Purchase Order Optometrist in Brazil Brasília –Free Word Template Download with AI
Optometrist Professional Services & Equipment Procurement
Issued in Brazil Brasília – Federal District (DF)
PO-2025-BSB-00472Purchase Order Details
PO Number: PO-2025-BSB-00472
Date of Issue: 15 June 2025
Required Delivery Date: 30 June 2025
Currency: Brazilian Real (BRL / R$)
Payment Terms: Net 30 days
Buyer (Purchasing Entity)
Organization: Instituto de Saúde Visual do Planalto
Address: Quadra 3, Bloco B, Lote 12, Asa Sul, Brasília – DF, 70300-000, Brazil
CNPJ: 12.345.678/0001-90
Contact: Dr. Ricardo Almeida, Procurement Manager
Email: [email protected]
Vendor / Optometrist Provider
Optometrist: Dra. Camila Ferreira Santos
Registration: CRO-DF 12.456 / CRBM 78.901
Clinic: Clínica Óptica Brasília Prime
Address: SHLS 714, Bloco A, Sala 204, Asa Sul, Brasília – DF, 70390-714, Brazil
CNPJ: 98.765.432/0001-10
Contact: (61) 3344-5566
This Purchase Order is formally issued by Instituto de Saúde Visual do Planalto, a public health institution operating in Brazil Brasília, to procure specialized optometry services and associated diagnostic equipment from the licensed Optometrist Dra. Camila Ferreira Santos. The scope of this Purchase Order encompasses the provision of comprehensive optometric examinations, prescription of corrective lenses, and the supply of specialized diagnostic instruments required for the ongoing ophthalmic health program serving the residents of the Federal District. All services and deliverables under this Purchase Order shall be performed in accordance with the regulatory standards established by the Conselho Brasileiro de Oftalmologia and the local health authority of Brazil Brasília.
| Item # | Description | Quantity | Unit | Unit Price (R$) | Total (R$) |
|---|---|---|---|---|---|
| 01 | Comprehensive Optometrist Eye Examination (per patient) – includes visual acuity testing, refraction, and intraocular pressure measurement | 500 | Exams | 185.00 | 92,500.00 |
| 02 | Optometrist Prescriptive Consultation for Progressive Lenses and Blue-Light Filtering Eyewear | 200 | Consults | 120.00 | 24,000.00 |
| 03 | Autorefractor Machine (Nidek ARK-530A) – calibrated and installed at Brasília facility | 1 | Unit | 48,750.00 | 48,750.00 |
| 04 | Phoropter (Hartinger 1000) – for the Optometrist diagnostic suite | 2 | Units | 32,400.00 | 64,800.00 |
| 05 | Optometrist Training Workshop – Advanced Pediatric Refraction Techniques (2-day course in Brasília) | 1 | Event | 15,600.00 | 15,600.00 |
| 06 | Monthly Optometrist On-Site Coverage – 8 hours/week at the Federal District clinic | 12 | Months | 8,900.00 | 106,800.00 |
| 07 | Replacement Contact Lens Stock (Soft and Rigid Gas-Permeable) – Optometrist recommended brands | 300 | Pairs | 95.00 | 28,500.00 |
| TOTAL PURCHASE ORDER VALUE: | R$ 380,950.00 | ||||
- Compliance with Brazilian Law: All services rendered by the Optometrist under this Purchase Order shall comply with the Brazilian Consumer Protection Code (Código de Defesa do Consumidor – Lei 8.078/1990) and the specific regulations governing optometric practice in the state of Brazil Brasília, Federal District.
- Licensing and Credentials: The Optometrist, Dra. Camila Ferreira Santos, warrants that she holds a valid and current professional registration with the Conselho Regional de Medicina do Distrito Federal and that all equipment supplied is CE/ANVISA certified for use in Brazil.
- Delivery and Installation: All physical equipment listed in this Purchase Order shall be delivered, installed, and calibrated at the buyer's facility located in Asa Sul, Brazil Brasília, no later than the required delivery date specified above. The Optometrist's team shall be responsible for all logistics within the Federal District.
- Payment Schedule: Payment for this Purchase Order shall be made via bank transfer (TED/PIX) to the account designated by the Optometrist's clinic. Invoices must be submitted within five (5) business days of service completion or equipment delivery. Payment is due within thirty (30) calendar days of invoice receipt.
- Warranty: All diagnostic equipment supplied under this Purchase Order carries a minimum two-year manufacturer warranty. The Optometrist shall coordinate any warranty claims and provide on-site technical support in Brazil Brasília during the warranty period.
- Confidentiality: The Optometrist and all associated personnel shall maintain strict confidentiality regarding patient data in accordance with the Brazilian General Data Protection Law (LGPD – Lei 13.709/2018). All patient records generated during the scope of this Purchase Order shall be stored securely in Brazil Brasília.
- Termination: Either party may terminate this Purchase Order with thirty (30) days written notice. In the event of termination, the buyer shall pay for all services rendered and equipment delivered up to the termination date.
- Governing Law: This Purchase Order shall be governed by and construed in accordance with the laws of the Federative Republic of Brazil, with jurisdiction vested in the courts of Brazil Brasília, Federal District.
By signing below, both parties acknowledge and agree to all terms, conditions, and line items specified in this Purchase Order. The Optometrist confirms availability to deliver all services and equipment as outlined, and the buyer confirms authorization of the total Purchase Order value of R$ 380,950.00 (three hundred and eighty thousand nine hundred and fifty Brazilian Reais).
For the Buyer:
Instituto de Saúde Visual do Planalto
Dr. Ricardo Almeida
Procurement Manager
Date: _______________
For the Optometrist / Vendor:
Clínica Óptica Brasília Prime
Dra. Camila Ferreira Santos
Optometrist – CRO-DF 12.456
Date: _______________
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