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Purchase Order Ophthalmologist in South Africa Johannesburg –Free Word Template Download with AI

MediSight Ophthalmic Centre (Pty) Ltd

1245 Rivonia Road, Sandton, Johannesburg, 2196, South Africa

Registration No: 2019/456789/07 | VAT No: 4930123456

Telephone: +27 (0)11 456 7890 | Email: [email protected]

Purchase Order No: PO-2025-JHB-00482

Date of Issue: 14 June 2025

Required Delivery Date: 28 June 2025

Payment Terms: Net 30 Days

Delivery Location: Sandton, Johannesburg, South Africa

Valid Until: 14 July 2025

SUPPLIER / RECIPIENT DETAILS

Dr. Thandiwe Mokoena, Ophthalmologist

Lead Ophthalmologist & Clinical Director

MediSight Ophthalmic Centre (Pty) Ltd

1245 Rivonia Road, Sandton, Johannesburg, 2196

Gauteng, South Africa

Medical Council of South Africa (MCSA) Reg. No: GP1234567

Specialist Registration: Ophthalmology (SAO) No: OP-2018-0091

Telephone: +27 (0)11 456 7891 | Email: [email protected]

PURCHASE ORDER LINE ITEMS

This Purchase Order is issued by MediSight Ophthalmic Centre (Pty) Ltd, a registered ophthalmic practice located in Johannesburg, South Africa, to procure the following medical equipment, consumables, and professional services required for the continued operation of our Ophthalmologist-led clinical services. All items and services listed below are to be delivered to or rendered at our Sandton, Johannesburg facility unless otherwise specified.

Line Description Qty Unit Unit Price (ZAR) Amount (ZAR)
1 Topcon TRC-NW6S Fundus Camera – Ophthalmologist diagnostic imaging system for retinal examination 1 Unit 485,000.00 485,000.00
2 Zeiss IOLMaster 700 Biometer – Optical coherence tomography device for cataract surgery planning by the Ophthalmologist 1 Unit 1,250,000.00 1,250,000.00
3 Alcon Centurion Phacoemulsification System – Surgical equipment for the Ophthalmologist's cataract and refractive surgery suite 1 Unit 2,875,000.00 2,875,000.00
4 Acuvue Oasys 1-Day Contact Lenses (Box of 30) – Patient consumables dispensed by the Ophthalmologist 200 Boxes 1,850.00 370,000.00
5 Visine Preservative-Free Artificial Tears (15ml) – Post-operative patient care supplies for the Ophthalmologist's clinic 500 Bottles 185.00 92,500.00
6 Professional Ophthalmologist Continuing Medical Education (CME) – Annual conference registration, Ophthalmological Society of South Africa, Johannesburg 3 Registrations 12,500.00 37,500.00
7 Annual Calibration and Maintenance Service – All Ophthalmologist diagnostic and surgical equipment at the Johannesburg facility 1 Contract 185,000.00 185,000.00
8 Custom Ophthalmologist Branded Patient Information Booklets (South Africa Johannesburg edition) – 5,000 copies 5,000 Copies 28.00 140,000.00
Subtotal (ZAR) 5,435,000.00
VAT @ 15% (ZAR) 815,250.00
TOTAL AMOUNT DUE (ZAR) 6,250,250.00
TERMS AND CONDITIONS

1. Scope of Purchase Order: This Purchase Order constitutes a binding agreement between MediSight Ophthalmic Centre (Pty) Ltd and the supplier for the procurement of ophthalmic medical equipment, patient consumables, and professional services as detailed above. All items are intended for use by the Ophthalmologist and clinical team at our Johannesburg, South Africa facility.

2. Delivery: All physical goods must be delivered to 1245 Rivonia Road, Sandton, Johannesburg, 2196, South Africa, no later than 28 June 2025. Delivery must be made between 08:00 and 16:00 on business days. The supplier is responsible for all transportation, insurance, and risk of loss until goods are received and signed for by our Ophthalmologist or designated receiving officer at the Johannesburg site.

3. Quality Assurance: All ophthalmic equipment must comply with the South African Health Products Regulatory Authority (SAHPRA) standards and the Medical Devices Act 103 of 2002. The Ophthalmologist reserves the right to reject any item that does not meet the specified clinical standards or that arrives damaged, incomplete, or non-functional.

4. Payment: Payment shall be made within thirty (30) calendar days of receipt of a valid tax invoice and confirmed delivery. Payment will be made via electronic funds transfer (EFT) to the supplier's registered South African bank account. The total amount due under this Purchase Order is Six Million Two Hundred and Fifty Thousand Two Hundred and Fifty Rand (ZAR 6,250,250.00), inclusive of VAT at 15%.

5. Warranties: All capital equipment (Lines 1, 2, and 3) must carry a minimum manufacturer's warranty of twenty-four (24) months from the date of installation at our Johannesburg facility. The Ophthalmologist's clinical team will perform a full acceptance inspection within five (5) business days of delivery.

6. Cancellation and Amendments: This Purchase Order may be amended or cancelled in writing by either party. Cancellation of capital equipment orders after the supplier has placed the order with the manufacturer will incur a 10% cancellation fee. All amendments must be approved in writing by the Ophthalmologist and the Procurement Manager.

7. Governing Law: This Purchase Order shall be governed by and construed in accordance with the laws of the Republic of South Africa. Any disputes arising from this Purchase Order shall be subject to the exclusive jurisdiction of the courts of Johannesburg, Gauteng, South Africa.

8. Confidentiality: All patient data, clinical protocols, and proprietary information shared in connection with this Purchase Order shall remain strictly confidential and shall not be disclosed to any third party without prior written consent from the Ophthalmologist and the practice director.

NOTE: This Purchase Order is issued in accordance with the internal procurement policies of MediSight Ophthalmic Centre (Pty) Ltd. All purchases exceeding ZAR 500,000 require dual sign-off by the Ophthalmologist (Clinical Director) and the Finance Manager. This document is valid for the South Africa Johannesburg operational site only and does not extend to any satellite clinics. AUTHORISATION AND SIGNATURES

Prepared by (Procurement Manager):

Name: Mr. James van der Merwe

Designation: Procurement Manager

Signature & Date

Approved by (Ophthalmologist / Clinical Director):

Name: Dr. Thandiwe Mokoena, Ophthalmologist

Designation: Lead Ophthalmologist & Clinical Director

Signature & Date

Finance Authorisation:

Name: Ms. Lerato Dlamini

Designation: Finance Manager

Signature & Date

Supplier Acknowledgement:

Name: ___________________________

Designation: Authorised Representative

Signature & Date

MediSight Ophthalmic Centre (Pty) Ltd | 1245 Rivonia Road, Sandton, Johannesburg, 2196, South Africa

Purchase Order No: PO-2025-JHB-00482 | Page 1 of 1 | This is a system-generated Purchase Order document.

For queries regarding this Purchase Order, contact the Procurement Department at [email protected] or +27 (0)11 456 7890.

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