Purchase Order Ophthalmologist in New Zealand Wellington –Free Word Template Download with AI
Wellington Regional Health Services Ltd.
145 Lambton Quay, Te Aro, Wellington 6011, New Zealand
Phone: +64 4 472 8800 | Email: [email protected]
Company Registration No. 942817365 | GST No. 942-817-365
SUPPLIER / SERVICE PROVIDER DETAILS| Supplier Name: | Dr. Sarah Mitchell, Ophthalmologist |
| Practice Name: | Wellington Vision & Ophthalmology Centre |
| Address: | Suite 4, Level 2, 22 Cuba Street, Te Aro, Wellington 6011, New Zealand |
| Registration: | Medical Council of New Zealand Reg. No. 104872 | Ophthalmologist Specialist Registration |
| Contact: | Phone: +64 4 382 5510 | Email: [email protected] |
| Bank Details: | ANZ Bank, Wellington Branch | Account: 01-0456-7890123-00 | BSB: 01-0456 |
| No. | Description of Goods / Services | Qty | Unit Price (NZD) | Total (NZD) | Delivery / Service Date |
|---|---|---|---|---|---|
| 1 | Comprehensive Ophthalmologist Consultation – Full Diagnostic Eye Examination including visual acuity testing, intraocular pressure measurement, and retinal assessment for Wellington Regional Health Services staff (batch of 45 employees) | 45 | $285.00 | $12,825.00 | 20 June – 10 July 2025 |
| 2 | Ophthalmologist Prescribed Optical Lenses – Custom ground progressive lenses (12 pairs) as prescribed by the Ophthalmologist following consultation | 12 | $620.00 | $7,440.00 | By 25 July 2025 |
| 3 | Optical Frame Supply – Prescription eyeglass frames (12 units) to match Ophthalmologist prescriptions, Wellington Vision & Ophthalmology Centre approved range | 12 | $310.00 | $3,720.00 | By 25 July 2025 |
| 4 | Ophthalmologist Follow-Up Appointment – Post-fitting review and lens adjustment session for all recipients in Wellington | 12 | $150.00 | $1,800.00 | By 30 July 2025 |
| 5 | Specialised Ophthalmologist Diagnostic Equipment Hire – OCT (Optical Coherence Tomography) scanner and fundus camera for on-site screening event at Wellington Regional Health Services headquarters | 1 | $4,500.00 | $4,500.00 | 22 June 2025 (1-day hire) |
| 6 | Ophthalmologist Written Report – Individual clinical reports for each employee, including diagnosis, treatment plan, and prescription details, delivered electronically to HR department in Wellington | 45 | $45.00 | $2,025.00 | Within 5 business days of each consultation |
| SUBTOTAL (NZD) | $32,310.00 | ||||
| GST (15%) – New Zealand Goods and Services Tax | $4,846.50 | ||||
| TOTAL AMOUNT DUE (NZD) | $37,156.50 | ||||
- This Purchase Order is issued by Wellington Regional Health Services Ltd. and constitutes a formal request for the Ophthalmologist services and associated optical goods as detailed above. All services must be delivered within the Wellington, New Zealand metropolitan area unless otherwise agreed in writing.
- The Ophthalmologist, Dr. Sarah Mitchell, confirms that all services rendered under this Purchase Order shall comply with the standards set by the Medical Council of New Zealand and the Ophthalmology Society of New Zealand. All clinical procedures must be performed in accordance with New Zealand health and safety legislation.
- Payment shall be made within thirty (30) calendar days of receipt of a valid tax invoice from the Ophthalmologist's practice. Payment will be processed via electronic funds transfer (EFT) to the bank account specified in the supplier details section of this Purchase Order.
- All prices quoted in this Purchase Order are in New Zealand Dollars (NZD) and include all applicable costs. The 15% Goods and Services Tax (GST) is calculated in accordance with the Inland Revenue Department of New Zealand regulations. No additional charges will be accepted without prior written amendment to this Purchase Order.
- The Ophthalmologist agrees to maintain full professional indemnity insurance with a minimum cover of NZD $5,000,000 for the duration of this Purchase Order. A certificate of insurance must be provided to Wellington Regional Health Services prior to the commencement of services.
- All patient data and clinical records generated under this Purchase Order must be handled in strict compliance with the New Zealand Privacy Act 2020. The Ophthalmologist shall not disclose any individual employee's medical information to any third party without written consent, except as required by New Zealand law.
- Delivery of optical goods (lenses and frames) shall be made to the Wellington Regional Health Services reception, 145 Lambton Quay, Te Aro, Wellington 6011. The Ophthalmologist's practice is responsible for all delivery costs within the Wellington region.
- Any disputes arising from this Purchase Order shall be resolved in accordance with the laws of New Zealand. The parties agree to first attempt resolution through mediation in Wellington before pursuing any legal action in the District Court of Wellington.
- This Purchase Order is valid for a period of ninety (90) days from the date of issue. If services are not commenced within this period, the Ophthalmologist may cancel this Purchase Order by providing fourteen (14) days written notice.
- The Ophthalmologist warrants that all optical products supplied are new, of the highest quality, and carry a minimum twelve-month manufacturer's warranty. Any defective items must be replaced at no additional cost to Wellington Regional Health Services.
For and on behalf of Wellington Regional Health Services Ltd.:
Name: James T. Walker
Title: Director of Procurement & Finance
Date: 14 June 2025
Signature: ___________________________
Accepted by the Ophthalmologist / Supplier:
Name: Dr. Sarah Mitchell, Ophthalmologist
Practice: Wellington Vision & Ophthalmology Centre
Date: _______________
Signature: ___________________________
Create your own Word template with our GoGPT AI prompt:
GoGPT