Purchase Order Ophthalmologist in Mexico Mexico City –Free Word Template Download with AI
| Provider Name: | Dr. Alejandro Ramírez Gutiérrez, Ophthalmologist (Médico Especialista en Oftalmología) |
| Professional License: | COEM No. 48291735 — Issued by the Secretaría de Salud, Mexico City |
| Specialty: | Comprehensive Ophthalmology, Cataract Surgery, Retinal Procedures, and Refractive Surgery |
| Practice Address: | Consultorio Médico, Piso 4, Torre Médica Norte, Av. Paseo de la Reforma 250, Col. Juárez, 06600 Mexico City, Mexico |
| Contact: | Phone: +52 (55) 5512-3456 | Email: [email protected] |
| RFC (Provider): | REG950612QZ8 |
This Purchase Order is issued by Clínica Oftalmológica del Valle, S.A. de C.V., a licensed medical institution operating in Mexico, Mexico City, to formally authorize and request the provision of specialized ophthalmological services and the supply of associated medical equipment by the designated Ophthalmologist, Dr. Alejandro Ramírez Gutiérrez. This document governs all terms, conditions, deliverables, and payment obligations related to the procurement of professional ophthalmic care services rendered within the jurisdiction of Mexico City, Mexico, in compliance with the regulations established by the Secretaría de Salud and the Comisión Federal para la Protección contra Riesgos Sanitarios (COFEPRIS).
3. Line Items & Services Ordered| Item # | Description | Quantity | Unit Price (MXN) | Subtotal (MXN) |
|---|---|---|---|---|
| 01 | Comprehensive Ophthalmologist consultation and diagnostic evaluation (visual acuity, tonometry, fundoscopy, OCT imaging) | 120 sessions | $1,850.00 | $222,000.00 |
| 02 | Cataract extraction surgery with intraocular lens (IOL) implantation performed by the Ophthalmologist | 45 procedures | $18,500.00 | $832,500.00 |
| 03 | Retinal laser photocoagulation and anti-VEGF intravitreal injections administered by the Ophthalmologist | 60 sessions | $7,200.00 | $432,000.00 |
| 04 | Refractive surgery (LASIK / PRK) performed by the Ophthalmologist with post-operative follow-up | 30 procedures | $22,000.00 | $660,000.00 |
| 05 | Supply of premium multifocal intraocular lenses (IOLs) for cataract procedures | 45 units | $8,750.00 | $393,750.00 |
| 06 | Post-operative follow-up consultations by the Ophthalmologist (3 visits per surgical patient) | 225 visits | $950.00 | $213,750.00 |
| 07 | Emergency ophthalmic on-call coverage by the Ophthalmologist (24/7 availability, Mexico City metropolitan area) | 12 months | $15,000.00 | $180,000.00 |
| TOTAL AMOUNT (before IVA 16%) | $2,934,000.00 | |||
| IVA (16% VAT) — Mexico, Mexico City | $469,440.00 | |||
| GRAND TOTAL (MXN) | $3,403,440.00 | |||
4.1 This Purchase Order is governed by the commercial and civil laws of the United Mexican States, with specific application to the regulations of Mexico City, Mexico. All disputes arising from this Purchase Order shall be resolved in the competent courts of Mexico City, Mexico.
4.2 The Ophthalmologist, Dr. Alejandro Ramírez Gutiérrez, shall perform all ophthalmological procedures and consultations in strict accordance with the clinical protocols established by the Mexican Ministry of Health (Secretaría de Salud) and the professional standards set forth by the Colegio de Oftalmólogos de México.
4.3 Payment terms: Net 30 days from the date of invoice issuance. Payment shall be made via bank transfer to the account designated by the Ophthalmologist. All amounts are denominated in Mexican Pesos (MXN) and are subject to the applicable 16% IVA (Value Added Tax) as mandated by the Servicio de Administración Tributaria (SAT) in Mexico, Mexico City.
4.4 The Ophthalmologist shall maintain valid professional liability insurance with a minimum coverage of MXN $5,000,000.00 throughout the duration of this Purchase Order. Proof of insurance shall be provided prior to the commencement of services.
4.5 All patient records, diagnostic imaging, and clinical data generated in Mexico City, Mexico, under this Purchase Order shall be handled in compliance with the Ley Federal de Protección de Datos Personales en Posesión de los Particulares and applicable health data regulations.
4.6 The Ophthalmologist shall provide a detailed monthly report summarizing all procedures performed, patient outcomes, and any complications encountered. This report shall be submitted to the administrative office of Clínica Oftalmológica del Valle no later than the 5th business day of the following month.
4.7 Either party may terminate this Purchase Order with a written notice of 30 days. In the event of termination, all completed services shall be invoiced and paid in full within the standard payment terms.
4.8 This Purchase Order does not constitute an employment relationship. The Ophthalmologist is engaged as an independent medical professional providing specialized ophthalmic services in Mexico, Mexico City.
5. Acceptance & AuthorizationBy signing below, both parties acknowledge and agree to all terms, conditions, and obligations set forth in this Purchase Order for the procurement of Ophthalmologist services in Mexico, Mexico City. This document constitutes a binding commercial agreement effective from the date of the last signature.
For the Issuing Entity:Lic. María Fernanda López Herrera
Directora General, Clínica Oftalmológica del Valle, S.A. de C.V.
Mexico City, Mexico
Date: _______________ For the Ophthalmologist / Service Provider:
Dr. Alejandro Ramírez Gutiérrez, M.D.
Ophthalmologist — COEM No. 48291735
Mexico City, Mexico
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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