Purchase Order Orthodontist in Mexico Mexico City –Free Word Template Download with AI
Clínica Dental Integral del Valle, S.A. de C.V.
Av. Insurgentes Sur 1250, Col. Del Valle, Benito Juárez, 03100, Mexico Mexico City
Phone: +52 (55) 5555-0142 | Email: [email protected] | RFC: CDI980512AB3
VENDOR / SUPPLIER INFORMATION| Company Name: | Dr. Alejandro Ramírez Ortega, DMD – Orthodontist |
| Specialty: | Clinical Orthodontist – Braces, Aligners, and Maxillofacial Correction |
| Address: | Blvd. Manuel Ávila Camacho 45, Piso 3, Col. Lomas Altas, Miguel Hidalgo, 11950, Mexico Mexico City |
| Contact: | Dr. Alejandro Ramírez Ortega | +52 (55) 5555-0387 | [email protected] |
| RFC / Tax ID: | RAO820315QX7 |
| Professional License: | COFEPRIS Registration No. ORT-2019-44821 (Mexico Mexico City Health Authority) |
| Bill To: | Clínica Dental Integral del Valle, S.A. de C.V. Av. Insurgentes Sur 1250, Col. Del Valle, Benito Juárez, 03100, Mexico Mexico City |
| Ship To: | Clínica Dental Integral del Valle – Storage & Equipment Room Av. Insurgentes Sur 1250, Bodega B-7, Col. Del Valle, Benito Juárez, 03100, Mexico Mexico City |
| Attn: | Ing. Patricia Solís – Procurement Manager |
| Item # | Description | Qty | Unit | Unit Price (MXN) | Subtotal (MXN) |
|---|---|---|---|---|---|
| 001 | Stainless Steel Orthodontic Brackets (MBT 0.022" slot), per patient set – supplied by the Orthodontist for installation at our Mexico Mexico City facility | 45 | Set | 3,850.00 | 173,250.00 |
| 002 | Ceramic Self-Ligating Brackets (Aesthetic series), per patient set – Orthodontist recommended for adult patients in Mexico Mexico City | 30 | Set | 5,200.00 | 156,000.00 |
| 003 | Nickel-Titanium (NiTi) Archwires, full assortment (0.014" to 0.021" x 0.025"), per box of 12 wires | 60 | Box | 1,450.00 | 87,000.00 |
| 004 | Clear Aligner Trays (Thermoplastic PETG), 28-tray full series per patient – fabricated per Orthodontist digital scan | 25 | Series | 12,500.00 | 312,500.00 |
| 005 | Orthodontic Elastomeric Ligatures & O-Rings, assorted colors, per bulk pack (5,000 units) | 20 | Pack | 680.00 | 13,600.00 |
| 006 | Professional Orthodontist Consultation & Treatment Planning Session (per patient, 90 min) – conducted at Mexico Mexico City clinic by Dr. Ramírez Ortega | 100 | Session | 1,800.00 | 180,000.00 |
| 007 | Orthodontist Supervised Installation & Adjustment Visits (per patient, 6-month treatment cycle, 8 visits) | 100 | Cycle | 9,500.00 | 950,000.00 |
| 008 | Digital Intraoral Scanner Calibration & Orthodontist Training Workshop (1-day, Mexico Mexico City venue) | 1 | Event | 45,000.00 | 45,000.00 |
| 009 | Orthodontic Bonding Adhesive & Etching Gel, per kit (sufficient for 50 brackets) | 15 | Kit | 2,300.00 | 34,500.00 |
| 010 | Retainer Fabrication (Hawley & Essix), per patient pair – Orthodontist specified design | 100 | Pair | 2,200.00 | 220,000.00 |
| SUBTOTAL | 2,171,850.00 | ||||
| IVA (16% VAT – Mexico Mexico City) | 347,496.00 | ||||
| TOTAL PURCHASE ORDER AMOUNT (MXN) | 2,519,346.00 | ||||
- This Purchase Order is issued by Clínica Dental Integral del Valle, S.A. de C.V., a legally registered entity operating in Mexico Mexico City, and constitutes a binding agreement upon acceptance by the named Orthodontist, Dr. Alejandro Ramírez Ortega, DMD.
- All orthodontic materials, equipment, and professional services listed herein shall be delivered and performed at the buyer's facility located in Mexico Mexico City, unless otherwise specified in individual line items. The Orthodontist shall ensure that all clinical procedures comply with the regulations established by COFEPRIS and the Mexico Mexico City Health Secretariat.
- Payment shall be made within thirty (30) calendar days from the date of invoice receipt. Invoices must be issued in Mexican Pesos (MXN) and must include the applicable 16% IVA (Value Added Tax) as mandated by the Mexican Federal Tax Administration (SAT) for transactions conducted in Mexico Mexico City.
- The Orthodontist warrants that all orthodontic brackets, wires, aligners, and adhesives supplied under this Purchase Order are new, unopened, and manufactured in compliance with NOM-240-SSA1-2012 and applicable international ISO standards for dental materials.
- Any deviation from the specifications outlined in this Purchase Order must be approved in writing by the Procurement Manager of Clínica Dental Integral del Valle prior to execution. Unauthorized substitutions of orthodontic materials by the Orthodontist will result in rejection of the affected line items.
- Delivery of all physical goods shall be made to the storage facility in Mexico Mexico City no later than July 15, 2025. Professional services (consultations, installations, adjustments, and training) shall be scheduled in coordination with the clinic's patient calendar and must be completed within the treatment cycle specified in Items 006 and 007.
- The Orthodontist shall maintain valid professional liability insurance with a minimum coverage of MXN 5,000,000 for all clinical services rendered under this Purchase Order in Mexico Mexico City. Proof of insurance shall be provided prior to the commencement of any patient-facing procedures.
- This Purchase Order is governed by the Commercial Code of Mexico and the applicable civil and health regulations of the Federal District (Mexico Mexico City). Any disputes arising from this agreement shall be resolved through binding arbitration in Mexico Mexico City in accordance with the rules of the Mexican Arbitration Center (CAM).
- Confidentiality: Both parties agree to maintain strict confidentiality regarding patient data, treatment plans, and commercial terms. All patient information handled by the Orthodontist in connection with this Purchase Order shall be protected in accordance with Mexico's Federal Law on the Protection of Personal Data Held by Private Parties (LFPDPPP) and the Mexico Mexico City data protection regulations.
- This Purchase Order may not be assigned or subcontracted by the Orthodontist without prior written consent from the buyer. All clinical services must be personally performed or directly supervised by Dr. Alejandro Ramírez Ortega or a licensed associate Orthodontist approved in writing by the clinic's medical director.
For the Buyer:
Clínica Dental Integral del Valle, S.A. de C.V.
Ing. Patricia Solís – Procurement Manager
Date: _______________
For the Vendor / Orthodontist:
Dr. Alejandro Ramírez Ortega, DMD
Orthodontist – License No. ORT-2019-44821
Date: _______________
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