Purchase Order Ophthalmologist in Venezuela Caracas –Free Word Template Download with AI
Clínica Ocular del Este, C.A.
Av. Francisco de Miranda, Torre Médica, Piso 12, Chacao, Venezuela Caracas, 1060
RIF: J-45872319-K | Tel: +58 (212) 555-0147 | Email: [email protected]
This Purchase Order is issued by Clínica Ocular del Este, C.A., a specialized ophthalmic medical center located in Venezuela Caracas, to formally authorize and request the provision of professional ophthalmology services, diagnostic equipment, and specialized medical supplies from the contracted Ophthalmologist, Dr. María Elena Rodríguez. This document serves as the binding procurement instrument governing the scope, pricing, delivery schedule, and professional obligations associated with the engagement of the Ophthalmologist for the upcoming fiscal quarter. All services and materials referenced herein are intended to support the clinical operations of the Ophthalmology Division at our primary facility in Chacao, Venezuela Caracas, and its satellite clinic in El Valle, Caracas.
| Item # | Description | Category | Qty | Unit Price (USD) | Total (USD) |
|---|---|---|---|---|---|
| 01 | Comprehensive Ophthalmologist consultation and patient evaluation (per session, 45 min) | Professional Service | 120 | 85.00 | 10,200.00 |
| 02 | Phacoemulsification cataract surgery performed by the Ophthalmologist (per procedure) | Surgical Service | 35 | 1,250.00 | 43,750.00 |
| 03 | Retinal laser photocoagulation treatment administered by the Ophthalmologist | Specialized Procedure | 50 | 420.00 | 21,000.00 |
| 04 | Optical coherence tomography (OCT) imaging – Ophthalmologist interpretation included | Diagnostic Service | 200 | 65.00 | 13,000.00 |
| 05 | Topographic corneal mapping – Ophthalmologist analysis and report | Diagnostic Service | 80 | 95.00 | 7,600.00 |
| 06 | Phacoemulsification surgical kits (disposable, single-use) | Medical Supply | 40 | 310.00 | 12,400.00 |
| 07 | Intraocular lens implants (premium multifocal, per unit) | Medical Supply | 70 | 480.00 | 33,600.00 |
| 08 | Post-operative ophthalmic medication kits (antibiotic drops, anti-inflammatory, lubricant) | Pharmaceutical | 150 | 28.50 | 4,275.00 |
| 09 | Monthly on-site availability of the Ophthalmologist for emergency consultations (Venezuela Caracas facility) | Professional Service | 3 | 2,800.00 | 8,400.00 |
| 10 | Continuing medical education and certification maintenance for the Ophthalmologist (annual) | Professional Development | 1 | 1,500.00 | 1,500.00 |
| Subtotal | $155,725.00 |
| Applicable Tax (IVAT 16% – Venezuela) | $24,916.00 |
| Logistics and Local Delivery (Caracas Metro Area) | $1,200.00 |
| GRAND TOTAL (USD) | $181,841.00 |
All professional services rendered by the Ophthalmologist shall be performed at the primary facility of Clínica Ocular del Este, C.A., located at Av. Francisco de Miranda, Torre Médica, Piso 12, Chacao, Venezuela Caracas, 1060. Surgical procedures (Items 02 and 03) will take place in the dedicated Ophthalmology Operating Suite, Room 12-B. All medical supplies, pharmaceuticals, and equipment listed in this Purchase Order must be delivered to the central receiving dock at the same Venezuela Caracas address no later than the dates specified in the delivery schedule attached as Annex A. The Ophthalmologist is required to maintain a minimum on-site presence of four (4) full working days per week at the Venezuela Caracas facility, with the remaining availability allocated to the El Valle satellite clinic in Caracas.
- Payment Schedule: 40% advance upon acceptance of this Purchase Order; 40% upon completion of 75% of contracted services; 20% upon final delivery and acceptance of all remaining items and services.
- Payment Method: Wire transfer to the Ophthalmologist's designated bank account in a Venezuelan financial institution, or via international SWIFT transfer in US Dollars as per the exchange rate published by the BCV (Banco Central de Venezuela) on the date of payment.
- Payment Terms: Net 30 days from the date of invoice submission. Late payments shall accrue interest at the rate of 1.5% per month.
- Currency: All amounts are denominated in US Dollars (USD). Conversion to Venezuelan Bolívares (VES) shall be at the official BCV rate on the transaction date.
- Invoicing: The Ophthalmologist shall submit itemized invoices referencing this Purchase Order number (PO-2025-OC-0487) for each billing cycle.
The Ophthalmologist, Dr. María Elena Rodríguez, agrees to perform all services in strict compliance with the regulations established by the Colegio de Médicos del Estado Miranda and the Ministry of Popular Power for Health (MINPPS) of the Bolivarian Republic of Venezuela. The Ophthalmologist shall maintain valid professional liability insurance with a minimum coverage of USD 2,000,000 per occurrence throughout the duration of this Purchase Order. All clinical records, patient data, and diagnostic imaging generated during the engagement shall be stored in accordance with Venezuelan data protection law (Ley Orgánica de Protección de Datos Personales) and the internal data governance policies of Clínica Ocular del Este, C.A. The Ophthalmologist shall submit a written clinical report to the Chief of Ophthalmology within 48 hours of each surgical procedure performed under this Purchase Order.
Either party may cancel this Purchase Order with a written notice of thirty (30) calendar days. In the event of cancellation, the Ophthalmologist shall be compensated for all services already rendered and non-refundable supplies already procured. Any disputes arising from the interpretation or execution of this Purchase Order shall be resolved through mediation in Venezuela Caracas before submission to the competent commercial courts of the state of Miranda. The governing law for this Purchase Order shall be the commercial and civil legislation of the Bolivarian Republic of Venezuela.
NOTE: This Purchase Order is valid only for the services and supplies explicitly listed herein. Any additional ophthalmology procedures, emergency interventions, or supplementary medical supplies requested by the Ophthalmologist beyond the scope of this document must be authorized in writing via a formal Purchase Order amendment signed by both parties prior to execution.For Clínica Ocular del Este, C.A. (Buyer)
Name: Lic. Ana Torres
Title: Procurement Manager
Signature: ___________________________
Date: ___________________________
For the Ophthalmologist (Vendor / Service Provider)
Name: Dr. María Elena Rodríguez, M.D.
Title: Ophthalmologist – C.O.M. 145.872
Signature: ___________________________
Date: ___________________________
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