Purchase Order Ophthalmologist in Indonesia Jakarta –Free Word Template Download with AI
PT. Nusantara Medika Vision Center
Jl. Jend. Sudirman Kav. 52-53, SCBD District, Jakarta Selatan, Indonesia Jakarta 12190
Tel: +62-21-5790-4455 | Email: [email protected]
NPWP: 01.234.567.8-051.000 | Business License: 110/0456/B/2024
1. PURPOSE AND SCOPE OF THIS PURCHASE ORDERThis Purchase Order is issued by PT. Nusantara Medika Vision Center, a leading ophthalmic healthcare facility located in Indonesia Jakarta, for the procurement of specialized ophthalmology equipment, diagnostic instruments, and professional services required to support the practice of our senior Ophthalmologist, Dr. Hendra Wijaya, Sp.M(K). This Purchase Order covers the acquisition of state-of-the-art diagnostic and surgical tools, as well as the engagement of a certified Ophthalmologist consultant for a twelve-month service contract, all to be delivered and executed within the Indonesia Jakarta metropolitan area.
The scope of this Purchase Order encompasses the supply, installation, calibration, and initial training for all listed ophthalmic devices. The Ophthalmologist services component includes weekly clinical consultations, surgical procedures, and patient follow-up sessions to be conducted at our primary clinic in Indonesia Jakarta. All items and services referenced in this Purchase Order must comply with the Indonesian National Agency of Drug and Food Control (BPOM) regulations and the Ministry of Health of the Republic of Indonesia standards for medical equipment and professional healthcare services.
2. LINE ITEMS – EQUIPMENT AND MATERIALS| No. | Description | Specification | Qty | Unit Price (IDR) | Total (IDR) | Delivery |
|---|---|---|---|---|---|---|
| 1 | Optical Coherence Tomography (OCT) Scanner – Next-Generation Spectral Domain | SD-OCT, 1310nm, 70kHz | 1 | 1,850,000,000 | 1,850,000,000 | 30 days |
| 2 | Phacoemulsification Surgical System with Integrated Dispersion Control | 2.4mW, 30kHz | 1 | 2,400,000,000 | 2,400,000,000 | 45 days |
| 3 | Wide-Field Fundus Camera with Autofluorescence Module | 200° FOV, 45MP | 1 | 980,000,000 | 980,000,000 | 30 days |
| 4 | Topography and Corneal Mapping System (Scheimpflug Principle) | 25,000 points/scan | 1 | 1,200,000,000 | 1,200,000,000 | 45 days |
| 5 | Perioperative Ophthalmic Microscope, Binocular, 400W LED | 4x–16x zoom | 2 | 750,000,000 | 1,500,000,000 | 60 days |
| 6 | Intraocular Lens (IOL) Power Calculation Biometer – Optical | ±0.02D accuracy | 1 | 620,000,000 | 620,000,000 | 30 days |
| 7 | Consumables: Phaco Tips, Capsulorhexis Forceps, IOL Inserters (Annual Supply) | Per Ophthalmologist usage | 12 | 45,000,000 | 540,000,000 | Monthly |
| 8 | Calibration and Annual Maintenance Service Contract for All Above Devices | 12-month coverage | 1 | 380,000,000 | 380,000,000 | Ongoing |
| Subtotal (Equipment & Materials): | 9,470,000,000 | |||||
| No. | Service Description | Duration | Unit Price (IDR) | Total (IDR) | Notes |
|---|---|---|---|---|---|
| 9 | Senior Ophthalmologist (Sp.M(K)) – Weekly Clinical Consultation & Outpatient Services (3 days/week, 8 hours/day) at Indonesia Jakarta clinic | 12 months | 85,000,000/month | 1,020,000,000 | Includes patient records |
| 10 | Ophthalmologist Surgical Procedures – Cataract, Refractive, and Glaucoma Surgery (up to 150 procedures/year) | 12 months | 12,000,000/procedure | 1,800,000,000 | Per actual usage |
| 11 | Ophthalmologist On-Call Emergency Service – 24/7 Coverage for Indonesia Jakarta facility | 12 months | 25,000,000/month | 300,000,000 | Max 4 calls/month |
| 12 | Continuing Medical Education & Training for Ophthalmology Residents (4 residents) | 12 months | 15,000,000/month | 180,000,000 | Includes materials |
| Subtotal (Ophthalmologist Services): | 3,300,000,000 | ||||
4.1 The total value of this Purchase Order, inclusive of all equipment, materials, and Ophthalmologist professional services, amounts to IDR 12,770,000,000 (Twelve Billion Seven Hundred Seventy Million Rupiah), subject to applicable Value Added Tax (VAT/PPN) of 11% as mandated by the Indonesian tax authority for transactions conducted in Indonesia Jakarta.
