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Purchase Order Orthodontist in Chile Santiago –Free Word Template Download with AI

Clínica Ortodóntica del Pacífico SpA

Orthodontist Practice & Dental Clinic

Av. Apoquindo 4567, Of. 1201, Las Condes, Santiago, Chile

Phone: +56 2 2345 6789 | Email: [email protected]

RUT: 76.543.210-K | Registro Sanitario: RS-2019-0847

SANTIAGO, CHILE
Purchase Order No.: PO-2025-04871 Date of Issue: June 12, 2025 Delivery Deadline: July 04, 2025 Payment Terms: Net 30 Days Supplier Information
Supplier Name: Dental Supply Chile SpA
Address: Calle San Diego 1234, Providencia, Santiago, Chile
RUT: 78.123.456-7
Contact Person: Ing. María Fernanda Rojas
Email: [email protected]
Phone: +56 2 2987 6543
Bill To / Ship To
Company: Clínica Ortodóntica del Pacífico SpA (Orthodontist Practice)
Address: Av. Apoquindo 4567, Of. 1201, Las Condes, Santiago, Chile
Attn: Dra. Carolina Muñoz, Lead Orthodontist
Phone: +56 2 2345 6789
Order Details – Orthodontic Supplies & Equipment
Item # Description Qty Unit Unit Price (CLP) Subtotal (CLP)
1 Self-ligating orthodontic brackets, 0.022" slot, stainless steel (per patient set) 45 Set 185,000 8,325,000
2 NiTi archwires, 0.014" to 0.021" x 0.025" (complete set per patient) 45 Set 92,500 4,162,500
3 Ceramic orthodontic brackets, aesthetic series (per patient set) 20 Set 245,000 4,900,000
4 Orthodontic elastics, 1/4" to 3/4" (box of 100) 120 Box 8,500 1,020,000
5 Orthodontic bonding kit (adhesive, etchant, base, light-cure unit compatible) 30 Kit 67,000 2,010,000
6 Orthodontic pliers set (distal end cutter, ligature cutter, bracket seater, pliers) 4 Set 385,000 1,540,000
7 Intraoral scanner compatible with orthodontic digital workflow (software license) 1 Unit 4,850,000 4,850,000
8 Orthodontic wax, patient comfort strips (box of 500) 10 Box 12,000 120,000
9 Orthodontic headgear, adjustable (adult and pediatric sizes) 15 Unit 198,000 2,970,000
10 Orthodontic forceps and extraction instruments (stainless steel, autoclavable) 8 Set 156,000 1,248,000
TOTAL (CLP): 31,145,500
IVA 19% (Chilean VAT): 5,917,645
GRAND TOTAL (CLP): 37,063,145
Terms and Conditions
  • Delivery: All orthodontic supplies and equipment listed in this Purchase Order must be delivered to the Santiago, Chile clinic address specified above no later than July 04, 2025. Delivery within the Metropolitan Region of Santiago is included in the quoted price.
  • Quality Standards: All orthodontic products must comply with the regulations established by the Instituto de Salud Pública de Chile (ISP) and the Superintendencia de Salud. The supplier guarantees that all items meet international ISO 13485 medical device standards and are approved for use by licensed orthodontists in Chile.
  • Payment: Payment shall be made via electronic bank transfer (transferencia electrónica) to the supplier's account in Chile within thirty (30) calendar days from the date of invoice issuance. The currency of payment shall be Chilean Pesos (CLP). The supplier must issue a formal Factura Electrónica (electronic invoice) compliant with the Servicio de Impuestos Nacionales (SII) of Chile.
  • Warranty: All orthodontic equipment and instruments carry a minimum warranty of twelve (12) months from the date of delivery. The supplier shall replace any defective orthodontic components at no additional cost to the clinic.
  • Regulatory Compliance: The supplier confirms that all orthodontic products are registered with the relevant Chilean health authorities and that proper import documentation (if applicable) has been completed. The orthodontist practice in Santiago, Chile reserves the right to inspect all delivered goods upon receipt.
  • Penalties: Late delivery beyond the specified deadline will incur a penalty of 0.5% of the total Purchase Order value per business day of delay, up to a maximum of 5% of the total amount.
  • Governing Law: This Purchase Order shall be governed by and interpreted in accordance with the commercial laws of the Republic of Chile. Any disputes arising from this document shall be resolved in the competent courts of Santiago, Chile.
  • Confidentiality: Both parties agree to maintain confidentiality regarding the terms of this Purchase Order and any patient-related orthodontic treatment plans that may be referenced in ancillary documentation.
Authorized Signatures Dra. Carolina Muñoz
Lead Orthodontist / Authorized Signatory
Clínica Ortodóntica del Pacífico SpA
Santiago, Chile
Date: _______________
Ing. María Fernanda Rojas
Sales Director / Authorized Signatory
Dental Supply Chile SpA
Santiago, Chile
Date: _______________

This Purchase Order (PO-2025-04871) is issued by Clínica Ortodóntica del Pacífico SpA, a licensed orthodontist practice operating in Santiago, Chile. This document is valid for a period of sixty (60) days from the date of issue. For any modifications or cancellations, written notice must be provided to both parties no later than five (5) business days prior to the delivery deadline. All communications regarding this Purchase Order should be directed to the purchasing department at [email protected]. This document is generated in compliance with Chilean commercial regulations and the SII electronic invoicing framework.

© 2025 Clínica Ortodóntica del Pacífico SpA – Santiago, Chile. All rights reserved.

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