Purchase Order Ophthalmologist in United States Miami –Free Word Template Download with AI
Formal Procurement Document for Ophthalmology Equipment and Professional Services
Issued in the State of Florida, United States Miami Metropolitan Area
PO No. MIA-OPH-2025-04872Purchasing Entity (Buyer)
Organization: Miami Vision Care & Ophthalmology Center, LLC
Address: 3401 Biscayne Boulevard, Suite 700, Miami, Florida 33137, United States
Primary Ophthalmologist: Dr. Elena Vasquez, MD, FACS
License No.: FL-OPH-2019-44821
Phone: (305) 555-0192
Email: [email protected]
Supplier / Vendor
Organization: Advanced Ophthalmic Technologies, Inc.
Address: 1200 NE 1st Avenue, Miami, Florida 33132, United States
Contact Person: Mr. David Chen, Regional Sales Director
Phone: (305) 555-0347
Email: [email protected]
Tax ID (EIN): 82-4471903
Order Details
Purchase Order Date: June 12, 2025
Required Delivery Date: July 15, 2025
Delivery Location: Miami Vision Care & Ophthalmology Center, 3401 Biscayne Blvd, Miami, FL 33137, United States
Payment Terms: Net 30 Days from Invoice Date
Currency: United States Dollars (USD)
Authorized Ophthalmologist
Name: Dr. Elena Vasquez, MD, FACS
Specialty: Comprehensive Ophthalmology, Corneal Transplantation, Refractive Surgery
Board Certification: American Board of Ophthalmology
Florida Medical License: Active, Renewed 2025
Role in This Purchase Order: Technical Specification Approver & Clinical Requirements Director
| Item # | Description | Specification / Model | Qty | Unit Price (USD) | Extended Price (USD) |
|---|---|---|---|---|---|
| 001 | Optical Coherence Tomography (OCT) Scanner – Spectral Domain | Zeiss Cirrus HD-OCT 6000, FDA Cleared | 1 | $187,500.00 | $187,500.00 |
| 002 | Phacoemulsification System with Integrated Dispersion Module | Alcon Infiniti LS Plus, Ophthalmologist-Configured | 2 | $94,200.00 | $188,400.00 |
| 003 | Slit Lamp Biomicroscope with Digital Imaging Attachment | Topcon SL-D7P with Retinal Camera Module | 3 | $12,850.00 | $38,550.00 |
| 004 | Anterior Segment Laser Interferometer (AS-OCT) | Heidelberg Spectralis HRA+OCT, Ophthalmologist-Grade | 1 | $215,000.00 | $215,000.00 |
| 005 | Annual Preventive Maintenance Contract – All Ophthalmic Devices | Comprehensive Service Agreement, 12-Month Term | 1 | $28,750.00 | $28,750.00 |
| 006 | Training Program for Ophthalmology Staff – New Equipment Operation | 40-Hour On-Site Certification, Miami, United States | 1 | $15,600.00 | $15,600.00 |
| 007 | Consumable Phacoemulsification Handpieces and Tips (Annual Supply) | Alcon OEM, 12-Month Ophthalmologist Usage Volume | 1 | $22,300.00 | $22,300.00 |
| 008 | Installation, Calibration, and Regulatory Compliance Inspection | FDA & Florida DOH Compliance, Miami, United States | 1 | $18,900.00 | $18,900.00 |
| Subtotal: | $715,000.00 | ||||
| Florida State Sales Tax (7.0%): | $50,050.00 | ||||
| Miami-Dade County Surcharge (0.5%): | $3,575.00 | ||||
| TOTAL PURCHASE ORDER AMOUNT (USD): | $768,625.00 | ||||
Terms and Conditions of This Purchase Order
- Acceptance: This Purchase Order becomes a binding agreement upon written acceptance by the Supplier. The Supplier must return a signed copy of this Purchase Order within five (5) business days of receipt, or the order shall be considered void.
- Delivery: All ophthalmology equipment listed in this Purchase Order must be delivered to the designated facility in Miami, Florida, United States, no later than July 15, 2025. Delivery must be made between the hours of 8:00 AM and 4:00 PM, Monday through Friday, to allow the Ophthalmologist and clinical staff to supervise unloading and initial inspection.
- Warranty: The Supplier warrants that all ophthalmic instruments and diagnostic equipment shall be free from defects in materials and workmanship for a period of not less than twenty-four (24) months from the date of installation in Miami, United States. The Ophthalmologist reserves the right to reject any equipment that fails to meet the clinical performance standards specified in this Purchase Order.
- Payment: Payment of the full Purchase Order amount of $768,625.00 USD shall be made within thirty (30) calendar days of the Supplier's invoice date, provided that all equipment has been installed, calibrated, and accepted by the Ophthalmologist in writing. Payment shall be made via wire transfer to the Supplier's designated United States bank account.
- Regulatory Compliance: The Supplier guarantees that all items in this Purchase Order are FDA-cleared or FDA-approved for use in the United States. The Supplier shall provide all necessary documentation, including 510(k) clearance letters, to the Ophthalmologist prior to delivery in Miami, Florida.
- Training Obligation: As specified in Line Item 006, the Supplier shall provide comprehensive on-site training for the Ophthalmologist, surgical assistants, and optometric technicians at the Miami facility. Training must be completed within ten (10) business days of equipment installation.
- Force Majeure: Neither party shall be liable for delays caused by acts of God, natural disasters (including hurricanes affecting the Miami, United States region), government actions, or other events beyond reasonable control.
- Governing Law: This Purchase Order shall be governed by and construed in accordance with the laws of the State of Florida, United States. Any disputes arising from this Purchase Order shall be resolved in the courts of Miami-Dade County, Florida.
- Confidentiality: All clinical data, patient information, and proprietary Ophthalmologist protocols shared in connection with this Purchase Order shall remain strictly confidential and shall not be disclosed to any third party without written consent.
- Amendments: Any modifications to this Purchase Order must be made in writing and signed by both the Ophthalmologist (or their authorized designee) and the Supplier's authorized representative.
For the Purchasing Entity:
Miami Vision Care & Ophthalmology Center, LLC
Signature: ______________________________
Name: Dr. Elena Vasquez, MD, FACS – Lead Ophthalmologist
Title: Medical Director & Procurement Authority
Date: ______________________________
For the Supplier:
Advanced Ophthalmic Technologies, Inc.
Signature: ______________________________
Name: David Chen
Title: Regional Sales Director, Miami, United States
Date: ______________________________
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