Purchase Order Physiotherapist in United States San Francisco –Free Word Template Download with AI
Physiotherapist Professional Services — United States San Francisco
Purchase Order No.: PO-SF-2025-04872 Date of Issue: June 12, 2025 Required Delivery Date: July 1, 2025 Valid Until: August 31, 2025Buyer (Purchasing Entity)
Golden Gate Rehabilitation & Wellness Center
1450 Market Street, Suite 820
San Francisco, California 94102
United States
Contact: Margaret Chen, Procurement Director
Phone: (415) 555-0198
Email: [email protected]
Tax ID (EIN): 94-2837461
Seller (Service Provider)
Dr. James A. Whitfield, DPT, PT
Bay Area Physiotherapy Associates
2200 Fillmore Street, Floor 3
San Francisco, California 94115
United States
Contact: Dr. James A. Whitfield
Phone: (415) 555-0342
Email: [email protected]
CA License No.: PT-1048293
| # | Description of Service | Qty | Unit | Unit Price (USD) | Extended Price (USD) |
|---|---|---|---|---|---|
| 1 | Comprehensive Physiotherapist initial assessment and treatment plan development for post-surgical orthopedic rehabilitation patients (minimum 60-minute session per patient) | 45 | Sessions | $285.00 | $12,825.00 |
| 2 | Ongoing Physiotherapist supervised manual therapy and therapeutic exercise programs (45-minute sessions, three times per week per patient) | 360 | Sessions | $195.00 | $70,200.00 |
| 3 | Physiotherapist-led aquatic therapy program in the facility's hydrotherapy pool (50-minute sessions, twice per week per patient) | 180 | Sessions | $220.00 | $39,600.00 |
| 4 | Physiotherapist ergonomic workplace assessment and corrective exercise prescription for corporate clients in the San Francisco financial district | 24 | Assessments | $450.00 | $10,800.00 |
| 5 | Monthly progress reports, clinical documentation, and coordination with referring physicians (administrative and reporting services) | 3 | Months | $1,200.00 | $3,600.00 |
| 6 | Emergency Physiotherapist on-call coverage for weekend and holiday periods at the United States San Francisco facility (24-hour standby) | 12 | Weekends | $350.00 | $4,200.00 |
| Subtotal: | $141,225.00 | ||||
| California Sales & Service Tax (8.63%): | $12,187.72 | ||||
| TOTAL PURCHASE ORDER AMOUNT: | $153,412.72 | ||||
- This Purchase Order constitutes a binding agreement between Golden Gate Rehabilitation & Wellness Center (hereinafter "Buyer") and Dr. James A. Whitfield, DPT, PT (hereinafter "Seller" or "Physiotherapist") for the provision of professional physiotherapy services as described in the line items above.
- All Physiotherapist services shall be rendered at the Buyer's facility located at 1450 Market Street, San Francisco, California, United States, or at such other location within the United States San Francisco metropolitan area as mutually agreed upon in writing by both parties.
- The Physiotherapist shall maintain a current California Physical Therapist license (License No. PT-1048293) and shall provide proof of professional liability insurance with a minimum coverage of $2,000,000 per occurrence for the duration of this Purchase Order.
- Payment terms: Net 30 days from the date of invoice submission. Invoices shall be submitted monthly on the last business day of each calendar month. Late payments shall accrue interest at a rate of 1.5% per month.
- The Physiotherapist shall comply with all applicable federal, state, and local regulations governing the practice of physical therapy in the State of California, including but not limited to the California Business and Professions Code, Title 16, and all San Francisco Municipal Code provisions related to healthcare providers.
- Confidentiality: The Physiotherapist shall adhere to the Health Insurance Portability and Accountability Act (HIPAA) and the California Confidentiality of Medical Information Act (CMIA). All patient records and clinical data generated under this Purchase Order shall remain the property of the Buyer.
- Cancellation: Either party may terminate this Purchase Order with thirty (30) days written notice. In the event of early termination, the Buyer shall be liable for all services rendered up to the date of termination plus any non-cancellable commitments.
- Dispute Resolution: Any disputes arising from this Purchase Order shall be resolved through mediation in San Francisco, California, United States, in accordance with the rules of the American Arbitration Association. If mediation fails, binding arbitration shall take place in the United States San Francisco judicial district.
- Governing Law: This Purchase Order shall be governed by and construed in accordance with the laws of the State of California, United States, without regard to its conflict of law principles.
- The Physiotherapist warrants that all services provided shall meet the standard of care expected of a reasonably competent physical therapist practicing in the United States San Francisco healthcare community and shall be performed in a professional, ethical, and competent manner.
- This Purchase Order is valid for a period of three (3) months from the date of issue, unless extended in writing by mutual consent of both parties. Any modifications to this Purchase Order must be documented in a written amendment signed by both parties.
By signing below, both parties acknowledge that they have read, understood, and agree to all terms, conditions, and service specifications outlined in this Purchase Order for Physiotherapist professional services in the United States San Francisco area.
BUYER AUTHORIZED SIGNATORY
Name: Margaret Chen
Title: Procurement Director
Golden Gate Rehabilitation & Wellness Center
Signature: ___________________________
Date: ___________________________
SELLER / PHYSIOTHERAPIST AUTHORIZED SIGNATORY
Name: Dr. James A. Whitfield, DPT, PT
Title: Lead Physiotherapist
Bay Area Physiotherapy Associates
Signature: ___________________________
Date: ___________________________
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