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Purchase Order Psychiatrist in Peru Lima –Free Word Template Download with AI

Professional Medical Services Procurement — Psychiatrist Consultation and Treatment Program

LIMA, PERU

Issuing Organization (Buyer)

Salud Integral del Pacífico S.A.C.

RUC: 20587432196

Av. Javier Prado Este 1245, Of. 802

Santiago de Surco, Lima, Peru

Phone: +51 1 445-7823

Email: [email protected]

Service Provider (Vendor)

Dr. Ricardo Mendoza Huamán, M.D., Psiquiatra

Colegio Médico del Perú Reg. N° 14872

Consultorio Psiquiátrico "Mente Serena"

Jr. Puno 456, 3er Piso

Miraflores, Lima, Peru

Phone: +51 1 448-9912

Email: [email protected]

Purchase Order No.: PO-2025-LIM-00472 Date of Issue: January 15, 2025 Required Service Start: February 3, 2025 Contract Duration: 12 Months
Item # Description of Psychiatrist Service Frequency Unit Price (PEN) Quantity Total (PEN)
01 Initial psychiatric evaluation and comprehensive diagnostic assessment by the Psychiatrist, including clinical interview, psychological testing, and medical history review conducted in Lima, Peru. One-time 1,200.00 1 1,200.00
02 Weekly outpatient psychiatric consultation sessions (50 minutes each) provided by the Psychiatrist at the Miraflores clinic in Lima, Peru, including ongoing therapeutic intervention and treatment plan adjustments. Weekly 450.00 52 23,400.00
03 Monthly psychiatric medication management and prescription renewal by the Psychiatrist, including pharmacological review, dosage adjustments, and coordination with the patient's primary care physician in Lima, Peru. Monthly 350.00 12 4,200.00
04 Emergency psychiatric consultation and crisis intervention by the Psychiatrist, available on a 24/7 basis for acute episodes, with response time not exceeding 4 hours within the Lima metropolitan area, Peru. As needed 1,800.00 4 7,200.00
05 Quarterly progress reports and clinical documentation prepared by the Psychiatrist, submitted to Salud Integral del Pacífico S.A.C. for insurance billing and treatment continuity records, formatted per Peruvian Ministry of Health (MINSA) standards. Quarterly 600.00 4 2,400.00
06 Family psychiatric psychoeducation sessions (up to 4 family members per session) facilitated by the Psychiatrist to support the patient's recovery environment in Lima, Peru. Bi-monthly 500.00 6 3,000.00
Summary Amount (PEN)
Subtotal 41,400.00
IGV (18% — Peruvian General Sales Tax) 7,452.00
Grand Total 48,852.00

1. Scope of Services: This Purchase Order authorizes the engagement of the named Psychiatrist to deliver the clinical services enumerated above. All psychiatric consultations, evaluations, and therapeutic interventions shall be performed in accordance with the ethical and professional standards established by the Colegio Médico del Perú and the Peruvian Ministry of Health (MINSA). The Psychiatrist shall maintain full clinical confidentiality in compliance with Peruvian data protection legislation (Ley N° 29733).

2. Service Location: All services under this Purchase Order shall be rendered at the Psychiatrist's registered practice location in Miraflores, Lima, Peru, unless otherwise agreed in writing. Emergency psychiatric interventions may be conducted at the patient's residence or any hospital facility within the Lima metropolitan area, Peru, as clinically necessary.

3. Payment Terms: Payment for services rendered under this Purchase Order shall be made via bank transfer to the account designated by the Psychiatrist within fifteen (15) calendar days of receipt of a valid Peruvian electronic invoice (Factura Electrónica) compliant with SUNAT regulations. The total contract value of this Purchase Order is PEN 48,852.00, inclusive of IGV.

4. Cancellation and Termination: Either party may terminate this Purchase Order with thirty (30) days' written notice. In the event of early termination, the Psychiatrist shall be compensated for all services rendered up to the effective date of termination. No penalty shall apply to the buyer for cancellation of individual scheduled sessions provided at least 48 hours' prior notice is given.

5. Professional Liability and Insurance: The Psychiatrist warrants that he maintains active professional liability insurance (seguro de responsabilidad civil profesional) with a minimum coverage of PEN 500,000.00, valid throughout the duration of this Purchase Order. The Psychiatrist shall be solely responsible for any clinical malpractice claims arising from the services provided in Lima, Peru.

6. Regulatory Compliance: The Psychiatrist confirms that he holds a valid and current registration with the Colegio Médico del Perú, a valid practicing license issued by the Peruvian Ministry of Health, and that all psychiatric medications prescribed are registered with DIGEMID (Dirección General de Medicamentos, Insumos y Drogas). All records shall be maintained in accordance with Peruvian health regulations.

7. Governing Law: This Purchase Order shall be governed by and construed in accordance with the civil and commercial laws of the Republic of Peru. Any disputes arising from this Purchase Order shall be resolved through the competent courts of Lima, Peru, or by arbitration before the Centro de Arbitraje y Conciliación de la Cámara de Comercio de Lima, as the parties may mutually agree.

8. Validity: This Purchase Order is valid for acceptance within ten (10) business days from the date of issue. Upon acceptance by the Psychiatrist, it constitutes a binding agreement between the parties for the full twelve-month contract period.

Authorized by (Buyer)
María Fernanda Torres Quispe
Gerente de Compras
Salud Integral del Pacífico S.A.C.
Lima, Peru
Date: _______________
Accepted by (Psychiatrist / Vendor)
Dr. Ricardo Mendoza Huamán, M.D.
Psiquiatra — C.M.P. Reg. N° 14872
Mente Serena, Miraflores
Lima, Peru
Date: _______________

This Purchase Order (PO-2025-LIM-00472) was issued by Salud Integral del Pacífico S.A.C., Lima, Peru, for the procurement of Psychiatrist services. All amounts are denominated in Peruvian Soles (PEN). This document is valid only when signed by both parties. For questions regarding this Purchase Order, contact the Procurement Department at [email protected] or +51 1 445-7823, Lima, Peru.

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