Purchase Order Radiologist 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
Issuing Entity:
Westside Medical Imaging Group, LLC
4730 Wilshire Boulevard, Suite 900
Los Angeles, California 90036
United States
Tax ID (EIN): 82-4471903
| Field | Details |
|---|---|
| Vendor Name | Dr. Marcus A. Chen, M.D., F.A.C.R. – Board-Certified Radiologist |
| Practice Address | 6200 Sunset Boulevard, Suite 410, Los Angeles, California 90028, United States |
| Specialty | Diagnostic Radiology, Interventional Radiology, and Advanced Imaging (MRI, CT, Ultrasound, Mammography) |
| State Medical License | CA License No. A-1184729 (California Medical Board) |
| Board Certification | American Board of Radiology (ABR), Certificate No. 2019-4472 |
| Contact Email | [email protected] |
| Contact Phone | (310) 555-0187 |
This Purchase Order is issued by Westside Medical Imaging Group, LLC (hereinafter referred to as the "Purchasing Entity") to engage the services of Dr. Marcus A. Chen, M.D., a licensed and board-certified Radiologist, to provide comprehensive diagnostic radiology interpretation services at the Purchasing Entity's facility located in Los Angeles, California, United States. The Radiologist shall perform all duties in accordance with the standards of care established by the American College of Radiology (ACR) and the California Medical Board.
The scope of this Purchase Order encompasses the following specific services to be rendered by the Radiologist on a full-time, exclusive basis for the contract period specified herein:
| Item # | Service Description | Frequency | Unit Rate (USD) | Quantity | Extended Amount (USD) |
|---|---|---|---|---|---|
| 001 | CT Scan Interpretation – Abdominal, Pelvic, and Thoracic (per study) | Monthly | $185.00 | 420 | $77,700.00 |
| 002 | MRI Interpretation – Whole Body and Neurological (per study) | Monthly | $245.00 | 180 | $44,100.00 |
| 003 | Digital Mammography and Breast Ultrasound Interpretation (per study) | Monthly | $165.00 | 310 | $51,150.00 |
| 004 | Interventional Radiology Procedures – Fluoroscopic Guidance (per procedure) | Monthly | $850.00 | 45 | $38,250.00 |
| 005 | Ultrasound – Obstetric, Gynecologic, and Abdominal (per study) | Monthly | $140.00 | 260 | $36,400.00 |
| 006 | Emergency Radiology Coverage – 24/7 On-Call Interpretation (per month) | Monthly | $12,500.00 | 12 | $150,000.00 |
| 007 | Consultation with Referring Physicians and Clinical Correlation (per hour) | As Needed | $325.00 | 60 | $19,500.00 |
| 008 | Quality Assurance and Peer Review Participation (per month) | Monthly | $2,800.00 | 12 | $33,600.00 |
| ANNUAL TOTAL (12-Month Contract Period) | $450,700.00 | ||||
All rates are stated in United States Dollars (USD). Applicable California state sales tax and federal withholding taxes shall be applied as required by the Internal Revenue Service (IRS) and the California Department of Tax and Fee Administration (CDTFA).
4.1 Contract Period: This Purchase Order shall be effective from July 1, 2025, through June 30, 2026, unless terminated earlier in accordance with Section 4.7. The Radiologist agrees to provide services exclusively at the Purchasing Entity's facility in Los Angeles, California, United States, during the stated period.
4.2 Payment Terms: Invoices shall be submitted by the Radiologist on the last business day of each calendar month. Payment shall be made via ACH electronic transfer within thirty (30) days of receipt of a valid invoice. Late payments shall accrue interest at a rate of 1.5% per month as permitted under California Commercial Code Section 2305.
4.3 Compliance and Licensure: The Radiologist warrants that he holds a valid, unrestricted medical license issued by the California Medical Board and maintains active board certification through the American Board of Radiology. The Radiologist shall maintain all required malpractice insurance coverage with a minimum limit of $5,000,000 per occurrence and $10,000,000 in the aggregate, naming Westside Medical Imaging Group, LLC as an additional insured party.
4.4 HIPAA and Data Privacy: The Radiologist shall comply fully with the Health Insurance Portability and Accountability Act (HIPAA), the California Confidentiality of Medical Information Act (CMIA), and all applicable federal and state privacy regulations governing the handling of Protected Health Information (PHI) generated in the United States, specifically within the jurisdiction of Los Angeles County.
4.5 Work Schedule: The Radiologist shall be available for clinical duties Monday through Friday, 8:00 AM to 5:00 PM Pacific Time, with additional on-call availability as specified in Line Item 006. The Radiologist shall adhere to the facility's scheduling protocols as established by the Medical Director in Los Angeles.
4.6 Equipment and Technology: The Purchasing Entity shall provide all necessary imaging equipment, PACS (Picture Archiving and Communication System) access, and workstation infrastructure. The Radiologist shall be responsible for maintaining proficiency with the specific modalities and software platforms utilized at the Los Angeles facility.
4.7 Termination: Either party may terminate this Purchase Order with sixty (60) days' written notice. Termination for cause may be effected immediately upon written notice if the Radiologist's medical license is suspended, revoked, or placed on probation by the California Medical Board, or if the Radiologist commits a material breach of this Purchase Order.
4.8 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. Any disputes arising under this Purchase Order shall be subject to the exclusive jurisdiction of the state and federal courts located in Los Angeles County, California.
By executing this Purchase Order, both parties acknowledge that they have read, understood, and agree to be bound by all terms, conditions, and specifications set forth herein. This Purchase Order constitutes the entire agreement between the parties regarding the engagement of the Radiologist for the services described and supersedes all prior negotiations, representations, or agreements, whether written or oral.
For the Purchasing Entity:
Westside Medical Imaging Group, LLC
Authorized Signature
Name: Sandra L. Whitfield, Chief Executive Officer
Date: _________________________
For the Radiologist / Vendor:
Dr. Marcus A. Chen, M.D., F.A.C.R.
Authorized Signature
Name: Marcus A. Chen, M.D.
Date: _________________________
This Purchase Order document was prepared and issued in Los Angeles, California, United States. All references to "United States Los Angeles" pertain to the geographic jurisdiction in which the services described herein shall be performed and under which all legal obligations are enforceable. This document is valid only when signed by both authorized parties and bears the official Purchase Order number PO-LA-2025-04872. Unauthorized reproduction or distribution of this Purchase Order is prohibited.
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