Purchase Order Ophthalmologist in Spain Valencia –Free Word Template Download with AI
Medical Services Procurement Document — Ophthalmology Department
Issued for use in Spain Valencia Region
SUPPLIER / SERVICE PROVIDER INFORMATION| Field | Details |
|---|---|
| Provider Name | Dr. Élvira Martínez Sánchez, Ophthalmologist, MD, PhD |
| Professional Registration | Colègi Oficial de Metges de València — License No. V-48291 |
| Specialty | Comprehensive Ophthalmology, Retinal Surgery, Cataract & Refractive Procedures |
| Clinic Address | Clinica Oftalmológica Levante, C/ Colón 42, 46004 Valencia, Spain |
| Contact | Phone: +34 963 554 210 | Email: [email protected] |
| VAT / NIF | ES-B-28471930 |
| Ref | Description of Service / Item | Qty | Unit Price (EUR) | Total (EUR) | Delivery / Service Date |
|---|---|---|---|---|---|
| 01 | Comprehensive ophthalmological examination and diagnostic workup (visual acuity, tonometry, OCT, fundus photography) performed by the contracted Ophthalmologist at the Valencia clinic | 120 | 185.00 | 22,200.00 | July 2025 |
| 02 | Phacoemulsification cataract surgery with premium intraocular lens implantation, performed by the Ophthalmologist Dr. Martínez at the operating theatre in Spain Valencia | 35 | 2,450.00 | 85,750.00 | July – August 2025 |
| 03 | Retinal laser photocoagulation and intravitreal anti-VEGF injection sessions supervised by the Ophthalmologist | 60 | 620.00 | 37,200.00 | August 2025 |
| 04 | Post-operative follow-up consultations (minimum 3 visits per surgical patient) conducted by the assigned Ophthalmologist | 105 | 95.00 | 9,975.00 | August – September 2025 |
| 05 | Emergency on-call ophthalmology coverage (24/7) at the Spain Valencia hospital facility, provided by the contracted Ophthalmologist or designated delegate | 90 days | 310.00 | 27,900.00 | July – September 2025 |
| 06 | Provision of premium IOL inventory (AcrySof IQ, Tecnis Symfony) and surgical consumables for the Ophthalmologist's operative schedule | 1 lot | 18,400.00 | 18,400.00 | June 2025 |
| SUBTOTAL | 201,425.00 | ||||
| VAT (21% — Spanish tax regime) | 42,299.25 | ||||
| GRAND TOTAL (EUR) | 243,724.25 | ||||
- This Purchase Order constitutes a binding agreement between Hospital Clínic de Valencia (hereinafter "the Buyer") and the named Ophthalmologist provider (hereinafter "the Supplier") for the delivery of ophthalmological medical services and associated consumables within the Spain Valencia metropolitan area.
- All services referenced in this Purchase Order shall be performed in strict compliance with the Ley General de Sanidad (Ley 14/1986), the applicable Valencian Community health regulations, and the professional code of ethics established by the Colègi Oficial de Metges de València.
- The Ophthalmologist shall maintain valid professional indemnity insurance with a minimum coverage of EUR 1,000,000 per claim throughout the validity period of this Purchase Order. A certificate of insurance must be submitted to the Buyer's Procurement Office prior to the commencement of services.
- Payment terms: Net 30 days from the date of invoice receipt, provided that all services have been rendered satisfactorily and documented in the patient medical records maintained at the Spain Valencia facility. Payment shall be made via bank transfer to the account specified on the Supplier's invoice.
- The Ophthalmologist is required to submit a monthly activity report to the Buyer's Ophthalmology Department Head by the 5th business day of the following month, detailing the number of procedures performed, patient outcomes, and any adverse events.
- Any modification, cancellation, or extension of this Purchase Order must be agreed upon in writing by both parties. Verbal authorizations shall not be valid under the commercial code applicable in the Spain Valencia jurisdiction.
- In the event of a dispute arising from the execution of this Purchase Order, both parties agree to first attempt resolution through mediation before the Centro de Arbitraje y Mediación de la Comunitat Valenciana. Should mediation fail, the competent courts of Valencia, Spain, shall have exclusive jurisdiction.
- The Ophthalmologist warrants that all diagnostic and surgical procedures shall be carried out with the standard of care expected of a board-certified ophthalmologist in the Spain Valencia region, utilizing evidence-based protocols and the latest approved medical devices.
- Confidentiality: All patient data processed under this Purchase Order shall be handled in accordance with the GDPR (Regulation (EU) 2016/679) and the Spanish Organic Law 3/2018 on Personal Data Protection. The Ophthalmologist shall not disclose any patient information to third parties without explicit written consent.
- This Purchase Order is valid for a period of three (3) months from the date of issue. Upon expiry, a new Purchase Order must be issued to continue the engagement of the Ophthalmologist services in Spain Valencia.
For the Buyer (Hospital Clínic de Valencia):
Dr. Carlos Ferrer López
Director of Procurement & Supply Chain
Date: _______________
For the Supplier (Ophthalmologist):
Dr. Élvira Martínez Sánchez
Ophthalmologist — Clinica Oftalmológica Levante
Date: _______________
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