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Purchase Order Optometrist in Canada Toronto –Free Word Template Download with AI

2847 Yonge Street, Suite 410, Canada Toronto, Ontario M4P 2A7

Phone: (416) 555-0192  |  Email: [email protected]

Ontario Health Insurance Plan (OHIP) Provider No. 7845-2291

Purchase Order

Purchase Order Details

PO Number: PO-2025-00472

Date of Issue: June 12, 2025

Required Delivery Date: July 1, 2025

Payment Terms: Net 30 Days

Currency: Canadian Dollars (CAD)

Prepared By: Margaret Chen, Procurement Manager

Vendor / Supplier Information

Company: Precision Optical Supply Inc.

Address: 1150 Bloor Street West, Canada Toronto, Ontario M6G 1M3

Contact: David Okafor, Sales Representative

Phone: (416) 555-0347

Email: [email protected]

HST Registration No.: 123456789RT0001

Delivery & Shipping

Ship To: Lakeshore Vision Care Centre

Address: 2847 Yonge Street, Suite 410, Canada Toronto, Ontario M4P 2A7

Attn: Dr. Sarah Whitfield, Lead Optometrist

Shipping Method: Ground Freight (Insured)

Incoterms: DDP – Canada Toronto

Item # Description SKU / Model Qty Unit Price (CAD) Line Total (CAD)
001 Topcon Autorefractor / Keratometer AR-1100 – for Optometrist diagnostic use TC-AR1100 1 $18,450.00 $18,450.00
002 Zeiss I-PROBE Plus Corneal Topographer – Optometrist clinical instrument ZS-IPROBE 1 $24,900.00 $24,900.00
003 Nidek OPK-1000 Optical Path Analyzer – Optometrist refraction suite ND-OPK1000 1 $12,750.00 $12,750.00
004 Essilor Varilux X Series Progressive Lenses (Assorted Powers) – 50 pairs ES-VARX-50 50 $89.00 $4,450.00
005 Ray-Ban Optical Frames – Assorted Styles for Optometrist patient dispensing RB-OPT-ASSORT 30 $145.00 $4,350.00
006 Wood's Lamp UV Examination Unit – Optometrist corneal assessment WL-UV-200 2 $1,280.00 $2,560.00
007 Phoropter Trial Lens Set (Complete) – Optometrist refraction kit PH-TLS-COMP 2 $3,400.00 $6,800.00
008 Anti-Fog & Anti-Scratch Coating Solution (Industrial Grade) – 20L AF-AS-20L 4 $320.00 $1,280.00
009 Optometrist Patient Examination Chairs (Hydraulic, Reclining) – Canada Toronto spec OC-HYD-REC 3 $2,150.00 $6,450.00
010 LED Illumination Overhead Surgical Light – Optometrist procedure room LED-OSL-300 1 $5,600.00 $5,600.00

Subtotal: $87,590.00 CAD

HST (13% – Ontario, Canada Toronto): $11,386.70 CAD

Shipping & Handling (Insured, Canada Toronto): $1,240.00 CAD

Grand Total: $100,216.70 CAD

Terms & Conditions – Purchase Order PO-2025-00472

  1. This Purchase Order is issued by Lakeshore Vision Care Centre, a licensed Optometrist practice operating in Canada Toronto, Ontario, and is governed by the laws of the Province of Ontario and the federal laws of Canada applicable therein.
  2. All items listed in this Purchase Order are intended for use by the Optometrist team at our Canada Toronto clinic for the purpose of patient diagnosis, refraction, and optical dispensing services. The vendor acknowledges that all equipment must comply with Health Canada regulatory standards and the College of Optometrists of Ontario (COO) practice guidelines.
  3. Delivery of all goods shall be made to the Canada Toronto address specified above no later than the Required Delivery Date. Late delivery beyond five (5) business days entitles the Optometrist practice to a 2% per diem penalty on the total Purchase Order value, up to a maximum of 10%.
  4. Payment shall be remitted in Canadian Dollars (CAD) via electronic funds transfer (EFT) within thirty (30) calendar days of receipt of a valid tax invoice from the vendor. The vendor must include their HST registration number on all invoices as required by the Canada Revenue Agency (CRA).
  5. All diagnostic and clinical equipment purchased under this Purchase Order must include a minimum two-year manufacturer's warranty covering parts and labour. The Optometrist practice reserves the right to reject any item that does not meet the specifications outlined in this document or that fails to meet Canada Toronto municipal health and safety codes.
  6. The vendor shall provide full installation, calibration, and staff training for all major Optometrist instruments (Items 001–003, 006, 007, 010) at the Canada Toronto clinic location. Training sessions must be conducted by certified technicians and shall include a minimum of four (4) hours of hands-on instruction for the Optometrist and support staff.
  7. This Purchase Order does not constitute a binding contract until countersigned by an authorized representative of the vendor. Any modifications to scope, quantity, or pricing must be documented in a written amendment to this Purchase Order and approved by both parties.
  8. The vendor warrants that all goods are free from liens, encumbrances, and defects in title. All optical lenses and frames must carry valid Canadian safety certification (CSA or equivalent) prior to delivery in Canada Toronto.
  9. Disputes arising from this Purchase Order shall be resolved through mediation in Canada Toronto, Ontario, in accordance with the Ontario Arbitration Act. If mediation fails, the matter shall be submitted to the courts of competent jurisdiction in the Regional Municipality of York / City of Toronto.
  10. This Purchase Order is valid for acceptance within fourteen (14) calendar days of the Date of Issue. After this period, the Optometrist practice reserves the right to cancel or renegotiate terms without liability.

Authorized by (Buyer):

Dr. Sarah Whitfield, Lead Optometrist

Lakeshore Vision Care Centre, Canada Toronto

Signature: ___________________________

Date: ___________________________

Accepted by (Vendor):

David Okafor, Sales Representative

Precision Optical Supply Inc., Canada Toronto

Signature: ___________________________

Date: ___________________________

Purchase Order PO-2025-00472 | Lakeshore Vision Care Centre | 2847 Yonge Street, Suite 410, Canada Toronto, Ontario M4P 2A7

This document is the property of Lakeshore Vision Care Centre. Unauthorized reproduction or distribution is prohibited. All transactions are subject to Ontario and federal Canadian tax regulations.

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