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Purchase Order Ophthalmologist in United Arab Emirates Dubai –Free Word Template Download with AI

Ophthalmology Professional Services & Equipment Procurement

United Arab Emirates — Dubai

Purchase Order No.: PO-DXB-OPH-2025-04782

Date of Issue: 15 June 2025

Valid Until: 15 July 2025

Payment Terms: Net 30 Days

Delivery Location: Dubai, United Arab Emirates

Currency: AED (UAE Dirham)

PARTIES INVOLVED

Buyer (Purchasing Entity)

Al Noor Eye Care Center LLC

Building 14, Sheikh Zayed Road

Dubai Health Care City, Dubai

United Arab Emirates

Tax Registration No.: TRN-100456789012

Trade License No.: 104567890

Contact: [email protected]

Seller (Supplier / Ophthalmologist)

Dr. Ahmed Al Mansoori, MD, FICO

Consultant Ophthalmologist & Retina Specialist

Suite 302, Medical Tower, JLT

Jumeirah Lakes Towers, Dubai

United Arab Emirates

DHA License No.: DHA-OPH-2021-45892

Contact: [email protected]

LINE ITEMS & SCOPE OF PROCUREMENT
# Description Qty Unit Price (AED) Total (AED) Delivery / Service Date
1 Consultation and comprehensive eye examination services by the Ophthalmologist for 200 patients (outpatient clinic, Dubai) 200 350.00 70,000.00 July 2025
2 Anterior and posterior segment OCT imaging performed by the Ophthalmologist (per session) 150 280.00 42,000.00 July 2025
3 Cataract surgery (phacoemulsification with IOL implantation) performed by the Ophthalmologist 45 8,500.00 382,500.00 Aug–Sep 2025
4 Retinal laser photocoagulation treatment administered by the Ophthalmologist 60 1,200.00 72,000.00 Aug 2025
5 Prescription of and dispensing of post-operative ophthalmic medications (per patient) 45 450.00 20,250.00 Aug–Sep 2025
6 Follow-up post-operative review appointments with the Ophthalmologist (3 visits per surgical patient) 135 200.00 27,000.00 Sep–Oct 2025
7 Provision of ophthalmic surgical instruments and consumables (surgical packs, IOLs, viscoelastic agents) 45 3,200.00 144,000.00 Aug 2025
8 Medical report documentation and digital records transfer to the buyer's EMR system 1 15,000.00 15,000.00 Oct 2025
SUBTOTAL 772,750.00
VAT (5% — UAE Federal Tax Authority) 38,637.50
GRAND TOTAL (AED) 811,387.50
TERMS AND CONDITIONS

1. Scope of Services: This Purchase Order authorizes the engagement of the named Ophthalmologist, Dr. Ahmed Al Mansoori, to provide the ophthalmic diagnostic, surgical, and follow-up services as itemized above. All clinical procedures shall be performed in compliance with the standards set forth by the Dubai Health Authority (DHA) and the Ministry of Health and Prevention (MOHAP) of the United Arab Emirates.

2. Licensing and Compliance: The Ophthalmologist warrants that he holds a valid DHA specialist license (License No. DHA-OPH-2021-45892) and that all services rendered under this Purchase Order shall be conducted within the regulatory framework governing medical practice in Dubai, United Arab Emirates. Any change in licensure status must be communicated to the Buyer within 48 hours.

3. Delivery and Performance: All services and physical goods (surgical consumables, medications) shall be delivered or performed at the Buyer's facility located in Dubai Health Care City, Dubai, United Arab Emirates, unless otherwise specified in the line items. The Ophthalmologist shall adhere to the scheduled delivery and service dates outlined in the table above. Delays exceeding five (5) business days without prior written approval shall constitute a breach of this Purchase Order.

4. Payment Terms: Payment shall be made within thirty (30) calendar days from the date of receipt of a valid tax invoice issued in accordance with the UAE Federal Tax Authority regulations. Payment shall be processed via bank transfer to the account designated by the Ophthalmologist. The total amount due under this Purchase Order is AED 811,387.50 (Eight Hundred Eleven Thousand Three Hundred Eighty-Seven Dirhams and Fifty Fils), inclusive of 5% Value Added Tax.

5. Quality Assurance: The Ophthalmologist shall maintain all clinical records in a secure, HIPAA-equivalent compliant manner as required by UAE data protection law (Federal Decree-Law No. 45 of 2021 on Personal Data Protection). All patient data collected in Dubai, United Arab Emirates, shall be stored on servers located within the UAE unless explicit written consent is obtained from the patient for cross-border transfer.

6. Cancellation and Amendment: Either party may cancel or amend this Purchase Order by providing fourteen (14) days' written notice. In the event of partial cancellation of surgical procedures, a cancellation fee of 25% of the scheduled procedure cost shall apply if notice is given less than seven (7) days prior to the scheduled date.

7. Governing Law and Dispute Resolution: This Purchase Order shall be governed by and construed in accordance with the laws of the United Arab Emirates, specifically the federal and Dubai emirate-level commercial and medical regulations. Any disputes arising from this Purchase Order shall be resolved through the Dubai Courts or, at the mutual election of the parties, through arbitration administered by the Dubai International Arbitration Centre (DIAC).

8. Insurance: The Ophthalmologist shall maintain professional medical malpractice insurance with a minimum coverage of AED 5,000,000 per claim, valid throughout the term of this Purchase Order. A certificate of insurance shall be provided to the Buyer upon request.

AUTHORIZATION & SIGNATURES

BUYER

Authorized Signatory
Al Noor Eye Care Center LLC
Name: _________________________
Title: Procurement Director
Date: _________________________

SELLER / OPHTHALMOLOGIST

Dr. Ahmed Al Mansoori, MD, FICO
Consultant Ophthalmologist
DHA License: DHA-OPH-2021-45892
Date: _________________________
Important Notice: This Purchase Order is issued in accordance with the commercial regulations of the United Arab Emirates and the specific healthcare procurement guidelines of the Dubai Health Authority. All transactions are subject to the UAE Value Added Tax (VAT) at the standard rate of 5%. This document constitutes a legally binding agreement between the parties upon execution. The Ophthalmologist's services are limited to the scope described herein and do not include emergency or unscheduled consultations unless a separate Purchase Order or service agreement is executed. For any queries regarding this Purchase Order, please contact the Procurement Department at Al Noor Eye Care Center, Dubai, United Arab Emirates.
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