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Purchase Order Pharmacist in United States New York City –Free Word Template Download with AI

Pharmacist Professional Services & Pharmaceutical Supply Procurement PO No.: NYC-PHARM-2025-00472 United States New York City | Effective Date: June 15, 2025 1. Parties to This Purchase Order Manhattan Community Health Alliance, LLC 450 West 42nd Street, Suite 1200
New York, NY 10036
United States New York City
Dr. Margaret Chen, Director of Pharmacy Operations [email protected] | (212) 555-0147
Empire State Pharmaceutical Consulting Group, Inc. 88 Park Avenue South, Floor 14
New York, NY 10016
United States New York City
James R. Whitfield, RPh, Principal Pharmacist [email protected] | (212) 555-0382
2. Purchase Order Details
Field Details
Purchase Order Number NYC-PHARM-2025-00472
Date of Issue June 15, 2025
Required Delivery / Service Start Date July 1, 2025
Service Completion Deadline December 31, 2025
Payment Terms Net 30 days from invoice receipt
Currency United States Dollars (USD)
Governing Jurisdiction State of New York, United States New York City
3. Scope of Work – Pharmacist Services

This Purchase Order authorizes the procurement of professional Pharmacist services and associated pharmaceutical supplies for the Manhattan Community Health Alliance outpatient pharmacy division located in United States New York City. The contracted Pharmacist shall provide comprehensive pharmaceutical care, medication therapy management, clinical pharmacy consultations, and regulatory compliance oversight in accordance with the New York State Education Law, Article 137, and all applicable regulations of the New York State Board of Pharmacy. The Pharmacist must hold a valid New York State Pharmacist License (License No. NY-RPH-2025-88412) and maintain current certification in the relevant therapeutic areas specified herein.

4. Line Items and Pricing
Item # Description Qty Unit Price (USD) Total (USD)
001 Full-time Pharmacist clinical services – outpatient medication management, patient counseling, and drug interaction review (40 hrs/week) 26 weeks $4,200.00 $109,200.00
002 Pharmacist-led immunization program administration and documentation (influenza, pneumococcal, Tdap) 1 program $8,500.00 $8,500.00
003 Pharmaceutical inventory management and controlled substance compliance auditing (DEA Schedule II–V) 6 audits $1,850.00 $11,100.00
004 Specialty pharmaceutical procurement – oncology and immunosuppressant agents (wholesale supply) 1 lot $34,750.00 $34,750.00
005 Pharmacist continuing education and regulatory training for 12 staff pharmacists (NY State Board of Pharmacy CPE credits) 12 seats $620.00 $7,440.00
006 Pharmacy information system (PIS) integration and electronic prescribing (e-Rx) compliance setup 1 project $12,300.00 $12,300.00
007 Emergency preparedness pharmaceutical stockpile – United States New York City disaster response protocol 1 kit $5,900.00 $5,900.00
SUBTOTAL $189,190.00
New York State Sales Tax (8.875%) $16,790.61
GRAND TOTAL $205,980.61
5. Terms and Conditions
  1. Pharmacist Licensure and Compliance: The Pharmacist engaged under this Purchase Order shall maintain an active, unrestricted New York State Pharmacist License throughout the entire contract period. Any lapse in licensure, disciplinary action, or suspension by the New York State Board of Pharmacy shall constitute immediate grounds for termination of this Purchase Order without penalty to the Buyer.
  2. Regulatory Adherence: All services and pharmaceutical supplies procured under this Purchase Order shall comply with the Federal Food, Drug, and Cosmetic Act, DEA regulations (21 CFR 1300–1321), New York State Public Health Law, and all municipal ordinances applicable within United States New York City, including but not limited to the NYC Health Code Title 13.
  3. Delivery and Service Location: All Pharmacist services shall be rendered at the Buyer's facility located at 450 West 42nd Street, New York, NY 10036, United States New York City. Pharmaceutical supplies shall be delivered to the same location with a minimum of 48 hours' prior written notice.
  4. Payment and Invoicing: The Seller shall submit itemized invoices referencing this Purchase Order number (NYC-PHARM-2025-00472) within ten (10) business days of service completion or delivery. Payment shall be remitted via ACH transfer to the account designated by the Seller within thirty (30) days of invoice receipt. Late payments shall accrue interest at 1.5% per month as permitted under New York State General Obligations Law § 5-531.
  5. Confidentiality and HIPAA: The Pharmacist and all associated personnel shall adhere strictly to the Health Insurance Portability and Accountability Act (HIPAA) and New York State Public Health Law Article 27-F regarding the protection of patient health information. A Business Associate Agreement (BAA) is attached as Exhibit A to this Purchase Order.
  6. Insurance Requirements: The Seller shall maintain professional liability (malpractice) insurance with a minimum coverage of $2,000,000 per occurrence and $5,000,000 aggregate, general liability insurance of $1,000,000, and workers' compensation insurance as required by New York State law. Certificates of insurance shall be provided prior to the commencement of services.
  7. Termination: Either party may terminate this Purchase Order with thirty (30) days' written notice. The Buyer may terminate immediately for material breach, failure to maintain Pharmacist licensure, or non-compliance with United States New York City health and safety regulations.
  8. Dispute Resolution: Any disputes arising from this Purchase Order shall be resolved through binding arbitration in New York County, United States New York City, in accordance with the rules of the American Arbitration Association. The prevailing party shall be entitled to recover reasonable attorney's fees and costs.
  9. Force Majeure: Neither party shall be liable for delays or failures in performance resulting from acts of God, natural disasters, pandemics, government orders, or other events beyond reasonable control, provided that written notice is given within five (5) business days of the occurrence.
6. Acceptance and Authorization

By signing below, both parties acknowledge that they have read, understood, and agree to all terms and conditions set forth in this Purchase Order. This document constitutes a binding agreement for the procurement of Pharmacist professional services and pharmaceutical supplies as described herein, governed by the laws of the State of New York and enforceable within the jurisdiction of United States New York City.

BUYER AUTHORIZED SIGNATURE
Dr. Margaret Chen, Director of Pharmacy Operations
Manhattan Community Health Alliance, LLC
Date: ______________________
SELLER AUTHORIZED SIGNATURE
James R. Whitfield, RPh, Principal Pharmacist
Empire State Pharmaceutical Consulting Group, Inc.
Date: ______________________

This Purchase Order (NYC-PHARM-2025-00472) is issued by Manhattan Community Health Alliance, LLC, a New York State limited liability company, for the procurement of Pharmacist services and pharmaceutical supplies within United States New York City. This document is valid for a period of one (1) year from the date of execution. All communications regarding this Purchase Order shall be directed to the addresses listed in Section 1. This Purchase Order supersedes all prior negotiations, representations, and agreements between the parties with respect to the subject matter herein.

Document Reference: NYC-PHARM-2025-00472 | Page 1 of 1 | Confidential – For Official Use Only

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