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Purchase Order Orthodontist in Netherlands Amsterdam –Free Word Template Download with AI

Amsterdam Dental Procurement Group B.V.

Herengracht 452, 1017 CA Amsterdam, Netherlands

KvK: 87654321 | VAT: NL861234567B01 | Tel: +31 20 555 0142

Purchase Order No.: PO-2025-AM-0847
Date of Issue: 14 June 2025
Valid Until: 14 July 2025
Supplier / Orthodontist Practice:
Dr. Hendrik van der Berg, Orthodontist
Prinsengracht 891, 1015 KZ Amsterdam, Netherlands
IBAN: NL91 ABNA 0417 1643 00
VAT: NL859876543B01
Delivery Location:
Amsterdam Central Clinic, Netherlands
Payment Terms: Net 30 days
Currency: EUR (€)
Item # Description Category Qty Unit Price (EUR) Line Total (EUR)
01 Custom-milled ceramic orthodontic brackets (Invisible Aligner System), per patient set Orthodontic Equipment 25 € 185.00 € 4,625.00
02 Self-ligating orthodontic brackets, stainless steel, 0.022" slot, full arch (32 pcs) Orthodontic Equipment 40 € 92.50 € 3,700.00
03 NiTi archwires, 0.014" to 0.022" gauge, 18-inch length, per box of 10 Orthodontic Supplies 60 € 34.00 € 2,040.00
04 Orthodontic elastics, 0.021" and 0.028" diameter, assorted colours, per pack of 100 Orthodontic Supplies 120 € 8.75 € 1,050.00
05 Digital intraoral scanner calibration kit and replacement tips for OrthoScan Pro Orthodontic Technology 2 € 1,240.00 € 2,480.00
06 Professional orthodontic consultation and treatment planning session (per patient, 60 min) Orthodontist Services 50 € 120.00 € 6,000.00
07 Orthodontic bonding adhesive and etchant gel, 50 ml each, per set Orthodontic Supplies 30 € 42.00 € 1,260.00
08 Annual maintenance and calibration of orthodontic X-ray imaging unit (Panoramic + Cephalometric) Orthodontist Services 1 € 2,850.00 € 2,850.00
09 Patient education materials and aftercare kits for orthodontic treatment in Netherlands Amsterdam clinics Orthodontic Supplies 200 € 6.50 € 1,300.00
10 Emergency orthodontic repair service retainer (annual contract, up to 20 interventions) Orthodontist Services 1 € 3,400.00 € 3,400.00
Subtotal: € 28,705.00
VAT (21% – Netherlands): € 6,028.05
Grand Total (EUR): € 34,733.05

All prices are in Euros (EUR). VAT is applied at the standard Dutch rate of 21% as per the Dutch Tax Administration (Belastingdienst) regulations. This Purchase Order is governed by the laws of the Netherlands.

  • 1. Scope: This Purchase Order is issued by Amsterdam Dental Procurement Group B.V. for the procurement of orthodontic supplies, equipment, and professional orthodontist services to be delivered and performed at the Amsterdam Central Clinic located in Netherlands Amsterdam. All items and services listed above are to be provided by the named Orthodontist practice, Dr. Hendrik van der Berg, in full compliance with Dutch healthcare regulations and the Dutch Dental Association (Nederlandse Vereniging van Orthodontisten) standards.
  • 2. Delivery: All physical orthodontic supplies and equipment must be delivered to the Amsterdam Central Clinic, Herengracht 452, 1017 CA Amsterdam, Netherlands, no later than 28 June 2025. The Orthodontist is responsible for ensuring that all orthodontic materials meet the European Union Medical Device Regulation (EU MDR 2017/745) and carry valid CE marking.
  • 3. Service Delivery: Professional orthodontist consultation sessions, treatment planning, and emergency repair services referenced in this Purchase Order shall be scheduled in coordination with the Amsterdam Central Clinic's patient roster. The Orthodontist must maintain valid professional registration with the Dutch Health and Youth Care Inspectorate (IGJ) and carry adequate professional liability insurance.
  • 4. Payment: Payment of the full Purchase Order amount of € 34,733.05 (including VAT) shall be made within thirty (30) calendar days of the date of this Purchase Order via bank transfer to the IBAN specified above. Late payments shall incur interest at the statutory Dutch rate as defined in Article 6:119a of the Dutch Civil Code.
  • 5. Quality Assurance: The Orthodontist warrants that all orthodontic brackets, archwires, elastics, adhesives, and digital scanning components supplied under this Purchase Order are new, unused, and free from defects. Any defective orthodontic materials must be replaced within five (5) business days at no additional cost to the purchaser.
  • 6. Confidentiality and Data Protection: All patient data processed during orthodontic consultations and treatment planning in Netherlands Amsterdam shall be handled in strict accordance with the General Data Protection Regulation (GDPR) and the Dutch Implementation Act (UAVG). The Orthodontist shall not disclose any patient information to third parties without explicit written consent.
  • 7. Cancellation and Amendment: This Purchase Order may be amended or cancelled in writing by either party with a minimum of fourteen (14) days' prior notice. Cancellation after the delivery date for physical goods or after the commencement of orthodontist services shall be subject to a 15% administrative fee on the remaining balance.
  • 8. Governing Law and Jurisdiction: This Purchase Order is governed by the laws of the Netherlands. Any disputes arising from or in connection with this Purchase Order shall be submitted to the competent court in Amsterdam, Netherlands.

For and on behalf of the Purchaser:

Amsterdam Dental Procurement Group B.V.

Name: _________________________
Title: Procurement Director
Signature: _________________________
Date: _________________________

For and on behalf of the Orthodontist / Supplier:

Dr. Hendrik van der Berg, Orthodontist

Name: _________________________
Title: Lead Orthodontist
Signature: _________________________
Date: _________________________

This Purchase Order (PO-2025-AM-0847) is a legally binding document issued in Amsterdam, Netherlands. It covers the procurement of orthodontic supplies, equipment, and orthodontist professional services for use at the Amsterdam Central Clinic. All references to Netherlands Amsterdam pertain to the geographic and legal jurisdiction of this transaction. Please retain a copy for your records. For queries, contact [email protected] or +31 20 555 0142.

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