Purchase Order Optometrist in Philippines Manila –Free Word Template Download with AI

Purchase Order

Purchase Order Details

PO Number: PO-2025-0714-OM

Date Issued: July 14, 2025

Required Delivery Date: August 1, 2025

Delivery Location: ClearVision Optometry Center, 128 Makati Avenue, Mandaluyong City, Philippines Manila

Payment Terms: Net 30 Days from Delivery

Currency: Philippine Peso (PHP)

Supplier Information

Supplier Name: Pacific Optical Supply Co., Ltd.

Address: 45 Ortigas Avenue, Quezon City, Philippines Manila 1101

Contact Person: Mr. Ricardo Tan, Procurement Manager

Tel: (+63) 2-8712-3399

Email: [email protected]

BIR TIN: 000-987-654-321

Line Items – Optometrist Equipment and Supplies

Item No.	Description	Qty	Unit	Unit Price (PHP)	Amount (PHP)
01	Autorefractor / Keratometer (Nidek ARK-530A) – for Optometrist diagnostic use	1	Unit	285,000.00	285,000.00
02	Phoropter Trial Frame (Hartinger 2000 Series) – Optometrist examination equipment	2	Units	98,500.00	197,000.00
03	Slit Lamp Biomicroscope (Topcon SL-18D) – for Optometrist anterior segment examination	1	Unit	342,000.00	342,000.00
04	Non-Mydriatic Fundus Camera (Kowa FX50) – Optometrist retinal imaging	1	Unit	415,000.00	415,000.00
05	Single Vision Lenses – CR-39 1.50 Index (Assorted Powers) – for Optometrist patient prescriptions	200	Pairs	1,850.00	370,000.00
06	Progressive Multifocal Lenses – 1.67 Index (Assorted Powers) – Optometrist specialty dispensing	80	Pairs	5,200.00	416,000.00
07	Optical Frames – Titanium & Acetate Collection (Mixed Styles) – for Optometrist retail dispensing	150	Units	3,500.00	525,000.00
08	UV400 Polycarbonate Lenses – Pediatric & Sports (Assorted) – Optometrist safety eyewear	100	Pairs	2,400.00	240,000.00
09	Optometrist Examination Chair – Hydraulic Adjustable, with Headrest	2	Units	45,000.00	90,000.00
10	Visual Acuity Chart Projector (Snellen / LogMAR) – Optometrist testing room	2	Units	28,000.00	56,000.00

Subtotal	2,936,000.00
VAT (12%)	352,320.00
Delivery & Installation (Philippines Manila Metro Area)	45,000.00
Grand Total (PHP)	3,333,320.00

Note: All equipment and supplies listed in this Purchase Order are intended for use by the licensed Optometrist team at ClearVision Optometry Center, Philippines Manila. All diagnostic instruments must comply with the Philippine Food and Drug Administration (FDA) registration requirements. Lenses and frames must meet the Philippine National Standards (PNS) for optical products. The Optometrist in charge, Dr. Maria Santos, O.D., will inspect all deliveries upon arrival at the Philippines Manila facility.

Terms and Conditions

This Purchase Order is issued by ClearVision Optometry Center, Philippines Manila, and constitutes a binding agreement upon acceptance by the supplier. All items are to be delivered to the Optometrist practice facility located in Mandaluyong City, Philippines Manila.
Payment shall be made within thirty (30) calendar days from the date of confirmed delivery and acceptance of all items by the supervising Optometrist. Payment shall be processed via bank transfer to the supplier's designated account in the Philippines.
All optical diagnostic equipment (Autorefractor, Phoropters, Slit Lamp, Fundus Camera) must be calibrated and certified prior to delivery. The Optometrist team will perform a functional verification upon receipt. Any equipment found defective or non-compliant will be returned at the supplier's expense.
Lenses and frames must be in their original, unopened packaging. The Optometrist dispensing team requires all prescription lenses to be cut to order specifications provided separately. Stock lenses must carry valid batch numbers and expiration dates.
Delivery must be completed no later than August 1, 2025, at the Philippines Manila address stated above. Late delivery beyond five (5) business days entitles the buyer to a penalty of 1% of the total Purchase Order value per day of delay.
The supplier warrants all equipment for a minimum of two (2) years from the date of delivery. Warranty service must be available within the Philippines Manila metropolitan area within forty-eight (48) hours of a service request.
This Purchase Order is governed by the laws of the Republic of the Philippines. Any disputes arising from this transaction shall be resolved through the courts of competent jurisdiction in the Philippines Manila region.
The supplier acknowledges that all items purchased under this Purchase Order will be used in the practice of Optometry by a licensed Optometrist in the Philippines and must comply with all regulations set by the Philippine Optometric Association and the Department of Health.

Prepared by (Buyer):

Engr. James Dela Cruz
Procurement Officer
ClearVision Optometry Center, Philippines Manila
Date: _______________

Approved by (Buyer):

Dr. Maria Santos, O.D.
Lead Optometrist / Practice Manager
ClearVision Optometry Center, Philippines Manila
Date: _______________

Accepted by (Supplier):

Mr. Ricardo Tan
Procurement Manager
Pacific Optical Supply Co., Ltd.
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX

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