Purchase Order Optometrist in Netherlands Amsterdam –Free Word Template Download with AI
Amsterdam Vision Care Group B.V.
Herengracht 412, 1017 BX Amsterdam, Netherlands
KvK: 87654321 | VAT: NL861234567B01 | Tel: +31 20 555 0198
Email: [email protected]
SUPPLIER / VENDOR INFORMATION| Optometrist Practice: Dr. J. van der Berg Optometrist & Vision Centre |
Contact Person: Dr. Jeroen van der Berg, Lead Optometrist |
| Address: Keizersgracht 287, 1016 DZ Netherlands Amsterdam |
Phone / Email: +31 20 555 0342 / [email protected] |
| VAT Number: NL859876543B01 |
Chamber of Commerce (KvK): 86543210 |
| Bill To: Amsterdam Vision Care Group B.V. Procurement Department Herengracht 412, 1017 BX Amsterdam, Netherlands |
Ship To: Amsterdam Vision Care Group B.V. Warehouse & Fitting Room Prinsengracht 556, 1016 KH Netherlands Amsterdam |
| # | Description | Qty | Unit Price (EUR) | Total (EUR) | Notes |
|---|---|---|---|---|---|
| 1 | Digital Autorefractor (Nidek ARK-530A) – for Optometrist diagnostic use | 2 | € 4,850.00 | € 9,700.00 | Includes calibration certificate |
| 2 | Non-Mydriatic Fundus Camera (Topcon TRC-NW6S) | 1 | € 12,400.00 | € 12,400.00 | For retinal imaging by Optometrist |
| 3 | Progressive Lenses – Varilux X4 (pair), Rx: -2.50 / -2.75 | 12 | € 185.00 | € 2,220.00 | Prescribed by Optometrist Dr. van der Berg |
| 4 | Blue-Light Filtering Single-Vision Lenses (pair) | 20 | € 95.00 | € 1,900.00 | For corporate client in Netherlands Amsterdam |
| 5 | Optical Frames – Titanium, Model "Amsterdam Classic" (various sizes) | 15 | € 120.00 | € 1,800.00 | Assorted colours; fitted by Optometrist |
| 6 | Comprehensive Optometrist Eye Examination Package (per patient) | 50 | € 85.00 | € 4,250.00 | Includes visual acuity, refraction, tonometry |
| 7 | Contact Lens Fitting & Follow-Up (Optometrist supervised) | 30 | € 65.00 | € 1,950.00 | Soft toric lenses included |
| 8 | Annual Preventive Eye Screening – Netherlands Amsterdam Community Programme | 200 | € 45.00 | € 9,000.00 | Delivered at Optometrist clinic, Keizersgracht |
| 9 | Phoropter (Nidek NP-200) – replacement unit | 1 | € 6,200.00 | € 6,200.00 | For Optometrist refraction suite |
| 10 | Optical Coating Solution – Anti-reflective, Hydrophobic (5 L) | 4 | € 320.00 | € 1,280.00 | For in-house lens lab |
| Subtotal: | € 50,700.00 | ||||
| VAT (21% – Netherlands): | € 10,647.00 | ||||
| GRAND TOTAL (EUR): | € 61,347.00 | ||||
- 1. Scope: This Purchase Order is issued by Amsterdam Vision Care Group B.V. to Dr. J. van der Berg Optometrist & Vision Centre, located in Netherlands Amsterdam, for the supply of optometric equipment, corrective lenses, optical frames, and professional Optometrist services as itemised above.
- 2. Delivery: All physical goods shall be delivered to the shipping address listed above no later than 05 July 2025. The Optometrist shall confirm delivery in writing within 48 hours of receipt. Late delivery beyond 10 business days entitles the buyer to a 5% discount per week of delay.
- 3. Payment: Payment shall be made via SEPA bank transfer within 30 calendar days of the invoice date. The Optometrist must include the Purchase Order number (PO-2025-AM-0472) on all invoices. Bank details: IBAN NL91 ABNA 0417 1643 00, BIC ABNANL2A.
- 4. Quality & Compliance: All equipment must comply with EU Medical Device Regulation (MDR 2017/745) and Dutch health authority (IGJ) standards. The Optometrist guarantees that all diagnostic and corrective services are performed in accordance with the Dutch Optometrist Code of Conduct (NVO).
- 5. Warranties: Equipment carries a minimum 24-month manufacturer warranty. Lenses and frames carry a 12-month defect warranty. The Optometrist shall replace or repair any defective item at no additional cost within the warranty period.
- 6. Cancellation: Either party may cancel this Purchase Order with 14 days' written notice prior to the delivery date. Cancellation after the delivery date is subject to a 15% restocking fee on undelivered items.
- 7. Governing Law: This Purchase Order is governed by the laws of the Netherlands. Any disputes shall be resolved by the competent court in Amsterdam, Netherlands.
- 8. Data Protection: All patient data processed in connection with Optometrist services shall comply with the EU General Data Protection Regulation (GDPR) and the Dutch UAVG. The Optometrist acts as a data processor under the buyer's data processing agreement.
- 9. Force Majeure: Neither party shall be liable for delays caused by events beyond reasonable control, including but not limited to natural disasters, pandemics, or government-mandated closures in Netherlands Amsterdam.
For and on behalf of Amsterdam Vision Care Group B.V. (Buyer):
Name: Sandra de VriesTitle: Head of Procurement
Signature: _________________________
Date: 14 June 2025
For and on behalf of Dr. J. van der Berg Optometrist & Vision Centre (Supplier):
Name: Dr. Jeroen van der BergTitle: Lead Optometrist / Practice Owner
Signature: _________________________
Date: _________________________ ⬇️ Download as DOCX Edit online as DOCX
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