Purchase Order Orthodontist in Philippines Manila –Free Word Template Download with AI

Purchase Order No.: PO-2025-07-0342
Date Issued: July 14, 2025
Valid Until: August 14, 2025 Payment Terms: Net 30 Days
Incoterms: DDP Manila
Delivery Location: Philippines Manila Supplier / Vendor Information

Company Name: DentalPro Asia Supply Co., Ltd.	Address: Unit 5, BDO Corporate Center, 1001 Shaw Boulevard, Mandaluyong City, Philippines Manila 1550
Contact Person: Engr. Rafael D. Cruz, Sales Manager	Tax ID (TIN): 201-456-789-000 VAT Reg. No.: 000-789-123-456

Bill To / Ship To

Bill To:
Dr. Maria Santos Orthodontic Clinic
Attn: Ms. Liza Tan, Office Manager
128 Ayala Avenue, Makati City, Philippines Manila 1226

Ship To:
Dr. Maria Santos Orthodontic Clinic – Storage Unit B
128 Ayala Avenue, Makati City, Philippines Manila 1226
Delivery Window: 8:00 AM – 4:00 PM, Monday to Friday

Line Items – Orthodontist Equipment and Supplies

No.	Description	Qty	Unit	Unit Price (PHP)	Amount (PHP)
1	Self-Ligating Orthodontic Brackets (Metal, 0.022" slot) – For Orthodontist use in fixed appliance therapy	200	pcs	₱185.00	₱37,000.00
2	NiTi Archwires, 0.014" to 0.022" (Full Set per Patient)	50	sets	₱1,250.00	₱62,500.00
3	Orthodontic Elastomeric Ligatures (Assorted Colors, 1000 pcs per box)	10	boxes	₱890.00	₱8,900.00
4	Clear Aligner Trays (Thermoform, 30 per set) – For Orthodontist clear aligner treatment protocol	25	sets	₱4,500.00	₱112,500.00
5	Orthodontic Bonding Agent & Light-Curing Unit (LED, 1000 mW/cm²)	2	units	₱18,750.00	₱37,500.00
6	Interproximal Reduction (IPR) Strips, Assorted Grits	30	boxes	₱620.00	₱18,600.00
7	Orthodontic Impression Material (Polyvinyl Siloxane, 500ml syringe)	40	syringes	₱1,100.00	₱44,000.00
8	Patient Retainers (Hawley Type, Upper & Lower)	60	pcs	₱950.00	₱57,000.00
9	Orthodontic Wax & Emergency Repair Kits (Patient Take-Home)	100	kits	₱120.00	₱12,000.00
10	Digital Intraoral Scanner Tips (Compatible with 3Shape TRIOS 5)	5	pcs	₱15,200.00	₱76,000.00
Subtotal:					₱466,000.00
VAT (12%):					₱55,920.00
Delivery & Handling (within Philippines Manila):					₱3,500.00
TOTAL AMOUNT DUE:					₱525,420.00

Note: This Purchase Order is issued by Dr. Maria Santos, a licensed Orthodontist practicing in the Philippines Manila metropolitan area, for the procurement of orthodontic materials and equipment necessary for the continued delivery of comprehensive orthodontic care to patients. All items listed must comply with the Philippine Food and Drug Administration (FDA) registration requirements and the standards set by the Philippine Dental Association (PDA). Terms and Conditions

This Purchase Order is valid for acceptance within thirty (30) calendar days from the date of issuance. The supplier must confirm acceptance in writing via email to [email protected].
All orthodontic products and equipment listed in this Purchase Order must be new, unused, and in their original manufacturer packaging. The Orthodontist reserves the right to reject any items that do not meet the specified quality standards or are past their expiration date.
Delivery shall be made to the designated address in Philippines Manila within fifteen (15) business days from the date of confirmed Purchase Order acceptance. Late delivery beyond the stipulated period shall incur a penalty of 1.5% of the total order value per day of delay.
Payment shall be made via bank transfer to the supplier's designated account within thirty (30) days from the date of receipt and acceptance of all goods. The Orthodontist's office will issue an Official Receipt (OR) upon full payment in compliance with Bureau of Internal Revenue (BIR) regulations in the Philippines.
The supplier warrants that all orthodontic materials and equipment are free from defects in workmanship and materials for a period of twelve (12) months from the date of delivery. Any defective items shall be replaced at no additional cost to the Orthodontist's clinic.
All products must be accompanied by valid Certificates of Analysis, FDA Philippines registration numbers, and import declarations where applicable. The Orthodontist's practice in Philippines Manila is subject to periodic inspection by the Philippine Dental Council, and all procurement records must be maintained for audit purposes.
This Purchase Order is governed by the laws of the Republic of the Philippines. Any disputes arising from this transaction shall be resolved through the courts of competent jurisdiction in the Philippines Manila region.
The supplier acknowledges that the goods procured under this Purchase Order are intended exclusively for the professional use of a licensed Orthodontist and shall not be resold or redistributed without prior written consent from Dr. Maria Santos Orthodontic Clinic.
Force majeure events, including but not limited to natural disasters common in the Philippines Manila area (typhoons, earthquakes, volcanic activity), shall extend the delivery timeline by a reasonable period as mutually agreed upon by both parties.

Authorization and Acceptance

Prepared by (Buyer):

Dr. Maria L. Santos, MD, MS
Licensed Orthodontist
PDC License No. PDC-2019-04521
Date: _______________

Accepted by (Supplier):

Engr. Rafael D. Cruz
Sales Manager, DentalPro Asia Supply Co., Ltd.
TIN: 201-456-789-000
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX

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