Purchase Order Ophthalmologist in Brazil Rio de Janeiro –Free Word Template Download with AI
Clínica Ocular Rio de Janeiro Ltda.
Av. Atlântica, 1250 – Copacabana, Rio de Janeiro, RJ – CEP 22070-001 – Brazil
CNPJ: 12.345.678/0001-90 | Phone: +55 (21) 3456-7890 | Email: [email protected]
1. PURCHASER INFORMATIONBuyer / Ordering Entity
Company: Clínica Ocular Rio de Janeiro Ltda.
Address: Av. Atlântica, 1250 – Copacabana, Rio de Janeiro, RJ – CEP 22070-001 – Brazil
Authorized Representative: Dr. Ricardo Almeida Santos, Chief Medical Officer
Procurement Department: Sra. Mariana Costa, Procurement Manager
Contact: +55 (21) 3456-7890 | [email protected]
2. SUPPLIER / SERVICE PROVIDER INFORMATIONOphthalmologist / Medical Service Provider
Professional Name: Dr. Helena Vasconcelos Ferreira
Specialty: Ophthalmologist – Vitreoretinal Surgery and Comprehensive Eye Care
CRM Registration: CRM-RJ 123.456-7
Professional Address: Rua Barata Ribeiro, 890 – Sala 412 – Botafogo, Rio de Janeiro, RJ – CEP 22250-001 – Brazil
Contact: +55 (21) 99876-5432 | [email protected]
Professional CNPJ: 98.765.432/0001-10
3. Download and customize a professional Purchase Order Ophthalmologist Brazil Rio de Janeiro Word template. Perfect for business, legal, and personal use. Editable and ready to boost your productivity. OF SERVICES AND LINE ITEMSThis Purchase Order is issued by Clínica Ocular Rio de Janeiro Ltda. to formally request and authorize the provision of specialized ophthalmological services by the contracted Ophthalmologist, Dr. Helena Vasconcelos Ferreira, to be performed at the clinic's facility located in Rio de Janeiro, Brazil. The following line items detail the scope of services, equipment usage, and professional fees covered under this Purchase Order:
| Item # | Description of Service / Item | Quantity | Unit | Unit Price (BRL) | Total (BRL) |
|---|---|---|---|---|---|
| 01 | Comprehensive Ophthalmological Consultation and Diagnostic Evaluation (including slit-lamp examination, tonometry, and visual field testing) performed by the Ophthalmologist at the Rio de Janeiro clinic | 120 | Sessions | R$ 350.00 | R$ 42,000.00 |
| 02 | Vitreoretinal Surgical Procedures (cataract extraction with intraocular lens implantation) performed by the Ophthalmologist in the operating room at Rio de Janeiro, Brazil | 15 | Procedures | R$ 8,500.00 | R$ 127,500.00 |
| 03 | Post-operative Ophthalmologist Follow-up Visits and Wound Assessment (minimum 3 follow-ups per surgical patient) | 45 | Visits | R$ 200.00 | R$ 9,000.00 |
| 04 | Retinal Imaging and OCT (Optical Coherence Tomography) Interpretation by the Ophthalmologist | 200 | Studies | R$ 180.00 | R$ 36,000.00 |
| 05 | Emergency Ophthalmologist On-Call Coverage (24-hour availability for urgent retinal detachment and ocular trauma cases in Rio de Janeiro) | 3 | Months | R$ 5,000.00 | R$ 15,000.00 |
| 06 | Medical-Device Consumables and Surgical Kits (intraocular lenses, viscoelastic agents, sutures) allocated to the Ophthalmologist's surgical schedule | 15 | Kits | R$ 3,200.00 | R$ 48,000.00 |
| 07 | Continuing Medical Education and Conference Attendance (Ophthalmologist participation in the Brazilian Society of Ophthalmology annual congress in Rio de Janeiro) | 1 | Event | R$ 4,500.00 | R$ 4,500.00 |
| GRAND TOTAL (BRL): | R$ 282,000.00 | ||||
- Scope of Engagement: This Purchase Order authorizes the Ophthalmologist, Dr. Helena Vasconcelos Ferreira, to render all ophthalmological services as described in Section 3 at the Clínica Ocular Rio de Janeiro Ltda. facility in Rio de Janeiro, Brazil, for the period of 01 August 2025 through 31 October 2025.
- Compliance and Regulation: The Ophthalmologist shall perform all services in strict compliance with the regulations established by the Conselho Regional de Medicina do Estado do Rio de Janeiro (CREMERJ) and the Brazilian Health Regulatory Agency (ANVISA). All procedures must adhere to the ethical code of the Brazilian Medical Association (CFM).
- Payment Terms: Payment shall be made within thirty (30) calendar days from the date of invoice submission. Invoices must be issued in Brazilian Reais (BRL) and submitted to the Procurement Department of Clínica Ocular Rio de Janeiro Ltda. via email or in person at the Rio de Janeiro office. Late payments shall incur a penalty of 1% per month plus SELIC interest as per Brazilian commercial law.
- Service Location: All services under this Purchase Order shall be performed exclusively at the clinic premises located at Av. Atlântica, 1250, Copacabana, Rio de Janeiro, RJ, Brazil, unless otherwise agreed in writing by both parties for telemedicine consultations.
- Confidentiality: The Ophthalmologist shall maintain strict confidentiality regarding all patient medical records, diagnostic data, and clinical information in accordance with the Brazilian General Data Protection Law (LGPD – Lei Geral de Proteção de Dados, Law No. 13.709/2018).
- Insurance and Liability: The Ophthalmologist shall maintain valid professional medical malpractice insurance (Seguro de Responsabilidade Civil Profissional) with a minimum coverage of R$ 500,000.00 for the duration of this Purchase Order. Proof of insurance must be provided prior to the commencement of services.
- Termination: Either party may terminate this Purchase Order with thirty (30) days written notice. In the event of termination, the Ophthalmologist shall be compensated for all services rendered up to the termination date, and the Purchaser shall settle all outstanding invoices within the standard payment period.
- Governing Law: This Purchase Order shall be governed by and construed in accordance with the laws of the Federative Republic of Brazil. Any disputes arising from this document shall be resolved by the competent courts of the city of Rio de Janeiro, State of Rio de Janeiro, Brazil.
- Force Majeure: Neither party shall be liable for failure to perform obligations under this Purchase Order due to events beyond reasonable control, including but not limited to natural disasters, pandemics, or government-mandated closures affecting the city of Rio de Janeiro.
By signing below, both parties acknowledge and agree to all terms, conditions, and service specifications outlined in this Purchase Order for the provision of Ophthalmologist services in Rio de Janeiro, Brazil.
For the Purchaser:Dr. Ricardo Almeida Santos
Chief Medical Officer
Clínica Ocular Rio de Janeiro Ltda.
Date: _______________ For the Ophthalmologist / Service Provider:
Dr. Helena Vasconcelos Ferreira
Ophthalmologist – CRM-RJ 123.456-7
Rio de Janeiro, RJ – Brazil
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
Create your own Word template with our GoGPT AI prompt:
GoGPT