Purchase Order Optometrist in Saudi Arabia Jeddah –Free Word Template Download with AI
Al-Shifa Optometry Center
Optometrist Practice & Vision Care Clinic
King Fahd Road, Al Shati District, Jeddah 23412, Saudi Arabia
CR No. 1010456789 | VAT No. 310123456700003
Phone: +966 12 654 3210 | Email: [email protected]
SUPPLIER INFORMATION| Supplier Name: VisionTech Middle East FZE | Supplier Address: Jebel Ali Free Zone, Dubai, UAE |
| Contact Person: Mr. Ahmed Hassan, Regional Sales Director | Contact: +971 4 555 8899 | [email protected] |
| Trade License No.: UAE-TL-2019-78453 | VAT / Tax ID: AE100456789 |
|
Bill To: Al-Shifa Optometry Center King Fahd Road, Al Shati District Jeddah 23412, Saudi Arabia Attn: Ms. Noura Al-Harbi, Practice Manager |
Ship To: Al-Shifa Optometry Center – Warehouse King Fahd Road, Al Shati District Jeddah 23412, Saudi Arabia Attn: Mr. Faisal Al-Dossari, Logistics Coordinator |
| # | Description | Item Code | Qty | Unit Price (SAR) | Total (SAR) | Delivery |
|---|---|---|---|---|---|---|
| 1 | Topcon AutoRef Plus Digital Autorefractor – for comprehensive Optometrist patient examinations | VT-AR-2025-001 | 2 | 48,500.00 | 97,000.00 | 30 Jun 2025 |
| 2 | Nidek OPK-1000 Plus Keratometer – corneal curvature measurement for the Optometrist team | VT-KT-2025-002 | 1 | 32,750.00 | 32,750.00 | 30 Jun 2025 |
| 3 | Zeiss I-PRO 100 Digital Phoropter – standard diagnostic instrument for Optometrist refraction | VT-PH-2025-003 | 2 | 27,300.00 | 54,600.00 | 30 Jun 2025 |
| 4 | Essilor Varilux X Series Progressive Lenses (assorted powers) – patient dispensing stock | VT-LE-2025-004 | 200 | 485.00 | 97,000.00 | 30 Jun 2025 |
| 5 | Ray-Ban Optical Frames – assorted models for the Optometrist dispensing counter | VT-FR-2025-005 | 150 | 620.00 | 93,000.00 | 30 Jun 2025 |
| 6 | Topcon SL-D5000 Slit Lamp Biomicroscope – anterior segment examination for the Optometrist | VT-SL-2025-006 | 1 | 62,400.00 | 62,400.00 | 30 Jun 2025 |
| 7 | Heine Omega 200 Direct Ophthalmoscope – portable diagnostic tool for Optometrist field visits | VT-OP-2025-007 | 4 | 3,850.00 | 15,400.00 | 30 Jun 2025 |
| 8 | UV400 Polycarbonate Single-Vision Lenses (assorted) – daily dispensing inventory | VT-LS-2025-008 | 500 | 95.00 | 47,500.00 | 30 Jun 2025 |
| 9 | Optometrist Patient Examination Chairs – ergonomic, adjustable, with integrated lighting | VT-CH-2025-009 | 4 | 8,200.00 | 32,800.00 | 30 Jun 2025 |
| 10 | Annual Preventive Maintenance Contract – all diagnostic Optometrist equipment listed above | VT-SV-2025-010 | 1 | 18,500.00 | 18,500.00 | N/A |
| Subtotal: | 550,950.00 | |||||
| VAT (15% – Saudi Arabia): | 82,642.50 | |||||
| Import Duty & Customs Clearance (Jeddah Port): | 12,370.88 | |||||
| GRAND TOTAL (SAR): | 645,963.38 | |||||
- This Purchase Order is issued by Al-Shifa Optometry Center, a licensed Optometrist practice operating in Jeddah, Saudi Arabia, and constitutes a binding procurement request upon written acceptance by the supplier.
- All items must be delivered to the specified address in Jeddah, Saudi Arabia, no later than 30 June 2025. Late delivery shall incur a penalty of 1% of the total Purchase Order value per day of delay, up to a maximum of 10%.
- Payment shall be made via bank transfer to the supplier's designated account within thirty (30) calendar days of receipt of a valid tax invoice and confirmation of satisfactory delivery and installation of all Optometrist equipment.
- The supplier warrants that all diagnostic instruments, lenses, and optical frames are new, unused, and free from defects for a minimum period of twenty-four (24) months from the date of delivery in Saudi Arabia Jeddah.
- Installation, calibration, and operator training for the Optometrist staff shall be provided by the supplier's certified technicians at no additional cost. Training sessions shall be conducted in English and Arabic at the Jeddah clinic premises.
- All equipment must be registered with the SFDA prior to importation. The supplier is responsible for obtaining and submitting all import permits, SFDA registration numbers, and customs documentation required for clearance through Jeddah customs.
- This Purchase Order is governed by the laws of the Kingdom of Saudi Arabia. Any disputes arising from this Purchase Order shall be resolved through the competent courts in Jeddah, Saudi Arabia.
- The supplier shall maintain full insurance coverage for all goods in transit from the point of origin to the final delivery location in Jeddah, Saudi Arabia.
- Any modifications or amendments to this Purchase Order must be made in writing and signed by both parties. Verbal agreements shall not be valid.
- The Optometrist practice reserves the right to reject any item that does not meet the specifications outlined in this Purchase Order or that fails to comply with Saudi Arabian regulatory standards for medical and optical devices.
______________________________
Dr. Khalid Al-Otaibi
Lead Optometrist, Al-Shifa Optometry Center
Date: 15 June 2025 Approved By (Practice Manager):
______________________________
Ms. Noura Al-Harbi
Practice Manager, Al-Shifa Optometry Center
Date: 15 June 2025 Accepted By (Supplier Representative):
______________________________
Mr. Ahmed Hassan
Regional Sales Director, VisionTech Middle East FZE
Date: _______________ Received By (Logistics – Jeddah):
______________________________
Mr. Faisal Al-Dossari
Logistics Coordinator, Al-Shifa Optometry Center
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
Create your own Word template with our GoGPT AI prompt:
GoGPT