Purchase Order Physiotherapist in United States Los Angeles –Free Word Template Download with AI
Purchase Order No.: PO-LA-2025-04872 | Date of Issue: June 12, 2025 | Valid Until: July 12, 2025
1. Parties to This Purchase OrderPurchasing Entity (Buyer)
Westside Rehabilitation & Wellness Center, LLC
4820 Wilshire Boulevard, Suite 310
United States Los Angeles, CA 90036
Tax ID (EIN): 82-4471903
Contact: Margaret Ellison, Procurement Director
Email: [email protected]
Phone: (310) 555-0147
Service Provider (Seller)
Dr. James A. Thornton, DPT, OCS
Independent Physiotherapist Practitioner
7150 Santa Monica Boulevard, Suite 204
United States Los Angeles, CA 90046
License No.: PT-104829 (State of California)
Contact: Dr. James Thornton
Email: [email protected]
Phone: (323) 555-0892
This Purchase Order is issued by Westside Rehabilitation & Wellness Center, LLC, a licensed healthcare facility operating in United States Los Angeles, to formally engage the services of Dr. James A. Thornton, a board-certified Physiotherapist, for the provision of outpatient physiotherapy and rehabilitation services. This Purchase Order governs the terms, conditions, compensation, and deliverables associated with the Physiotherapist's contracted engagement. All services rendered under this Purchase Order shall be performed within the jurisdiction of United States Los Angeles, in compliance with the California Business and Professions Code, the California Physical Therapy Act, and all applicable federal regulations administered by the U.S. Department of Health and Human Services.
3. Line Items and Service Schedule| Item # | Description of Physiotherapist Services | Frequency | Duration | Unit Rate (USD) | Extended Amount (USD) |
|---|---|---|---|---|---|
| 01 | Initial comprehensive Physiotherapist assessment and treatment plan development for orthopedic patients | Per patient | 60 min / session | $185.00 | $3,700.00 |
| 02 | Ongoing Physiotherapist manual therapy sessions (joint mobilization, soft tissue manipulation, myofascial release) | 3x per week | 45 min / session | $145.00 | $18,360.00 |
| 03 | Physiotherapist-guided therapeutic exercise and functional rehabilitation programs | 5x per week | 40 min / session | $120.00 | $24,000.00 |
| 04 | Physiotherapist consultation and progress documentation for insurance and medical-legal reporting | Bi-weekly | 30 min / session | $95.00 | $3,800.00 |
| 05 | Physiotherapist on-site supervision and staff training at the United States Los Angeles facility | 2x per month | 4 hours / session | $250.00 | $6,000.00 |
| TOTAL CONTRACT VALUE (12-Month Term) | $55,860.00 | ||||
- Engagement Period: This Purchase Order authorizes the Physiotherapist to provide services for a continuous twelve (12) month period commencing July 1, 2025, and concluding June 30, 2026, unless terminated earlier in accordance with Section 7.
- Location of Services: All Physiotherapist services shall be rendered at the Westside Rehabilitation & Wellness Center facility located in United States Los Angeles, or at such other approved site within the greater Los Angeles metropolitan area as mutually agreed upon in writing.
- Licensing and Compliance: The Physiotherapist warrants that he holds a current, unrestricted license to practice physical therapy in the State of California and shall maintain all required malpractice insurance coverage (minimum $2,000,000 per occurrence) throughout the term of this Purchase Order.
- Payment Terms: The Purchasing Entity shall remit payment within thirty (30) days of receipt of an itemized invoice from the Physiotherapist. Invoices shall be submitted on a monthly basis by the fifth (5th) business day of the following month. Late payments shall accrue interest at a rate of 1.5% per month.
- Confidentiality: The Physiotherapist shall comply with all provisions of the Health Insurance Portability and Accountability Act (HIPAA) and the California Confidentiality of Medical Information Act (CMIA). All patient records generated under this Purchase Order shall remain the property of the Purchasing Entity.
- Independent Contractor Status: The Physiotherapist is engaged as an independent contractor and not as an employee of the Purchasing Entity. The Physiotherapist shall be solely responsible for all federal and state tax obligations, including self-employment tax, applicable to the compensation received under this Purchase Order.
- Termination: Either party may terminate this Purchase Order with thirty (30) days written notice. The Purchasing Entity may terminate immediately for material breach, loss of professional licensure, or failure to maintain required insurance. Upon termination, the Physiotherapist shall be compensated for all services rendered through the effective date of termination.
- Governing Law: This Purchase Order shall be governed by and construed in accordance with the laws of the State of California, with venue exclusively in the Superior Court of Los Angeles County, United States Los Angeles.
- Dispute Resolution: Any dispute arising out of or relating to this Purchase Order shall first be subject to good-faith mediation in United States Los Angeles. If mediation fails within sixty (60) days, the dispute shall be resolved by binding arbitration under the rules of the American Arbitration Association.
- 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 the affected party gives prompt written notice.
By signing below, both parties acknowledge that they have read, understood, and agree to be bound by all terms and conditions set forth in this Purchase Order. This document constitutes the entire agreement between the Purchasing Entity and the Physiotherapist regarding the subject matter herein and supersedes all prior negotiations, representations, or agreements, whether oral or written.
For the Purchasing Entity:
Westside Rehabilitation & Wellness Center, LLC
_________________________________
Margaret Ellison, Procurement Director
Date: ___________________
For the Physiotherapist (Service Provider):
Dr. James A. Thornton, DPT, OCS
_________________________________
Dr. James A. Thornton
Date: ___________________
Create your own Word template with our GoGPT AI prompt:
GoGPT