Purchase Order Orthodontist in Brazil Brasília –Free Word Template Download with AI
Orthodontic Supply Procurement – Brazil Brasília
PO Number: PO-2025-0847-BR
Date of Issue: 14 June 2025
Valid Until: 14 July 2025
Page: 1 of 1
BUYER (Receiving Party)
Clinica Ortodontica Brasília Prime
Dr. Helena Vasconcelos – Lead Orthodontist
SHIS QI 05, Lote 12, Asa Sul
Brasília – DF, CEP 70330-000
Brazil
CNPJ: 12.345.678/0001-90
Tel: +55 (61) 3344-5566
Email: [email protected]
VENDOR (Supplier)
OrtoSupply Brasil Distribuidora Ltda.
Attn: Sr. Ricardo Almeida – Sales Director
Av. das Nações, Ed. Corporate Towers, 14º andar
Brasília – DF, CEP 70040-020
Brazil
CNPJ: 98.765.432/0001-15
Tel: +55 (61) 3211-8899
Email: [email protected]
PURPOSE AND SCOPEThis Purchase Order is issued by Clinica Ortodontica Brasília Prime, a specialized orthodontic practice located in the Federal District of Brazil Brasília, for the procurement of orthodontic materials, equipment, and consumables required for the ongoing clinical operations of our lead Orthodontist, Dr. Helena Vasconcelos, and her supporting clinical team. This Purchase Order governs the terms, quantities, pricing, delivery schedule, and acceptance criteria for all items listed herein. All transactions under this Purchase Order shall comply with the commercial regulations of Brazil and the specific municipal ordinances applicable to healthcare supply procurement in Brazil Brasília.
LINE ITEMS – ORTHODONTIC SUPPLIES AND EQUIPMENT| # | Description | SKU / Ref. | Qty | Unit Price (BRL) | Total (BRL) | Delivery Date |
|---|---|---|---|---|---|---|
| 1 | Self-ligating orthodontic brackets, 0.022" slot, stainless steel (full arch set, 28 pcs) | OSB-BRK-022-SS | 50 | R$ 1,850.00 | R$ 92,500.00 | 28 Jun 2025 |
| 2 | NiTi archwires, 0.014" to 0.021" x 0.025", full range set | OSB-WIR-NITI-FR | 100 | R$ 320.00 | R$ 32,000.00 | 28 Jun 2025 |
| 3 | Orthodontic elastics, 1/16" to 3/16", assorted colors (box of 1,000) | OSB-ELA-ASS-1000 | 200 | R$ 85.00 | R$ 17,000.00 | 28 Jun 2025 |
| 4 | Ceramic composite brackets, 0.022" slot, full arch set | OSB-BRK-022-CE | 30 | R$ 2,400.00 | R$ 72,000.00 | 05 Jul 2025 |
| 5 | Orthodontic bonding kit (adhesive, etchant, base, light-cure unit consumables) | OSB-BND-KIT-01 | 40 | R$ 450.00 | R$ 18,000.00 | 28 Jun 2025 |
| 6 | Portable intraoral digital scanner (compatible with 3D treatment planning software) | OSB-SCN-PORT-01 | 2 | R$ 48,500.00 | R$ 97,000.00 | 12 Jul 2025 |
| 7 | Orthodontic forceps, pliers, and cutting instruments (12-piece professional set) | OSB-INS-SET-12 | 5 | R$ 3,200.00 | R$ 16,000.00 | 28 Jun 2025 |
| 8 | Clear aligner thermoplastic sheets (BPA-free, 1.5mm thickness, 50 sheets) | OSB-ALN-SHT-50 | 10 | R$ 1,100.00 | R$ 11,000.00 | 05 Jul 2025 |
| 9 | Patient comfort kit (wax, oral rinse, instruction cards – Portuguese) | OSB-CMT-KIT-PT | 200 | R$ 45.00 | R$ 9,000.00 | 28 Jun 2025 |
| 10 | Orthodontic X-ray film and digital sensor maintenance kit (annual) | OSB-RAD-MAINT-AN | 1 | R$ 6,800.00 | R$ 6,800.00 | 12 Jul 2025 |
| Subtotal: | R$ 371,300.00 | |||||
| ICMS (18% – DF, Brazil Brasília): | R$ 66,834.00 | |||||
| Freight & Insurance (Brasília – DF): | R$ 4,500.00 | |||||
| GRAND TOTAL (BRL): | R$ 442,634.00 | |||||
- Payment Terms: Net 30 days from the date of invoice receipt. Payment shall be made via bank transfer (TED/PIX) to the vendor's account registered under CNPJ 98.765.432/0001-15. Late payments shall accrue interest at the rate of 1% per month plus a 2% penalty, in accordance with Brazilian commercial law (Código Civil, Art. 412).
