Purchase Order Radiologist in Indonesia Jakarta –Free Word Template Download with AI
PT Medika Radiologi Nusantara
Jl. Jend. Sudirman Kav. 52-53, SCBD Lot 3, Jakarta Selatan 12190, Indonesia Jakarta
Tel: +62-21-5790-4422 | Email: [email protected]
NPWP: 01.234.567.8-011.000 | Business License (NIB): 8120012345678
Dear Dr. Hendra Wijaya, Sp.Rad (K) Onkologi,
This Purchase Order is issued by PT Medika Radiologi Nusantara, a licensed diagnostic imaging facility operating in Indonesia Jakarta, to formally engage the services of a qualified Radiologist for the provision of advanced diagnostic radiology, interventional radiology, and oncological imaging interpretation services. This Purchase Order constitutes a binding agreement between the purchasing entity and the Radiologist for the duration and scope specified herein, in full compliance with the regulations set forth by the Indonesian Ministry of Health (Kementerian Kesehatan Republik Indonesia) and the applicable professional standards of the Indonesian Radiology Society (PERSI).
1. Scope of Services and Line ItemsThe following services and deliverables are authorized under this Purchase Order for the Radiologist to perform at our facility located in Indonesia Jakarta:
| No. | Description of Service / Item | Quantity | Unit | Unit Price (IDR) | Total (IDR) |
|---|---|---|---|---|---|
| 1 | Full-time Radiologist consultation and image interpretation services (CT, MRI, X-ray, Ultrasound) – 8 hours/day, 5 days/week | 22 | Working Days | 15,000,000 | 330,000,000 |
| 2 | On-call Radiologist coverage for emergency imaging interpretation (24/7 rotation, 4 shifts/month) | 4 | Shifts | 8,500,000 | 34,000,000 |
| 3 | Interventional Radiology procedures (biopsies, angioplasty, embolization) – estimated 12 procedures/month | 12 | Procedures | 25,000,000 | 300,000,000 |
| 4 | Provision and calibration of portable ultrasound device (GE LOGIQ E10) for bedside Radiologist use | 1 | Unit | 485,000,000 | 485,000,000 |
| 5 | Annual professional development and PERSI certification renewal support for the Radiologist | 1 | Year | 25,000,000 | 25,000,000 |
| 6 | Medical malpractice insurance coverage for the Radiologist (annual policy, limit IDR 5,000,000,000) | 1 | Policy | 45,000,000 | 45,000,000 |
| 7 | PACS (Picture Archiving and Communication System) workstation license and integration for Radiologist reporting | 2 | Stations | 32,000,000 | 64,000,000 |
| 8 | Monthly quality assurance audit and peer review sessions led by the Radiologist | 12 | Sessions | 5,000,000 | 60,000,000 |
| Subtotal (IDR) | 1,343,000,000 | ||||
| VAT (PPN) 11% | 147,730,000 | ||||
| TOTAL AMOUNT (IDR) | 1,490,730,000 | ||||
2.1 This Purchase Order is governed by the laws of the Republic of Indonesia, including but not limited to the Indonesian Civil Code (Kitab Undang-Undang Hukum Perdata), the Health Law (UU No. 17 Tahun 2023), and the regulations of the Indonesian Medical Council (Konsil Kedokteran Indonesia) pertaining to the practice of a Radiologist in Indonesia Jakarta.
2.2 The Radiologist shall maintain a valid Surat Tanda Registrasi (STR) and Surat Izin Praktik (SIP) throughout the entire contract period. Any lapse in professional licensing shall constitute grounds for immediate termination of this Purchase Order.
2.3 All diagnostic reports and imaging interpretations produced by the Radiologist shall be issued in accordance with PERSI guidelines and the Indonesian National Standard (SNI) for radiological reporting. Reports shall be available in both Bahasa Indonesia and English upon patient request.
2.4 The Radiologist shall comply with all radiation safety protocols as mandated by BAPETEN (Badan Pengawas Tenaga Nuklir) and shall not exceed the annual dose limits established for medical personnel operating in Indonesia Jakarta.
2.5 Payment shall be made within thirty (30) calendar days from the date of invoice submission. Payment shall be processed via bank transfer to the account designated by the Radiologist. All amounts are stated in Indonesian Rupiah (IDR) and are subject to applicable withholding tax (PPh Pasal 21) as required by the Directorate General of Taxes (Ditjen Pajak).
2.6 The Radiologist agrees to a non-compete clause for a period of twelve (12) months following the termination of this Purchase Order, within a radius of ten (10) kilometers from the facility location in Indonesia Jakarta.
2.7 Any disputes arising from this Purchase Order shall be resolved through mediation at the Jakarta Arbitration Board (BANI) before proceeding to litigation at the Jakarta Central District Court (Pengadilan Negeri Jakarta Pusat).
3. Commencement and DurationThis Purchase Order shall become effective on 1 July 2025 and shall remain in force for a period of twelve (12) months, unless terminated earlier by mutual written agreement or in accordance with the termination clauses herein. The Radiologist is expected to commence all duties at the PT Medika Radiologi Nusantara facility in Indonesia Jakarta no later than the effective date.
4. Acceptance and AuthorizationBy signing below, both parties acknowledge and accept all terms, conditions, and obligations set forth in this Purchase Order. The undersigned represent that they have the legal authority to bind their respective parties to the commitments contained herein.
For and on behalf of PT Medika Radiologi Nusantara
Ir. Bambang Sutrisno, M.M.Director of Procurement & Operations
Date: _______________
Service Provider / Radiologist
Dr. Hendra Wijaya, Sp.Rad (K) OnkologiRadiologist
Date: _______________ IMPORTANT NOTES:
• This Purchase Order is valid only for the specific services and quantities listed above. Any modifications require a written amendment signed by both parties.
• The Radiologist must submit a copy of their current STR, SIP, and PERSI membership certificate prior to the commencement date.
• All equipment listed (Item 4 and Item 7) shall be delivered, installed, and calibrated at the Indonesia Jakarta facility within fourteen (14) days of the effective date.
• This document is issued in duplicate (2 copies), one for each party. Both copies carry equal legal validity.
• For any inquiries regarding this Purchase Order, please contact the Procurement Department at [email protected] or visit our office in Indonesia Jakarta during business hours (08:00–17:00 WIB, Monday to Friday). ⬇️ Download as DOCX Edit online as DOCX
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