Purchase Order Optometrist in Senegal Dakar –Free Word Template Download with AI

Buyer (Optometrist Practice)

Clinique Optométrique du Lac Rose

Dr. Awa Ndiaye, D.Optom, FICO

12, Avenue Cheikh Anta Diop

Plateau, Dakar, Senegal

Tel: +221 33 849 2210

Email: [email protected]

RC: SN-DKR-2019-44821

Supplier / Vendor

OptiVision International S.A.

Attn: Mr. Jean-Marc Dupont, Export Manager

45, Rue de la République, 75011 Paris, France

Tel: +33 1 43 55 78 90

Email: [email protected]

SIRET: 512 384 771 00032

Delivery Address (Senegal Dakar)

Clinique Optométrique du Lac Rose

12, Avenue Cheikh Anta Diop, Plateau

Dakar, Senegal

Port of Entry: Port Autonome de Dakar

Customs Code: SN-DKR-PA-001

Payment & Delivery Terms

Payment: 40% advance, 60% on delivery

Incoterms: CIF Port of Dakar

Delivery Window: 30 calendar days

Currency: XOF (West African CFA Franc)

Bank: BICEF, Dakar — IBAN: SN07 1000 2000 0123 4567 8901 2345

Item #	Description	Qty	Unit	Unit Price (XOF)	Line Total (XOF)
01	Autorefractometer / Keratometer (Nidek ARK-530A) — for optometrist diagnostic use in Dakar clinic	1	Unit	4,850,000	4,850,000
02	Phoropter (Hartinger 2000) — standard optometrist refraction instrument	2	Unit	3,200,000	6,400,000
03	Slit Lamp Biomicroscope (Topcon SL-15) — for optometrist anterior segment examination	1	Unit	5,600,000	5,600,000
04	Non-Mydriatic Fundus Camera (Kowa FX50) — retinal imaging for optometrist practice	1	Unit	7,200,000	7,200,000
05	Optical Lenses — Single Vision (CR-39, various powers) — bulk supply for optometrist dispensing in Senegal	200	Pairs	18,500	3,700,000
06	Progressive / Multifocal Lenses (Varilux X series) — for optometrist patient prescriptions	80	Pairs	95,000	7,600,000
07	Optical Frames — Assorted (metal, acetate, titanium) — for optometrist retail dispensing in Dakar	150	Units	32,000	4,800,000
08	UV400 Sunglasses Lenses — polarized, for optometrist dispensing in tropical Senegal climate	100	Pairs	45,000	4,500,000
09	Contact Lens Trial Kits & Solution (daily disposable) — for optometrist fitting in Dakar	50	Kits	28,000	1,400,000
10	Optical Dispensing Machine (Eden Opti-Form 400) — for optometrist lens edging in clinic	1	Unit	6,800,000	6,800,000

Subtotal	52,850,000 XOF
Import Duty (Senegal Customs — 20%)	10,570,000 XOF
Value Added Tax (TVA — 18% Senegal)	11,374,200 XOF
Freight & Insurance (CIF Dakar)	2,100,000 XOF
GRAND TOTAL (XOF)	76,894,200 XOF

Important Note for Senegal Dakar Delivery: All medical and optometrist diagnostic equipment listed above must comply with the regulatory standards set by the Agence Nationale de Régulation de la Santé (ANRS) of Senegal and the Ministère de la Santé et de l'Action Sociale. The optometrist practice in Dakar is required to present valid import permits and CE/ISO certification documentation at the Port Autonome de Dakar for customs clearance. All optical products must bear appropriate labeling in French and/or English as per Senegalese consumer protection law. The optometrist, Dr. Awa Ndiaye, holds a valid professional license (N° OPT-SN-2020-0117) issued by the Senegalese Optometry Board, and all equipment purchased under this Purchase Order is intended exclusively for licensed optometrist clinical and dispensing use within the Dakar region.

Terms & Conditions of this Purchase Order

This Purchase Order is issued by the undersigned optometrist practice in Dakar, Senegal, and constitutes a binding procurement request for the optical and optometrist equipment specified herein.
The supplier shall deliver all items to the designated address in Plateau, Dakar, Senegal, within thirty (30) calendar days of the Purchase Order issue date, via the Port Autonome de Dakar.
All optometrist diagnostic instruments (items 01–04, 10) must be shipped with full manufacturer warranties of no less than two (2) years, with authorized service coverage available in Dakar, Senegal.
Payment shall be made in West African CFA Francs (XOF) via bank transfer to the supplier's designated international account. The 40% advance payment is due within five (5) business days of Purchase Order acceptance.
The supplier is responsible for all export documentation, including commercial invoice, packing list, certificate of origin, and any required phytosanitary or medical device export permits for entry into Senegal.
Any items found defective upon delivery at the Dakar clinic shall be replaced or repaired at the supplier's sole expense within fifteen (15) business days. The optometrist practice reserves the right to withhold the final 60% payment until all items are verified as conforming to the specifications in this Purchase Order.
This Purchase Order is governed by the laws of the Republic of Senegal. Any disputes arising from this transaction shall be resolved through the commercial courts of Dakar, Senegal. The optometrist practice and the supplier agree to attempt amicable resolution before initiating legal proceedings.
The supplier warrants that all optical lenses, frames, and contact lens products comply with the West African Economic and Monetary Union (WAEMU/UEMOA) standards for medical and optical devices as applicable in Senegal.
This Purchase Order may not be assigned or transferred without the prior written consent of both the optometrist buyer in Dakar and the supplier.
All intellectual property, trademarks, and proprietary specifications associated with the optometrist equipment remain the property of the respective manufacturers. This Purchase Order grants the optometrist practice in Senegal a non-exclusive license to use the equipment for clinical and commercial optometry services in Dakar.

Authorized Signatory — Buyer (Optometrist)

Dr. Awa Ndiaye, D.Optom
Clinique Optométrique du Lac Rose
Dakar, Senegal
Date: _______________

Authorized Signatory — Supplier

Mr. Jean-Marc Dupont
OptiVision International S.A.
Paris, France
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX

Create your own Word template with our GoGPT AI prompt:

GoGPT