- Delivery: All items shall be delivered to the buyer's premises at SHIS QI 05, Lote 12, Asa Sul, Brazil Brasília – DF, CEP 70330-000. The vendor is responsible for all transportation, handling, and insurance costs until the goods are received and signed for by the buyer's authorized representative in Brazil Brasília.
- Quality and Compliance: All orthodontic products supplied under this Purchase Order must comply with the regulatory standards established by ANVISA (Agência Nacional de Vigilância Sanitária) and must carry valid registration numbers. The vendor warrants that all materials are new, unused, and manufactured in accordance with ISO 13485 medical device quality management standards.
- Acceptance and Inspection: The buyer's lead Orthodontist, Dr. Helena Vasconcelos, or her designated clinical assistant, shall inspect all delivered goods within five (5) business days of receipt. Any items found to be defective, damaged, or non-conforming to the specifications in this Purchase Order must be reported in writing to the vendor within the same period. The vendor shall replace or credit non-conforming items within ten (10) business days at no additional cost to the buyer.
- Warranty: All equipment items (including the portable intraoral digital scanners and instrument sets) carry a minimum manufacturer warranty of twenty-four (24) months from the date of delivery. Consumable items are warranted to be free from manufacturing defects at the time of delivery.
- Intellectual Property and Branding: The vendor grants the buyer the right to use all product names, model numbers, and technical documentation associated with the supplied orthodontic items for internal clinical and administrative purposes within the practice in Brazil Brasília.
- Force Majeure: Neither party shall be liable for delays or failures in performance resulting from events beyond reasonable control, including but not limited to natural disasters, government sanctions, or public health emergencies affecting the Federal District of Brazil Brasília.
- Governing Law: This Purchase Order shall be governed by and construed in accordance with the laws of the Federative Republic of Brazil. Any disputes arising from this Purchase Order shall be subject to the exclusive jurisdiction of the courts of Brazil Brasília – DF.
- Confidentiality: Both parties agree to maintain the confidentiality of all commercial terms, pricing, and patient-related information exchanged in connection with this Purchase Order. This obligation survives the termination or expiration of this Purchase Order for a period of three (3) years.
- Amendments: No modification, amendment, or supplement to this Purchase Order shall be valid unless made in writing and signed by authorized representatives of both parties.
This Purchase Order is issued in support of the expanded orthodontic treatment program at Clinica Ortodontica Brasília Prime, which serves approximately 350 active patients under the direct supervision of the lead Orthodontist. The procurement of these materials ensures continuity of care for patients undergoing fixed appliance therapy, clear aligner treatment, and comprehensive orthodontic rehabilitation. The vendor is requested to include detailed technical data sheets, ANVISA registration certificates, and material safety data sheets (FISPQ) with each shipment. All documentation accompanying the delivery must be provided in Portuguese, as required for regulatory compliance in Brazil Brasília.
AUTHORIZATION AND SIGNATURESFor the Buyer:
Dr. Helena Vasconcelos
Lead Orthodontist / Clinical Director
Clinica Ortodontica Brasília Prime
CRO-DF: 12345
Date: _______________
For the Vendor:
Sr. Ricardo Almeida
Sales Director
OrtoSupply Brasil Distribuidora Ltda.
CNPJ: 98.765.432/0001-15
Date: _______________
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