Purchase Order Orthodontist in Senegal Dakar –Free Word Template Download with AI
Orthodontic Equipment & Supplies Procurement
Issued for the Orthodontist Practice in Senegal Dakar
Purchase Order Details
Purchase Order No.: PO-SD-2025-0472
Date of Issue: 14 June 2025
Required Delivery Date: 05 July 2025
Payment Terms: Net 30 Days from Invoice Date
Currency: West African CFA Franc (XOF)
Incoterms: DDP – Dakar, Senegal
Vendor / Supplier Information
Supplier Name: MedDental International S.A.
Address: 12 Rue de la Santé, 75014 Paris, France
Contact Person: Mr. Laurent Dubois
Email: [email protected]
Phone: +33 1 44 55 66 77
Tax ID (FR): FR 88 445566778
Bill To / Ship To – Orthodontist Practice
Practice Name: Clinique Orthodontique du Lac Rose
Attending Orthodontist: Dr. Awa Ndiaye, DMD, MSc Orthodontics
Address: 45 Boulevard de la Médina, Plateau District, Dakar, Senegal
City / Country: Senegal Dakar, 10000
Contact Person: Dr. Awa Ndiaye
Email: [email protected]
Phone: +221 33 849 12 34
NIF (Tax ID): SN-2019-44556677
Delivery & Logistics
Shipping Method: Air Freight (Priority)
Port of Entry: Blaise Diagne International Airport (DKR), Senegal Dakar
Customs Clearance Agent: TransDakar Logistics SARL
Customs Agent Contact: +221 33 820 55 66
Storage upon Arrival: Clinique Orthodontique du Lac Rose, Plateau, Dakar
Special Handling: Fragile – Orthodontic brackets and aligners require climate-controlled transport (18–22 °C)
| No. | Description | SKU / Ref. | Qty | Unit Price (XOF) | Line Total (XOF) | Delivery |
|---|---|---|---|---|---|---|
| 1 | Self-Ligating Orthodontic Bracket System (Ceramic, Upper & Lower, 28 pcs/set) – for the Orthodontist at Clinique Orthodontique du Lac Rose | SLB-CER-28 | 50 | 185,000 | 9,250,000 | 05 Jul 2025 |
| 2 | Nickel-Titanium (NiTi) Archwires, 0.014" to 0.022" (Full Set, 10 wires per pack) | NITI-ARCH-10 | 120 | 42,500 | 5,100,000 | 05 Jul 2025 |
| 3 | Orthodontic Elastic Ligatures, Assorted Colors (500 pcs per box) | ELAST-ASSORT-500 | 80 | 18,000 | 1,440,000 | 05 Jul 2025 |
| 4 | Clear Aligner Trays (Thermoformable, 0.75 mm, 20 trays per kit) – for the Orthodontist's Invisalign-style treatment plan | ALIGN-TRAY-20 | 60 | 95,000 | 5,700,000 | 05 Jul 2025 |
| 5 | Orthodontic Bonding Agent & Light-Curing Unit (LED, 1000 mW/cm²) | BOND-LED-1000 | 10 | 320,000 | 3,200,000 | 05 Jul 2025 |
| 6 | Interproximal Reduction (IPR) Diamond Bur Set (12 burs per set) | IPR-BUR-12 | 30 | 28,500 | 855,000 | 05 Jul 2025 |
| 7 | Orthodontic Headgear & Facebow Assembly (Adjustable, 5 sizes) | HEADGEAR-ADJ-5 | 25 | 145,000 | 3,625,000 | 05 Jul 2025 |
| 8 | Patient Instruction Booklets (French & English, 100 copies) – for the Orthodontist's patient education program in Senegal Dakar | EDU-BOOK-FR-EN | 100 | 3,500 | 350,000 | 05 Jul 2025 |
| 9 | Orthodontic Wax & Comfort Strips (Patient Comfort Kit, 200 units) | WAX-COMF-200 | 40 | 12,000 | 480,000 | 05 Jul 2025 |
| 10 | Digital Intraoral Scanner (3D, 20 fps, USB-C) – for the Orthodontist's digital workflow | SCAN-3D-20FPS | 2 | 4,500,000 | 9,000,000 | 05 Jul 2025 |
| Subtotal (10 line items) | 39,000,000 XOF |
| International Air Freight & Insurance (DDP Dakar) | 2,850,000 XOF |
| Senegal Customs Duty & Import Tax (estimated 18%) | 7,020,000 XOF |
| Local Delivery within Senegal Dakar (Plateau District) | 150,000 XOF |
| Grand Total (XOF) | 49,020,000 XOF |
| Grand Total (USD equivalent, approx.) | ≈ 80,000 USD |
- This Purchase Order is issued by Clinique Orthodontique du Lac Rose, an Orthodontist practice located in Senegal Dakar, and constitutes a binding agreement upon acceptance by the supplier MedDental International S.A.
