalmic services and equipment in Brazil Brasília.
For the Issuing Entity:Hospital das Clínicas de Brasília
Dr. Ricardo Almeida Santos
Director of Procurement & Medical Affairs
Date: _______________ For the Ophthalmologist / Vendor:
Clínica Ocular Brasília
Dr. Helena Vasconcelos
Ophthalmologist, CRM-DF 48.291
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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