4.2 Payment for equipment and materials (Items 1–8) shall be made in three installments: 40% upon signing of this Purchase Order, 40% upon delivery and successful installation in Indonesia Jakarta, and 20% upon completion of calibration and acceptance testing.
4.3 Payment for Ophthalmologist professional services (Items 9–12) shall be made on a monthly basis, within 30 days of receipt of the monthly service invoice, via bank transfer to the supplier's designated account at Bank Mandiri, Indonesia Jakarta branch.
4.4 All payments shall be processed in Indonesian Rupiah (IDR). Late payments shall incur a penalty of 1.5% per month on the outstanding balance.
5. DELIVERY, INSTALLATION, AND ACCEPTANCEAll equipment specified in this Purchase Order shall be delivered to the PT. Nusantara Medika Vision Center facility located at Jl. Jend. Sudirman Kav. 52-53, SCBD District, Indonesia Jakarta 12190. The supplier is responsible for all shipping, insurance, customs clearance (where applicable for imported ophthalmic devices), and installation within the Indonesia Jakarta premises. Installation must be completed within the delivery timelines stated in Section 2. Acceptance shall be confirmed in writing by the facility's Chief of Ophthalmology within five (5) business days of installation completion. Any equipment that fails to meet the specified performance parameters shall be replaced or repaired at the supplier's sole expense within fourteen (14) calendar days.
6. TERMS AND CONDITIONS – GENERAL6.1 This Purchase Order is governed by the laws of the Republic of Indonesia. Any disputes arising from this Purchase Order shall be resolved through arbitration in Indonesia Jakarta in accordance with the rules of the Indonesian National Board of Arbitration (BANI).
6.2 The Ophthalmologist engaged under this Purchase Order must hold a valid specialist certification (Sp.M(K)) issued by the Indonesian Ophthalmology Association (PERDAMI) and a current medical practice license (STR) registered with the local health office in Indonesia Jakarta.
6.3 The supplier warrants that all ophthalmic equipment supplied under this Purchase Order is new, unused, and free from defects. A minimum two-year warranty is included for all capital equipment.
6.4 Neither party may assign or transfer this Purchase Order without the prior written consent of the other party. This Purchase Order remains in full force and effect for the duration specified herein unless terminated earlier by mutual written agreement.
6.5 All data and patient records generated during the Ophthalmologist's service period in Indonesia Jakarta shall remain the exclusive property of PT. Nusantara Medika Vision Center and must comply with Indonesian data protection regulations (UU PDP No. 27 Tahun 2022).
NOTE: This Purchase Order is valid for a period of thirty (30) days from the date of issue. Failure to execute within this period will require re-issuance. All references to "Indonesia Jakarta" in this document pertain to the administrative and operational jurisdiction of the transaction. The Ophthalmologist services are contingent upon the availability of the designated specialist and the operational readiness of the Indonesia Jakarta facility. 7. AUTHORIZATION AND SIGNATURESBy signing below, both parties acknowledge and agree to all terms, conditions, and obligations set forth in this Purchase Order for the procurement of ophthalmology equipment and Ophthalmologist professional services in Indonesia Jakarta.
For and on behalf of the Buyer:
PT. Nusantara Medika Vision Center
Dr. Ratna Kusuma, MARSDirector of Procurement & Operations
Date: _______________
For and on behalf of the Supplier:
PT. Optima Medisindo Sejahtera
Budi Santoso, S.E.General Manager – Sales & Distribution
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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