Purchase Order Orthodontist in United States Miami –Free Word Template Download with AI
Orthodontist Professional Services & Equipment Procurement
United States Miami, Florida
PO No. MIA-ORTHO-2025-00472Date of Issue: June 12, 2025
Delivery Location: 1200 Brickell Avenue, Suite 850, Miami, FL 33131, United States
Purchasing Party (Buyer)
Entity: Miami Coral Gables Orthodontic Group, LLC
Address: 1200 Brickell Avenue, Suite 850, Miami, FL 33131, United States
Phone: (305) 555-0142
Email: [email protected]
Tax ID (EIN): 82-4471903
Contact Person: Dr. Elena Vasquez, DMD, MS – Lead Orthodontist
Supplier / Vendor (Seller)
Entity: Advanced Dental Solutions & Orthodontic Supply Co.
Address: 4500 NW 27th Avenue, Hialeah, FL 33012, United States Miami-Dade County
Phone: (305) 555-0287
Email: [email protected]
Tax ID (EIN): 59-8832147
Contact Person: Mr. Robert Chen, Regional Sales Director
Line Items – Orthodontist Equipment, Materials & Services| Item # | Description | Category | Qty | Unit Price (USD) | Extended Price (USD) |
|---|---|---|---|---|---|
| 001 | Self-Ligating Orthodontic Brackets – Roth 0.22" Slot (Complete Set, 32 pcs) | Orthodontist Brackets | 25 | $185.00 | $4,625.00 |
| 002 | Nickel-Titanium (NiTi) Archwires – 0.014" to 0.021" x 0.025" (Assorted Pack) | Orthodontist Wires | 50 | $42.50 | $2,125.00 |
| 003 | Clear Aligner Trays – Custom Fabricated for Orthodontist Treatment Plans (Set of 20) | Orthodontist Aligners | 10 | $1,250.00 | $12,500.00 |
| 004 | Orthodontic Bonding Agent & Light-Curing Resin Kit (Professional Grade) | Orthodontist Adhesives | 30 | $68.00 | $2,040.00 |
| 005 | Interproximal Reduction (IPR) Strips – Diamond Coated (Box of 100) | Orthodontist IPR | 15 | $34.00 | $510.00 |
| 006 | Orthodontic Elastics – Assorted Colors & Sizes (Bulk Pack, 500 pcs) | Orthodontist Elastics | 40 | $28.00 | $1,120.00 |
| 007 | Ceramic & Metal Molar Bands – Assorted Sizes (Complete Kit) | Orthodontist Bands | 20 | $95.00 | $1,900.00 |
| 008 | 3D Intraoral Scanner Software License – Annual Renewal for Orthodontist Practice | Orthodontist Software | 2 | $3,800.00 | $7,600.00 |
| 009 | Orthodontic Headgear & Facebow Components (Complete Assembly Kit) | Orthodontist Appliances | 12 | $210.00 | $2,520.00 |
| 010 | Professional Orthodontist Continuing Education Workshop – 2-Day Intensive, Miami Convention Center | Orthodontist Training | 4 | $1,450.00 | $5,800.00 |
| SUBTOTAL | $40,740.00 | ||||
| Florida State Sales Tax (7.0%) | $2,851.80 | ||||
| Miami-Dade County Surcharge (1.0%) | $407.40 | ||||
| GRAND TOTAL (USD) | $44,000.20 | ||||
- Acceptance: This Purchase Order is issued by Miami Coral Gables Orthodontic Group, LLC, a licensed orthodontic practice operating in the United States Miami metropolitan area. The supplier must confirm acceptance of this Purchase Order in writing within five (5) business days of the date of issue. Failure to confirm shall render this Purchase Order void.
- Delivery: All physical orthodontist supplies, brackets, wires, aligners, and equipment listed in this Purchase Order must be delivered to the buyer's facility at 1200 Brickell Avenue, Suite 850, Miami, FL 33131, United States, no later than July 15, 2025. The orthodontist practice requires all materials to be in stock prior to the start of the new patient intake cycle in August 2025.
- Quality Standards: All orthodontist-grade products must comply with the American Dental Association (ADA) standards, the American Association of Orthodontists (AAO) guidelines, and all applicable United States Food and Drug Administration (FDA) regulations. The supplier warrants that all items are new, unused, and free from defects.
- Payment Terms: Net 30 days from the date of confirmed delivery and acceptance of goods. Payment shall be made via ACH bank transfer to the account designated by the supplier. The buyer reserves the right to withhold payment for any items that do not meet the specifications outlined in this Purchase Order.
- Warranty: The supplier provides a minimum twelve (12) month warranty on all orthodontist equipment and materials. Any defective items discovered within the warranty period shall be replaced at no additional cost to the buyer, including shipping within the United States Miami-Dade County area.
- Training & Education: The orthodontist continuing education workshop (Item #010) shall be conducted at the Miami Convention Center, 800 Biscayne Blvd, Miami, FL 33132, United States, on August 22–23, 2025. The supplier is responsible for providing all instructional materials, CE credits (minimum 16 hours), and catering for the four (4) attending orthodontist professionals.
- Compliance: This Purchase Order is governed by the laws of the State of Florida and the United States. All transactions are subject to applicable federal, state, and local tax obligations within the United States Miami jurisdiction. The supplier must maintain all necessary business licenses and orthodontist supply distribution permits valid in the State of Florida.
- Confidentiality: Both parties agree to maintain strict confidentiality regarding patient treatment plans, orthodontist clinical data, and proprietary pricing information exchanged in connection with this Purchase Order. This obligation survives the termination of this agreement for a period of three (3) years.
- Dispute Resolution: Any disputes arising from this Purchase Order shall be resolved through mediation in Miami, Florida, United States, before resorting to litigation in the appropriate circuit court of Miami-Dade County.
- Force Majeure: Neither party shall be liable for delays caused by acts of God, natural disasters (including hurricanes common to the United States Miami region), government actions, or other events beyond reasonable control.
Authorized by (Buyer):
Dr. Elena Vasquez, DMD, MS
Lead Orthodontist, Miami Coral Gables Orthodontic Group, LLC
Signature: ___________________________
Date: ___________________________
Accepted by (Supplier):
Mr. Robert Chen
Regional Sales Director, Advanced Dental Solutions & Orthodontic Supply Co.
Signature: ___________________________
Date: ___________________________
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