Purchase Order Orthodontist in Canada Toronto –Free Word Template Download with AI
ClearSmile Orthodontics & Dental Studio
2875 Yonge Street, Suite 410, Toronto, Ontario, Canada M4P 2A9
Phone: (416) 555-0192 | Email: [email protected]
Business Number: 123456789 RT0001 | HST Reg. No.: 123456789RT0001
PO No.: CSO-2025-04782| Field | Information |
|---|---|
| Purchase Order Date | June 12, 2025 |
| Required Delivery Date | July 15, 2025 |
| Delivery Location | ClearSmile Orthodontics & Dental Studio, 2875 Yonge Street, Suite 410, Toronto, Ontario, Canada M4P 2A9 |
| Payment Terms | Net 30 days from date of invoice |
| Currency | Canadian Dollars (CAD) |
| Incoterms | DDP (Delivered Duty Paid) – Toronto, Canada |
| Authorized By | Dr. Margaret Chen, DDS, Orthodontist – Practice Owner |
| Field | Information |
|---|---|
| Supplier Name | OrthoSupply Canada Inc. |
| Address | 1450 Bloor Street West, Unit 300, Toronto, Ontario, Canada M6M 3W4 |
| Contact Person | James Whitfield, Regional Sales Manager |
| Phone | (416) 555-0347 |
| [email protected] | |
| Supplier Tax ID | 987654321 RT0001 |
| Item # | Description | SKU / Part No. | Qty | Unit Price (CAD) | Line Total (CAD) |
|---|---|---|---|---|---|
| 1 | Self-Ligating Orthodontic Brackets – Ceramic, Universal Fit (Box of 50) | OS-CLB-50C | 12 | $1,245.00 | $14,940.00 |
| 2 | NiTi Archwires – 0.014" x 0.025" (Pack of 10) | OS-NIT-01425 | 20 | $89.50 | $1,790.00 |
| 3 | Intraoral Digital Scanner – 3Shape TRIOS 5 | OS-3ST-TRIOS5 | 1 | $28,500.00 | $28,500.00 |
| 4 | Orthodontic Elastics – Assorted Sizes (Case of 2,000) | OS-ELC-2000A | 8 | $62.00 | $496.00 |
| 5 | Clear Aligner Trays – Thermoform Sheets (Box of 100) | OS-ALN-100T | 15 | $310.00 | $4,650.00 |
| 6 | Orthodontic Bonding Agent Kit – Light-Cure (Set of 20) | OS-BND-20LC | 10 | $145.00 | $1,450.00 |
| 7 | Patient Comfort Kits – Wax, Rinsing Solution, Instruction Cards (Box of 100) | OS-PCK-100 | 25 | $38.00 | $950.00 |
| 8 | Orthodontic Forceps and Pliers Set – Stainless Steel (Set of 12) | OS-FPS-12SS | 2 | $425.00 | $850.00 |
| Subtotal | $53,626.00 | ||||
| HST (13% – Ontario, Canada) | $6,971.38 | ||||
| Freight & Delivery (Toronto, Canada) | $385.00 | ||||
| TOTAL AMOUNT DUE (CAD) | $60,982.38 | ||||
- This Purchase Order is issued by ClearSmile Orthodontics & Dental Studio, a licensed orthodontic practice operating in Canada Toronto, and constitutes a binding offer to purchase the goods and services listed herein upon acceptance by the supplier.
- All items listed in this Purchase Order must comply with Health Canada regulations and meet the Canadian Standards Association (CSA) requirements for medical and orthodontic devices. The supplier warrants that all orthodontic products are manufactured to ISO 13485 standards and carry valid Medical Device Licences issued by Health Canada.
- Delivery of all goods shall be made to the practice address in Canada Toronto as specified in Section 1. The supplier is responsible for all shipping, handling, and insurance costs until the goods are received and inspected at the Orthodontist's clinic premises.
- The Orthodontist (Dr. Margaret Chen) or her designated practice manager shall inspect all delivered items within five (5) business days of receipt. Any damaged, defective, or non-conforming items must be reported in writing to the supplier within this period. The supplier shall replace or credit non-conforming items at no additional cost to the practice.
- Payment shall be remitted in Canadian Dollars (CAD) via electronic funds transfer (EFT) to the supplier's designated bank account within thirty (30) calendar days of the date of a valid tax invoice. Late payments shall accrue interest at the rate of 1.5% per month as permitted under the Ontario Interest Act.
- This Purchase Order is governed by the laws of the Province of Ontario and the federal laws of Canada applicable therein. Any disputes arising from this order shall be resolved through mediation in Canada Toronto before proceeding to litigation in the Ontario Superior Court of Justice.
- The supplier acknowledges that the goods purchased under this Purchase Order are intended for use in a clinical Orthodontist practice serving patients in the Greater Toronto Area. The supplier shall maintain full product traceability records and shall notify the practice immediately of any Health Canada safety recalls or field safety corrective actions affecting the supplied items.
- Neither party may assign this Purchase Order or any rights or obligations hereunder without the prior written consent of the other party. This order may not be modified except by a written amendment signed by both the Orthodontist practice owner and an authorized representative of the supplier.
- All intellectual property, proprietary information, and patient data referenced in connection with this Purchase Order shall remain the exclusive property of ClearSmile Orthodontics & Dental Studio. The supplier shall not disclose any practice-specific information to third parties without express written authorization.
- This Purchase Order remains valid for acceptance for a period of fourteen (14) calendar days from the date of issue. Failure to accept within this period shall render the order null and void.
By signing below, the supplier acknowledges and accepts all terms, conditions, quantities, and pricing set forth in this Purchase Order for the supply of orthodontic equipment and materials to the Orthodontist practice located in Canada Toronto.
For: ClearSmile Orthodontics & Dental Studio (Buyer)
Signature: ___________________________
Name: Dr. Margaret Chen, DDS
Title: Orthodontist / Practice Owner
Date: ___________________________
For: OrthoSupply Canada Inc. (Supplier)
Signature: ___________________________
Name: James Whitfield
Title: Regional Sales Manager
Date: ___________________________
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