Purchase Order Orthodontist in Brazil São Paulo –Free Word Template Download with AI
Orthodontist Practice – Brazil São Paulo
Official Procurement Document for Orthodontic Supplies and Services
PO Number: BRS-SP-2025-04871Purchasing Entity (Orthodontist)
Dr. Helena Martins Costa
Orthodontist – CRO-SP 48.721
Clinica Ortodôntica São Paulo
Av. Paulista, 1578 – Conj. 1204
Bela Vista, São Paulo – SP, 01310-200
Brazil
CNPJ: 12.345.678/0001-90
Phone: +55 (11) 3284-5678
Email: [email protected]
Supplier / Vendor
OrtoSupply Brasil Ltda.
Av. Faria Lima, 4440 – Torre B
Jardim Paulistano, São Paulo – SP, 01452-000
Brazil
CNPJ: 98.765.432/0001-15
Phone: +55 (11) 4567-8901
Email: [email protected]
Order Details
Date of Issue: 15 June 2025
Required Delivery Date: 29 June 2025
Delivery Address: Av. Paulista, 1578 – Conj. 1204, São Paulo – SP, Brazil
Payment Terms: Net 30 days (boleto bancário)
Currency: Brazilian Real (BRL – R$)
Incoterms: DDP – São Paulo, Brazil
Authorized By
Name: Dr. Helena Martins Costa
Role: Owner / Lead Orthodontist
Department: Clinical Procurement
Approval Date: 15 June 2025
Reference: Internal Budget Code SP-ORT-2025-Q2
| Item # | Description | Qty | Unit | Unit Price (R$) | Total (R$) |
|---|---|---|---|---|---|
| 01 | Self-ligating orthodontic brackets (metal, 0.022" slot) – 16 per set | 40 | sets | 185.00 | 7,400.00 |
| 02 | NiTi archwires – 0.014" x 0.025" (18" length) | 120 | units | 32.50 | 3,900.00 |
| 03 | SS archwires – 0.019" x 0.025" (18" length) | 80 | units | 28.00 | 2,240.00 |
| 04 | Elastomeric ligatures (assorted colors, 500 per box) | 25 | boxes | 45.00 | 1,125.00 |
| 05 | Orthodontic bonding agent kit (etch, primer, adhesive) | 15 | kits | 120.00 | 1,800.00 |
| 06 | Composite resin for bonding (A2 shade, 4g syringe) | 30 | units | 68.00 | 2,040.00 |
| 07 | Orthodontic separators (stainless steel, 100 per pack) | 20 | packs | 22.00 | 440.00 |
| 08 | Removable orthodontic appliances – clear aligner trays (custom, São Paulo lab) | 12 | sets | 850.00 | 10,200.00 |
| 09 | Orthodontic forceps and pliers set (12-piece professional kit) | 3 | sets | 1,250.00 | 3,750.00 |
| 10 | Patient instruction kits (orthodontic care guides, Portuguese) | 200 | units | 8.50 | 1,700.00 |
| 11 | Orthodontic wax and emergency repair kits | 100 | units | 12.00 | 1,200.00 |
| 12 | Cephalometric film holders and digital sensor calibration service | 1 | service | 2,400.00 | 2,400.00 |
| Subtotal | R$ 38,195.00 |
| ICMS (18% – São Paulo state tax) | R$ 6,875.10 |
| Freight & Delivery (within São Paulo, Brazil) | R$ 350.00 |
| Discount (volume – 5%) | - R$ 1,909.75 |
| GRAND TOTAL (BRL) | R$ 43,510.35 |
Terms, Conditions & Notes – Purchase Order for Orthodontist in Brazil São Paulo
- This Purchase Order is issued by the undersigned Orthodontist, Dr. Helena Martins Costa, operating a licensed orthodontic practice in the city of São Paulo, state of São Paulo, Brazil. All items listed herein are intended exclusively for clinical orthodontic use within the practice premises located on Av. Paulista.
- The supplier, OrtoSupply Brasil Ltda., is a registered orthodontic equipment and materials distributor based in São Paulo, Brazil, and is responsible for the full delivery of all items specified in this Purchase Order to the designated address in São Paulo within the timeframe stated above.
- All orthodontic products must comply with ANVISA (Agência Nacional de Vigilância Sanitária) registration requirements and must carry valid RDC (Resolução da Diretoria Colegiada) certification for use in clinical orthodontic procedures in Brazil.
- Payment shall be made via boleto bancário within 30 calendar days of the invoice date. Late payments shall incur a penalty of 1% per month plus SELIC interest, in accordance with Brazilian commercial law (Código Civil, Art. 412).
- The Orthodontist reserves the right to inspect all delivered orthodontic materials upon receipt at the São Paulo clinic. Any items found to be defective, expired, or non-conforming to the specifications in this Purchase Order must be replaced within 10 business days at no additional cost to the purchasing Orthodontist.
- Delivery shall be made to the practice address in São Paulo, Brazil, between 08:00 and 17:00 (BRT – Brasília Time) on business days. The supplier must provide a nota fiscal (NF-e) for all items delivered, as required by the Brazilian tax authority (Receita Federal).
- This Purchase Order is valid for acceptance within 10 business days from the date of issue. After this period, the Orthodontist may revise quantities or pricing based on current market conditions in São Paulo.
- All communications regarding this Purchase Order shall be directed to the purchasing department of the orthodontic practice in São Paulo via the email and phone number listed above. Disputes arising from this Purchase Order shall be governed by the laws of the Federative Republic of Brazil, with jurisdiction in the courts of the city of São Paulo, SP.
- The Orthodontist practice in São Paulo maintains a minimum inventory policy for all critical orthodontic supplies. This Purchase Order represents the quarterly replenishment order for the second quarter of 2025 and is part of the annual procurement plan approved by the practice's financial management team.
Orthodontist – CRO-SP 48.721
Purchasing Authority – Clinica Ortodôntica São Paulo
Date: 15/06/2025 OrtoSupply Brasil Ltda.
Authorized Representative
Supplier Acceptance – São Paulo, Brazil
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