Purchase Order Orthodontist in Peru Lima –Free Word Template Download with AI
Orthodontist Practice Peru Lima
PO Number: PO-ORT-2025-00487 | Date of Issue: June 12, 2025 | Status: PENDING APPROVAL
Buyer (Orthodontist Practice)
Clínica Ortodóntica del Pacífico S.A.C.
Av. Javier Prado Este 1245, San Isidro
Lima, Peru – CEP 15081
RUC: 20601234567
Contact: Dr. Ricardo Mendoza, Lead Orthodontist
Email: [email protected]
Phone: +51 1 445-6789
Supplier / Vendor
OrtoSupply International S.R.L.
Calle Los Pinos 890, Surco
Lima, Peru – CEP 15008
RUC: 20509876543
Contact: Lic. Carmen Torres, Sales Director
Email: [email protected]
Phone: +51 1 278-4321
Delivery Details
Ship To: Clínica Ortodóntica del Pacífico S.A.C.
Av. Javier Prado Este 1245, San Isidro, Lima, Peru
Delivery Window: June 25 – June 28, 2025
Delivery Hours: 08:00 – 17:00 (Lima local time)
Receiving Contact: Sra. Patricia Vega, Office Manager
Payment Terms
Method: Bank Transfer (Interbank)
Account: BCP – Cta. Cte. 191-12345678-0-15
Terms: Net 30 days from invoice date
Currency: Peruvian Sol (PEN / S/.)
Invoice Reference: Must cite PO-ORT-2025-00487
| # | Description | SKU / Ref. | Qty | Unit Price (S/.) | Subtotal (S/.) | Notes |
|---|---|---|---|---|---|---|
| 1 | Self-ligating orthodontic brackets (metal, 0.022" slot) – full arch set | OSI-BR-022M | 40 | 185.00 | 7,400.00 | For new patient intakes at Lima clinic |
| 2 | NiTi archwires, 0.014" – 0.019" x 0.025" (assorted pack) | OSI-AW-NITI | 60 | 42.50 | 2,550.00 | Standard orthodontist inventory restock |
| 3 | Ceramic orthodontic brackets (aesthetic, 0.022" slot) | OSI-BR-022C | 25 | 320.00 | 8,000.00 | Requested by Dr. Mendoza for adult patients |
| 4 | Orthodontic elastics (assorted colors, 3/16" – 5/16") | OSI-EL-ASSORT | 100 | 18.75 | 1,875.00 | Monthly supply for all active cases |
| 5 | Intraoral scanner (3D digital impression system) | OSI-IS-3D01 | 1 | 48,500.00 | 48,500.00 | Capital equipment; includes 1-yr warranty |
| 6 | Orthodontic bonding kit (adhesive, primer, light-cure unit) | OSI-BK-001 | 15 | 95.00 | 1,425.00 | Consumable; replace every 6 months |
| 7 | Clear aligner trays (thermoplastic, 50-pack) | OSI-CA-50P | 20 | 210.00 | 4,200.00 | For Invisalign-style treatment in Lima |
| 8 | Orthodontic forceps and pliers set (12-piece) | OSI-FT-12P | 4 | 385.00 | 1,540.00 | Sterilizable stainless steel |
| 9 | Patient instruction cards (Spanish/English, orthodontic care) | OSI-PC-ES/EN | 500 | 2.10 | 1,050.00 | Bilingual for Peru Lima patient base |
| 10 | CBCT imaging software license (1-year renewal) | OSI-SW-CBCT | 1 | 6,800.00 | 6,800.00 | For orthodontist diagnostic planning |
Subtotal: S/. 83,340.00
IGV (18% VAT – Peru): S/. 14,999.20
Freight & Delivery (within Lima, Peru): S/. 450.00
Grand Total: S/. 98,789.20
Terms & Conditions – Purchase Order for Orthodontist Practice in Peru Lima
- This Purchase Order is issued by Clínica Ortodóntica del Pacífico S.A.C., a registered orthodontist practice operating in the district of San Isidro, Lima, Peru, and is governed by the commercial laws of the Republic of Peru.
- All orthodontic products listed herein must comply with the technical standards established by DIGEMID (Dirección General de Medicamentos, Insumos y Productos Médicos) under the Ministry of Health of Peru. The supplier shall provide certificates of conformity and sanitary permits for all medical devices and orthodontic materials.
- Delivery shall be made to the orthodontist's clinic address in Lima, Peru, during the specified delivery window. Late delivery beyond June 28, 2025, will incur a penalty of 0.5% of the total order value per calendar day, up to a maximum of 5%.
- The supplier guarantees that all orthodontic brackets, wires, elastics, and equipment are new, unused, and within their manufacturer's expiration dates. Any item found defective upon receipt at the Lima facility must be reported within 5 business days for replacement or credit.
- Payment shall be processed via interbank transfer in Peruvian Soles (PEN) within 30 calendar days of the supplier's invoice date, provided all goods have been received and inspected by the orthodontist's office manager.
- This Purchase Order does not constitute a long-term supply agreement. Any future orthodontic supply orders for the Lima practice will require a separate Purchase Order issued by the clinic's procurement department.
- The supplier acknowledges that the buyer is a licensed orthodontist practice and that all purchased items are intended exclusively for professional orthodontic treatment of patients in Peru. Resale or redistribution of these materials is prohibited.
- Disputes arising from this Purchase Order shall be resolved through the competent commercial courts of Lima, Peru, in accordance with the Peruvian Civil Code and Commercial Code.
- All communications regarding this Purchase Order shall be directed to the contact persons listed above. Electronic communications sent to the registered email addresses in Lima, Peru, shall be considered valid and binding.
Prepared By (Buyer)
Dr. Ricardo MendozaLead Orthodontist & Director
Clínica Ortodóntica del Pacífico S.A.C.
Lima, Peru
Date: _______________
Approved By (Supplier)
Lic. Carmen TorresSales Director
OrtoSupply International S.R.L.
Lima, Peru
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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