Purchase Order Optometrist in United States New York City –Free Word Template Download with AI
PO No. NYC-OPH-2025-00472
Optometrist Practice Procurement Document
United States New York City | New York State
| Purchase Order Number: | NYC-OPH-2025-00472 |
| Date of Issue: | June 12, 2025 |
| Required Delivery Date: | July 15, 2025 |
| Payment Terms: | Net 30 days from date of invoice |
| Currency: | United States Dollars (USD) |
| Governing Jurisdiction: | State of New York, United States New York City |
Purchasing Party (Buyer)
Name: Dr. Margaret A. Sullivan, O.D.
Title: Licensed Optometrist, Principal Practitioner
Practice Name: Manhattan Vision Optometry Center
Address: 1420 Broadway, Suite 850, New York, NY 10018
United States New York City
Phone: (212) 555-0187
Email: [email protected]
NYS License No.: OD-2019-44871
Supplier (Seller)
Name: Precision Optical Equipment & Supplies, Inc.
Contact: Robert J. Tanaka, Sales Director
Address: 88 Commerce Street, Newark, NJ 07102
Phone: (973) 555-0342
Email: [email protected]
Tax ID (EIN): 47-2298301
This Purchase Order is issued by the undersigned Optometrist for the procurement of diagnostic equipment, clinical supplies, and professional services necessary for the continued operation of the Manhattan Vision Optometry Center located in United States New York City. All items listed below are subject to the terms and conditions specified in Section 5 of this Purchase Order.
| Item # | Description | Qty | Unit Price (USD) | Extended Price (USD) |
|---|---|---|---|---|
| 001 | Topcon Autorefractor / Keratometer ARK-530A (for Optometrist clinical use) | 1 | $18,450.00 | $18,450.00 |
| 002 | Zeiss IOLMaster 700 Biometer (optical coherence tomography) | 1 | $42,300.00 | $42,300.00 |
| 003 | Heine Omega 200 Direct Ophthalmoscope (Optometrist examination set) | 4 | $1,275.00 | $5,100.00 |
| 004 | Penlight, LED, 100,000 Lux (clinical examination) | 10 | $89.00 | $890.00 |
| 005 | Disposable Trial Lens Set, 200-piece (for Optometrist refraction) | 6 | $340.00 | $2,040.00 |
| 006 | Non-Contact Tonometer, NCT-2000 (intraocular pressure measurement) | 1 | $6,780.00 | $6,780.00 |
| 007 | Optical Coherence Tomography (OCT) Scanner, Heidelberg Spectralis | 1 | $95,000.00 | $95,000.00 |
| 008 | Annual Calibration and Maintenance Service Agreement (all diagnostic equipment) | 1 | $4,200.00 | $4,200.00 |
| 009 | White Balance Chart, 24-step (for Optometrist color vision testing) | 5 | $125.00 | $625.00 |
| 010 | Shipping, Installation, and On-Site Training (United States New York City delivery) | 1 | $3,500.00 | $3,500.00 |
| Subtotal: | $179,085.00 | |||
| New York State Sales Tax (8.875%): | $15,893.88 | |||
| TOTAL PURCHASE ORDER AMOUNT: | $194,978.88 | |||
All items referenced in this Purchase Order shall be delivered to the Optometrist's practice facility at 1420 Broadway, Suite 850, New York, NY 10018, United States New York City. The supplier is responsible for all freight, insurance, and handling charges associated with delivery within the five boroughs of New York City. Installation of all major diagnostic equipment, including the OCT scanner, biometer, and autorefractor, shall be performed by certified technicians from the supplier. The Optometrist and designated clinical staff shall be present during installation for on-site training, which shall not exceed two (2) business days. Delivery is subject to the building management access requirements of the Manhattan Vision Optometry Center and must be scheduled in coordination with the practice's front office no fewer than five (5) business days in advance.
- Acceptance: This Purchase Order constitutes a binding offer to purchase. The supplier's acceptance of this Purchase Order shall be confirmed in writing within five (5) business days of the date of issue. Failure to confirm within this period shall render this Purchase Order null and void.
- Compliance: All equipment and supplies must comply with the Federal Food and Drug Administration (FDA) regulations, the New York State Education Department requirements for Optometrist practice, and all applicable United States New York City health and safety codes.
- Warranty: The supplier warrants that all items delivered under this Purchase Order shall be free from defects in materials and workmanship for a period of no less than two (2) years from the date of installation. The Optometrist shall notify the supplier in writing of any defects within thirty (30) days of discovery.
- Payment: Payment of the total Purchase Order amount of $194,978.88 shall be made via wire transfer to the supplier's designated bank account within thirty (30) days of receipt of a valid invoice. Late payments shall accrue interest at a rate of 1.5% per month, in accordance with New York State commercial law.
- Right of Inspection: The Optometrist reserves the right to inspect all goods upon delivery. Any items found to be damaged, incomplete, or not conforming to the specifications in this Purchase Order shall be rejected at the supplier's expense, and replacement shall be arranged within ten (10) business days.
- Confidentiality: The supplier acknowledges that in the course of fulfilling this Purchase Order, it may have access to the Optometrist's patient records, practice protocols, and proprietary clinical data. All such information shall be treated as strictly confidential and shall not be disclosed to any third party without the prior written consent of the Optometrist, in compliance with HIPAA regulations.
- Force Majeure: Neither party shall be liable for delays or failures in performance resulting from events beyond its reasonable control, including but not limited to natural disasters, acts of government, or supply chain disruptions affecting the United States New York City metropolitan area.
- Governing Law: This Purchase Order shall be governed by and construed in accordance with the laws of the State of New York. Any disputes arising hereunder shall be resolved in the state or federal courts located in New York County, United States New York City.
- Amendments: No modification or amendment to this Purchase Order shall be valid unless made in writing and signed by both the Optometrist and an authorized representative of the supplier.
By signing below, the parties acknowledge and agree to all terms, conditions, and line items set forth in this Purchase Order. This document represents a formal procurement action by the Optometrist for the operational needs of the practice in United States New York City.
For the Purchasing Party (Optometrist):
Dr. Margaret A. Sullivan, O.D.
Licensed Optometrist, Manhattan Vision Optometry Center
Date: ______________________
For the Supplier:
Robert J. Tanaka, Sales Director
Precision Optical Equipment & Supplies, Inc.
Date: ______________________
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