Purchase Order Pharmacist in Netherlands Amsterdam –Free Word Template Download with AI
Pharmaceutical Procurement Document — Netherlands Amsterdam
Pharmacist: Dr. Hendrik van der Berg, PharmD
Practice Name: Amsterdam Centrum Apotheek
Address: Herengracht 245, 1016 BX Amsterdam, Netherlands
Chamber of Commerce (KvK): 67432198
IBG Number: 876543212B01
License No.: NL-AP-2019-4482 (Issued by IGJ — Inspectie voor de Gezondheidszorg)
Contact: [email protected] | +31 20 555 0142 Company: EuroPharma Distribution B.V.
Address: Industrieweg 88, 1101 AB Amsterdam, Netherlands
KvK: 55219873
IBG: 823456789B01
Contact: [email protected] | +31 20 555 0387
Pharmacist & Owner, Amsterdam Centrum Apotheek
Signature & Date: ___________________________
Sales Director, EuroPharma Distribution B.V.
Signature & Date: ___________________________ ⬇️ Download as DOCX Edit online as DOCX
Practice Name: Amsterdam Centrum Apotheek
Address: Herengracht 245, 1016 BX Amsterdam, Netherlands
Chamber of Commerce (KvK): 67432198
IBG Number: 876543212B01
License No.: NL-AP-2019-4482 (Issued by IGJ — Inspectie voor de Gezondheidszorg)
Contact: [email protected] | +31 20 555 0142 Company: EuroPharma Distribution B.V.
Address: Industrieweg 88, 1101 AB Amsterdam, Netherlands
KvK: 55219873
IBG: 823456789B01
Contact: [email protected] | +31 20 555 0387
| Item No. | Description | SKU / Batch Ref. | Qty | Unit | Unit Price (€) | Line Total (€) |
|---|---|---|---|---|---|---|
| 01 | Amoxicillin 500 mg capsules, 28-count blister (prescription-only, registered with CBG) | AMX-500-28 / B-2025-0612 | 200 | boxes | 12.40 | 2,480.00 |
| 02 | Insulin Glargine 100 IU/mL, 3 mL pre-filled pen (cold-chain required, 2–8°C) | INS-GLA-100 / B-2025-0589 | 150 | pens | 38.75 | 5,812.50 |
| 03 | Pharmaceutical-grade paracetamol 500 mg tablets, 100-count bottle (OTC) | PAR-500-100 / B-2025-0620 | 500 | bottles | 4.20 | 2,100.00 |
| 04 | Compounding-grade lactose monohydrate, 1 kg sealed bags (for Pharmacist preparation) | LAC-MON-1KG / B-2025-0601 | 40 | bags | 18.60 | 744.00 |
| 05 | Pharmaceutical balance, 0.1 mg precision, CE-marked, for compounding laboratory | PHB-01-CE / S/N-2025-0034 | 1 | unit | 1,245.00 | 1,245.00 |
| 06 | Refrigerated transport case, 2–8°C, 48-hour capacity (for cold-chain delivery in Netherlands Amsterdam area) | REF-CASE-48 / S/N-2025-0078 | 2 | units | 320.00 | 640.00 |
| 07 | Pharmacist PPE kit: nitrile gloves (L), face shields, lab coats (annual supply) | PPE-ANNUAL-L / B-2025-0630 | 12 | kits | 89.50 | 1,074.00 |
| 08 | Pharmaceutical waste disposal containers, 20 L, biohazard-rated, compliant with Dutch environmental law | WST-20L-BH / S/N-2025-0112 | 6 | units | 45.00 | 270.00 |
| Subtotal: | 14,365.50 | |||||
| VAT (21% — Netherlands standard rate): | 3,016.76 | |||||
| Total Purchase Order Amount: | 17,382.26 | |||||
All goods under this Purchase Order shall be delivered to the Pharmacist’s premises at Herengracht 245, 1016 BX Amsterdam, Netherlands. Delivery must be scheduled between 08:00 and 16:00 CET on a weekday. Cold-chain items (Item No. 02) must arrive in a validated temperature-controlled container and must not exceed 8°C at any point during transit within the Netherlands Amsterdam metropolitan area. The Pharmacist or an authorized delegate must inspect all items upon receipt and sign the delivery manifest. Any temperature excursion or packaging damage must be documented and reported to the supplier within 24 hours.
- This Purchase Order is governed by the laws of the Netherlands and shall be interpreted in accordance with Dutch commercial law (Burgerlijk Wetboek, Book 7).
- All pharmaceutical products listed herein must comply with the regulations of the Dutch Medicines Evaluation Board (CBG) and the European Medicines Agency (EMA). The Pharmacist reserves the right to reject any product that does not meet current pharmacopeia standards.
- The supplier warrants that all items are in full compliance with the Dutch Pharmaceutical Law (Geneesmiddelenwet) and applicable EU directives. Batch numbers, expiry dates, and storage conditions must be clearly labeled on every unit.
- Payment shall be made via SEPA bank transfer to the supplier’s designated account within thirty (30) calendar days of the date of this Purchase Order, provided that all goods have been received and accepted by the Pharmacist without discrepancy.
- In the event of a supply shortage or recall, the supplier must notify the Pharmacist in writing within four (4) business days and provide a replacement or full refund in accordance with Dutch consumer and commercial protection statutes.
- All compounding materials (Item No. 04) must be accompanied by a Certificate of Analysis (CoA) confirming purity, identity, and absence of contaminants, as required for the Pharmacist’s preparation activities under IGJ supervision.
- This Purchase Order does not constitute a long-term supply agreement. Each subsequent order shall require a new Purchase Order issued by the Pharmacist.
- Disputes arising from this Purchase Order shall be resolved by the competent court in Amsterdam, Netherlands, in accordance with Dutch jurisdictional rules.
For the Purchasing Entity (Pharmacist):
Dr. Hendrik van der Berg, PharmDPharmacist & Owner, Amsterdam Centrum Apotheek
Signature & Date: ___________________________
For the Supplier:
Ms. Anouk de VriesSales Director, EuroPharma Distribution B.V.
Signature & Date: ___________________________ ⬇️ Download as DOCX Edit online as DOCX
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