Purchase Order Orthodontist in Canada Montreal –Free Word Template Download with AI
Dr. Marie-Claire Tremblay, Orthodontist
4520 Boulevard Saint-Laurent, Suite 310, Canada Montreal, QC H2T 1N4
Telephone: (514) 555-0187 | Email: [email protected]
Business Number (BN): 123456789 RT0001
PO No. OT-2025-0047| Field | Information |
|---|---|
| Purchase Order Date | June 12, 2025 |
| Required Delivery Date | July 15, 2025 |
| Delivery Location | 4520 Boulevard Saint-Laurent, Suite 310, Canada Montreal, QC H2T 1N4 |
| Payment Terms | Net 30 days from invoice date |
| Currency | Canadian Dollars (CAD) |
| Prepared By | Jonathan Beauchamp, Office Manager, Orthodontist Practice |
| Approved By | Dr. Marie-Claire Tremblay, DMD, Orthodontist |
| Field | Information |
|---|---|
| Supplier Name | DentalPro Solutions Inc. |
| Address | 8800 Rue de l'Église, Canada Montreal, QC H4L 4V8 |
| Contact Person | Sophie Lavoie, Regional Sales Director |
| Telephone | (514) 555-0342 |
| [email protected] | |
| Supplier BN | 987654321 RT0001 |
| Item # | Description | SKU / Part No. | Qty | Unit Price (CAD) | Line Total (CAD) |
|---|---|---|---|---|---|
| 1 | Self-Ligating Orthodontic Brackets (Ceramic, Upper & Lower Set) – for Orthodontist clinical use | SLB-CER-2025 | 25 | $185.00 | $4,625.00 |
| 2 | NiTi Archwires, 0.014" to 0.022" (Complete Set per Patient) | NITI-SET-1422 | 50 | $42.50 | $2,125.00 |
| 3 | Clear Aligner Trays (Thermoform, 30-pack) – Orthodontist treatment protocol | CL-TRAY-30 | 15 | $310.00 | $4,650.00 |
| 4 | Intraoral Digital Scanner (3Shape TRIOS 5) – for Orthodontist diagnostic imaging | 3S-TRIOS5-2025 | 1 | $28,500.00 | $28,500.00 |
| 5 | Orthodontic Elastics, Assorted (Box of 500) | ORTH-EL-500 | 40 | $18.75 | $750.00 |
| 6 | CBCT Cone Beam CT Imaging Software License (Annual) – Orthodontist planning module | CBCT-SW-ANL | 1 | $4,200.00 | $4,200.00 |
| 7 | Patient Education Kits (Bilingual English/French) – Canada Montreal clinic standard | EDU-KIT-BI | 100 | $12.00 | $1,200.00 |
| 8 | Orthodontic Bonding Agent & Adhesive Kit (Professional Grade) | BOND-ORTH-PRO | 30 | $67.00 | $2,010.00 |
| Subtotal | $48,060.00 | ||||
| GST (5% – Quebec QST 9.975% combined 14.975%) | $7,196.60 | ||||
| TOTAL AMOUNT DUE (CAD) | $55,256.60 | ||||
- This Purchase Order is issued by the Orthodontist practice of Dr. Marie-Claire Tremblay, located in Canada Montreal, and constitutes a binding request for the supply of orthodontic equipment, materials, and software as itemized above.
- All goods must be delivered to the Orthodontist clinic address in Canada Montreal no later than the required delivery date specified in Section 1. Late delivery beyond five (5) business days entitles the purchasing Orthodontist practice to a 2% discount per week of delay, up to a maximum of 10%.
- The supplier, DentalPro Solutions Inc., warrants that all orthodontic products supplied under this Purchase Order are new, unused, and comply with Health Canada regulatory standards and the Quebec College of Dental Surgeons (OCDQ) guidelines for orthodontic practice in Canada Montreal.
- Payment shall be made within thirty (30) days of receipt of a valid invoice. The Orthodontist practice in Canada Montreal shall remit payment via electronic funds transfer (EFT) to the supplier's designated account.
- All orthodontic equipment and consumables must be accompanied by proper documentation, including certificates of origin, safety data sheets, and warranty documentation where applicable. The intraoral scanner (Item #4) carries a two-year manufacturer's warranty with on-site service in Canada Montreal.
- The supplier acknowledges that this Purchase Order is subject to the Civil Code of Quebec and applicable federal Canadian trade regulations. Any disputes arising from this Purchase Order shall be resolved through mediation in Canada Montreal before proceeding to litigation in the Superior Court of Quebec.
- The Orthodontist practice reserves the right to inspect all delivered goods within ten (10) business days of receipt. Any items found defective, damaged, or non-conforming to the specifications in this Purchase Order must be replaced or refunded at the supplier's expense within fifteen (15) business days.
- Prices quoted in this Purchase Order are fixed in Canadian Dollars (CAD) and include all applicable taxes as calculated for the province of Quebec. No additional charges, including shipping or handling fees, shall be added beyond those explicitly stated.
- This Purchase Order may only be modified or amended in writing, signed by both the Orthodontist practice representative and the authorized supplier representative. Verbal agreements do not constitute a valid amendment.
- The supplier shall maintain confidentiality regarding all patient-related data, clinical protocols, and business information shared with the Orthodontist practice in Canada Montreal in connection with this Purchase Order, in compliance with Quebec's Law 25 and federal PIPEDA regulations.
By signing below, both parties acknowledge and agree to the terms, conditions, and line items specified in this Purchase Order for the Orthodontist practice operating in Canada Montreal.
For the Purchasing Party (Orthodontist Practice):Signature: ______________________________
Name: Dr. Marie-Claire Tremblay, DMD
Title: Principal Orthodontist
Date: ______________________________ For the Supplier (DentalPro Solutions Inc.):
Signature: ______________________________
Name: Sophie Lavoie
Title: Regional Sales Director
Date: ______________________________ ⬇️ Download as DOCX Edit online as DOCX
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