Purchase Order Pharmacist in United States Chicago –Free Word Template Download with AI
MediPharm Solutions, Inc.
1200 South Michigan Avenue, Suite 4500, Chicago, Illinois 60605, United States
Phone: (312) 555-0187 | Email: [email protected] | Tax ID: 36-4829105
This Purchase Order is issued by MediPharm Solutions, Inc., a pharmaceutical distribution and consulting firm headquartered in Chicago, Illinois, United States, to engage the professional services of a licensed Pharmacist for the duration specified herein. The Pharmacist, Dr. Elena M. Vasquez, is a fully credentialed and board-certified clinical pharmacist holding an active Illinois State Board of Pharmacy license and a valid DEA registration. The scope of this Purchase Order encompasses the provision of comprehensive pharmacist services including but not limited to medication therapy management, drug interaction analysis, compounding oversight, regulatory compliance auditing, and clinical pharmacy consultation for MediPharm Solutions' client portfolio within the Chicago metropolitan area and the broader state of Illinois.
The Pharmacist shall perform all duties in strict accordance with the Illinois Pharmacy Practice Act (220 ILCS 45), the United States Federal Food, Drug, and Cosmetic Act, and all applicable Chicago municipal health ordinances. All services rendered under this Purchase Order shall be conducted at the designated facility located at 1200 South Michigan Avenue, Chicago, Illinois, or at such other location within the United States as mutually agreed upon in writing by both parties.
| Item No. | Description of Pharmacist Service | Unit | Qty | Unit Price (USD) | Extended Price (USD) |
|---|---|---|---|---|---|
| 001 | Clinical Pharmacist consultation for medication therapy management (per 4-hour session) | Session | 24 | $385.00 | $9,240.00 |
| 002 | Pharmacist-led drug interaction and adverse event review for institutional clients (per report) | Report | 60 | $125.00 | $7,500.00 |
| 003 | Regulatory compliance audit of pharmacy operations in Chicago, Illinois (per audit cycle) | Audit | 4 | $2,200.00 | $8,800.00 |
| 004 | Pharmacist supervision of sterile and non-sterile compounding operations (per 8-hour shift) | Shift | 16 | $520.00 | $8,320.00 |
| 005 | Continuing education and training sessions for pharmacy technicians in Chicago (per 3-hour workshop) | Workshop | 8 | $450.00 | $3,600.00 |
| 006 | Emergency Pharmacist on-call coverage for United States Chicago facility (per month) | Month | 3 | $1,800.00 | $5,400.00 |
| Subtotal | $42,860.00 |
| Illinois State Sales Tax (10.25%) | $4,393.15 |
| Chicago Municipal Tax (2.5%) | $1,071.50 |
| Expedited Service Surcharge | $500.00 |
| Grand Total (USD) | $48,824.65 |
- Acceptance: This Purchase Order shall become a binding agreement upon written acceptance by the Pharmacist within five (5) business days of the date of issue. Failure to respond within this period shall constitute automatic rejection of this Purchase Order.
- Payment Terms: Net 30 days from the date of invoice. Payment shall be made via ACH transfer to the account designated by the Pharmacist. Late payments shall accrue interest at a rate of 1.5% per month as permitted under Illinois commercial code provisions.
- Licensing and Compliance: The Pharmacist warrants that all professional licenses, including the Illinois Pharmacist license and DEA registration, shall remain in good standing for the entire duration of this Purchase Order. The Pharmacist shall immediately notify MediPharm Solutions of any disciplinary action, suspension, or revocation of licensure by the Illinois State Board of Pharmacy or any United States federal regulatory body.
- Scope Limitation: The Pharmacist shall not be authorized to modify the scope of services defined in this Purchase Order without a written amendment signed by both parties. Any additional services requested in Chicago or elsewhere in the United States shall be subject to a separate Purchase Order or change order.
- Confidentiality: The Pharmacist agrees to maintain strict confidentiality of all patient records, proprietary formulary data, and business information encountered during the performance of services under this Purchase Order, in compliance with the Health Insurance Portability and Accountability Act (HIPAA) and Illinois Personal Information Protection Act.
- Insurance: The Pharmacist shall maintain professional liability (malpractice) insurance with a minimum coverage of $1,000,000 per occurrence and $3,000,000 in the aggregate, naming MediPharm Solutions, Inc. as an additional insured. Proof of insurance shall be provided prior to the commencement of services in Chicago.
- Governing Law: This Purchase Order shall be governed by and construed in accordance with the laws of the State of Illinois, United States, and the municipal ordinances of the City of Chicago. Any disputes arising hereunder shall be resolved through binding arbitration in Cook County, Illinois, in accordance with the rules of the American Arbitration Association.
- Termination: Either party may terminate this Purchase Order with thirty (30) days written notice. In the event of termination, the Pharmacist shall be compensated for all services rendered through the effective date of termination.
- Force Majeure: Neither party shall be liable for failure to perform obligations under this Purchase Order due to acts of God, natural disasters, pandemics, government orders, or other events beyond reasonable control, provided that written notice is given within forty-eight (48) hours of the occurrence.
For MediPharm Solutions, Inc. (Buyer):
Jonathan R. Whitfield, Director of Procurement
Date: ______________________
For Dr. Elena M. Vasquez, Pharm.D. (Pharmacist / Vendor):
Dr. Elena M. Vasquez, Pharm.D., R.Ph.
Date: ______________________
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