Purchase Order Pharmacist in Canada Montreal –Free Word Template Download with AI
Professional Pharmacist Services & Pharmaceutical Supply Procurement
Canada Montreal — Province of Québec
PO-2025-MTL-PHARM-0047 1. BUYER INFORMATION| Organization: Clinique Pharmaceutique du Centre-Ville Inc. | Address: 1450 Rue Sainte-Catherine Ouest, Suite 320, Canada Montreal, Québec H3G 1Z4 |
| Contact Person: Marie-Claire Tremblay, Director of Operations | Phone: (514) 555-0187 | Email: [email protected] |
| Business Number (QST):strong> 123456789 QST 0001 | Regulatory Body: Ordre des pharmaciens du Québec (OPQ) |
| Pharmacist Name: Dr. Antoine Lavoie, Pharm.D., R.Ph. | OPQ License No.: Q-2019-44872 |
| Practice Address: 890 Boulevard Saint-Laurent, Canada Montreal, Québec H2X 2V5 | Contact: (514) 555-0342 | Email: [email protected] |
| Specialization: Clinical Pharmacy, Immunization Services, Medication Therapy Management | Insurance Certificate: Valid through December 31, 2025 (attached as Appendix A) |
This Purchase Order is issued by Clinique Pharmaceutique du Centre-Ville Inc. to procure the professional services of a licensed Pharmacist and associated pharmaceutical supplies for delivery and execution within the Canada Montreal metropolitan area. The Pharmacist engaged under this Purchase Order shall comply with all regulations set forth by the Ordre des pharmaciens du Québec, the Québec College of Pharmacists, and applicable federal health legislation under the Pharmacy Act (R.S.Q., c. P-9.001). All services rendered under this Purchase Order shall be performed in Canada Montreal or its immediate surrounding municipalities as specified herein.
4. LINE ITEMS| Item # | Description | Qty | Unit | Unit Price (CAD) | Line Total (CAD) |
|---|---|---|---|---|---|
| 1 | Pharmacist Clinical Consultation & Medication Review Services — 40 hours per month, delivered at the Canada Montreal clinic location. Includes comprehensive patient medication assessments, drug interaction screening, and therapeutic recommendations. | 40 | Hours | $145.00 | $5,800.00 |
| 2 | Pharmacist Immunization Administration Services — Administration of seasonal influenza, pneumococcal, and tetanus vaccines to patients in Canada Montreal. Includes documentation, adverse event monitoring, and reporting to the Québec public health authority. | 120 | Doses | $32.50 | $3,900.00 |
| 3 | Pharmacist Medication Therapy Management (MTM) Program — Ongoing management of chronic disease patients (diabetes, hypertension, cardiovascular conditions) residing in the Canada Montreal region. Includes quarterly follow-up visits and personalized treatment plans. | 60 | Patients | $85.00 | $5,100.00 |
| 4 | Pharmaceutical Supplies — Sterile compounding materials, IV admixture kits, syringes, gloves, and ancillary supplies required for the Pharmacist to perform clinical duties in Canada Montreal. Delivered to the buyer's facility. | 1 | Lot | $2,340.00 | $2,340.00 |
| 5 | Pharmacist Continuing Education & Compliance Training — Annual CPD credits, Québec-specific regulatory updates, and Canada Montreal public health protocol training for the assigned Pharmacist. | 1 | Year | $1,200.00 | $1,200.00 |
| 6 | Pharmacist Telehealth & Remote Consultation Services — Virtual medication counselling sessions for patients in the Canada Montreal area who are unable to attend in-person appointments. Includes secure platform licensing. | 30 | Sessions | $65.00 | $1,950.00 |
| SUBTOTAL | $20,290.00 | ||||
| QST (5%) — Québec Sales Tax | $1,014.50 | ||||
| GST (5%) — Goods and Services Tax | $1,014.50 | ||||
| GRAND TOTAL (CAD) | $22,319.00 | ||||
- Compliance with Canadian and Québec Law: The Pharmacist engaged under this Purchase Order shall hold a valid, active license issued by the Ordre des pharmaciens du Québec and shall comply with all federal, provincial, and municipal regulations applicable to pharmacy practice in Canada Montreal. Any lapse in licensure shall constitute immediate grounds for termination of this Purchase Order.
- Service Location: All in-person services described in this Purchase Order shall be performed at the buyer's facility located in Canada Montreal or at such other location within the Canada Montreal metropolitan area as mutually agreed upon in writing. The Pharmacist shall not subcontract or delegate any clinical duties to unlicensed personnel.
- Confidentiality and Patient Privacy: The Pharmacist shall adhere strictly to the Québec Act respecting the protection of personal information in the private sector (L.R.Q., c. P-39.1) and all applicable privacy standards. Patient records generated under this Purchase Order shall remain the property of the buyer and shall be stored in Canada Montreal.
- Payment Schedule: Payment for this Purchase Order shall be made within thirty (30) calendar days of receipt of a valid invoice. Invoices shall reference Purchase Order number PO-2025-MTL-PHARM-0047 and shall be submitted to the buyer's accounts payable department in Canada Montreal.
- Insurance and Liability: The Pharmacist shall maintain professional liability insurance with a minimum coverage of $2,000,000 per occurrence, valid throughout the term of this Purchase Order. A certificate of insurance shall be provided prior to the commencement of services in Canada Montreal.
- Termination: Either party may terminate this Purchase Order with thirty (30) days written notice. In the event of regulatory non-compliance, disciplinary action by the Ordre des pharmaciens du Québec, or material breach, the buyer may terminate this Purchase Order immediately upon written notice.
- Dispute Resolution: Any dispute arising from this Purchase Order shall be resolved through mediation in Canada Montreal, Québec, in accordance with the Civil Code of Québec. If mediation fails, the matter shall be submitted to the courts of competent jurisdiction in the judicial district of Canada Montreal.
- Language of the Purchase Order: This Purchase Order is executed in English. In the event of any discrepancy between the English and French versions, the French version shall prevail in accordance with the Charter of the French Language (Bill 101) applicable in Canada Montreal.
For the Buyer:
Clinique Pharmaceutique du Centre-Ville Inc.
Name: Marie-Claire TremblayTitle: Director of Operations
Signature: _________________________
Date: _________________________
For the Pharmacist / Vendor:
Dr. Antoine Lavoie, Pharm.D., R.Ph.
Name: Antoine LavoieTitle: Licensed Pharmacist, OPQ Q-2019-44872
Signature: _________________________
Date: _________________________ ⬇️ Download as DOCX Edit online as DOCX
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