- All orthodontic products listed in this Purchase Order must comply with the Senegalese Ministry of Health (Ministère de la Santé et de l'Action Sociale) regulatory standards and the West African Economic and Monetary Union (WAEMU/UEMOA) medical device import regulations applicable in Senegal Dakar.
- The Orthodontist, Dr. Awa Ndiaye, reserves the right to inspect all delivered goods within five (5) business days of arrival at the Plateau District facility in Dakar. Any items found defective, damaged in transit, or non-conforming to the specifications in this Purchase Order must be replaced or refunded at the supplier's expense within fourteen (14) days.
- Payment shall be made via bank transfer to the supplier's designated account within thirty (30) days of the invoice date, provided that all goods have been received and accepted by the Orthodontist's practice in Senegal Dakar. Late payments shall incur a penalty of 1.5% per month.
- The supplier guarantees that all orthodontic brackets, archwires, aligners, and digital scanning equipment are new, unused, and carry a minimum manufacturer warranty of two (2) years from the date of delivery in Senegal Dakar.
- Intellectual property and proprietary technology (including the digital intraoral scanner firmware) remain the property of the manufacturer. The Orthodontist practice in Senegal Dakar is granted a non-transferable, single-practice license for clinical use.
- Force majeure events, including but not limited to port strikes at the Port of Dakar, customs delays at Blaise Diagne International Airport, or national public health emergencies in Senegal, shall extend the delivery deadline by a period equal to the duration of the disruption, provided written notice is given within 48 hours.
- This Purchase Order shall be governed by and construed in accordance with the laws of the Republic of Senegal. Any disputes arising from this Purchase Order shall be resolved through arbitration in Dakar, Senegal, in accordance with the rules of the OHADA (Organisation pour l'Harmonisation en Afrique du Droit des Affaires) arbitration center.
- All communications regarding this Purchase Order, including amendments, change orders, and delivery confirmations, must be sent in writing to the email addresses specified above. Verbal agreements made by any representative of the Orthodontist practice or the supplier shall not modify the terms of this Purchase Order.
- The supplier acknowledges that the end-user of all goods is a licensed Orthodontist operating a registered dental practice in Senegal Dakar and that the goods are intended exclusively for professional orthodontic clinical use and not for resale.
For the Orthodontist Practice (Buyer)
Clinique Orthodontique du Lac Rose – Senegal Dakar
_______________________________
Dr. Awa Ndiaye, DMD, MSc
Orthodontist / Practice Director
Date: _______________
For the Supplier (Vendor)
MedDental International S.A.
_______________________________
Mr. Laurent Dubois
Regional Sales Director – West Africa
Date: _______________
Document Reference: This Purchase Order (PO-SD-2025-0472) is the official procurement document for all orthodontic supplies and equipment ordered by the Orthodontist practice Clinique Orthodontique du Lac Rose, located in Senegal Dakar. A copy of this Purchase Order must accompany all shipping documents, customs declarations, and invoices submitted to the Senegalese customs authority (Direction Générale des Douanes du Sénégal) at the point of entry in Dakar. The Orthodontist's NIF number (SN-2019-44556677) must appear on all import documentation. This document is valid for a period of ninety (90) days from the date of issue. After this period, a new Purchase Order must be generated for any outstanding items.
⬇️ Download as DOCX Edit online as DOCXCreate your own Word template with our GoGPT AI prompt:
GoGPT