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Purchase Order Radiologist in United States San Francisco –Free Word Template Download with AI

Bay Area Medical Imaging & Diagnostics Group, Inc.

1855 Market Street, Suite 2400, San Francisco, California 94102, United States

Phone: (415) 555-0192 | Email: [email protected]

California Medical Board License No. CA-MED-2024-08847

Purchase Order Details

Purchase Order No.: PO-SF-2025-00472

Date of Issue: June 12, 2025

Required Delivery Date: July 1, 2025

Payment Terms: Net 30 Days

Currency: United States Dollars (USD)

Incoterms: N/A (Professional Services)

Vendor / Service Provider

Name: Dr. Elena Vasquez, M.D., F.A.C.R.

Title: Board-Certified Radiologist

Practice: Pacific Coast Radiology Associates

Address: 2200 California Street, Suite 900, San Francisco, CA 94115, United States

License No.: CA-RAD-2019-33412

Tax ID (EIN): 94-2847103

Contact: (415) 555-0347 | [email protected]

# Description of Service Qty Unit Price (USD) Extended Price (USD) Service Period
1 Consultation and interpretation of MRI scans (neurological and musculoskeletal) for inpatient and outpatient referrals at Bay Area Medical Imaging & Diagnostics Group facility in San Francisco, United States 120 $385.00 $46,200.00 Jul 1 – Sep 30, 2025
2 Urgent and emergency CT scan interpretation services, including 24/7 on-call coverage for the San Francisco, United States emergency department 48 $520.00 $24,960.00 Jul 1 – Sep 30, 2025
3 Ultrasound imaging and real-time guidance procedures (interventional radiology support) performed at the San Francisco, United States clinic location 60 $410.00 $24,600.00 Jul 1 – Sep 30, 2025
4 Written radiology reports and peer-to-peer physician consultations with referring physicians in the San Francisco Bay Area, United States 200 $95.00 $19,000.00 Jul 1 – Sep 30, 2025
5 Quality assurance review, peer review committee participation, and compliance reporting as required by California State Medical Board and the American College of Radiology 1 $8,500.00 $8,500.00 Jul 1 – Sep 30, 2025
Subtotal: $123,260.00
Applicable Sales Tax (San Francisco, CA – 8.63%): $10,637.34
TOTAL AMOUNT DUE (USD): $133,897.34

Terms and Conditions of This Purchase Order

  1. This Purchase Order is issued by Bay Area Medical Imaging & Diagnostics Group, Inc., a California corporation headquartered in San Francisco, United States, and constitutes a binding agreement for the professional services of the named Radiologist, Dr. Elena Vasquez, M.D., F.A.C.R.
  2. The Radiologist shall perform all diagnostic imaging interpretation services in strict compliance with the standards established by the American College of Radiology (ACR), the California Medical Board, and all applicable federal and state regulations governing medical imaging in the United States.
  3. All services described in this Purchase Order shall be rendered at the facility located at 1855 Market Street, San Francisco, California 94102, United States, or at such other location within the San Francisco metropolitan area as mutually agreed upon in writing by both parties.
  4. Payment shall be made within thirty (30) calendar days of receipt of a valid invoice from the Radiologist. Late payments shall accrue interest at a rate of 1.5% per month, in accordance with California Commercial Code Section 2210.2.
  5. The Radiologist warrants that all interpretations and reports shall be completed within twenty-four (24) hours for routine studies and within four (4) hours for urgent or emergency studies, consistent with the standards of care expected in San Francisco, United States medical facilities.
  6. This Purchase Order is subject to the Radiologist maintaining active and unrestricted medical licensure with the California Medical Board, valid DEA registration, and current malpractice insurance coverage of no less than $2,000,000 per occurrence and $6,000,000 in the aggregate.
  7. Either party may terminate this Purchase Order with thirty (30) days written notice. In the event of termination, all services rendered through the effective date of termination shall be invoiced and paid in full.
  8. All patient health information handled in connection with this Purchase Order shall be protected in accordance with the Health Insurance Portability and Accountability Act (HIPAA), the California Confidentiality of Medical Information Act (CMIA), and all applicable data privacy laws of the United States.
  9. This Purchase Order shall be governed by and construed in accordance with the laws of the State of California, United States. Any disputes arising hereunder shall be resolved through binding arbitration in San Francisco, California, in accordance with the rules of the American Arbitration Association.
  10. Acceptance of this Purchase Order by the Radiologist constitutes full agreement to all terms, conditions, and specifications outlined herein. No modification of this Purchase Order shall be valid unless made in writing and signed by authorized representatives of both parties.

Authorized by (Buyer):

Bay Area Medical Imaging & Diagnostics Group, Inc.

Michael T. Okafor, C.P.A.
Director of Procurement & Finance
Date: ______________________

Accepted by (Vendor / Radiologist):

Pacific Coast Radiology Associates

Dr. Elena Vasquez, M.D., F.A.C.R.
Board-Certified Radiologist
Date: ______________________

This Purchase Order (PO-SF-2025-00472) was generated and issued in San Francisco, California, United States. This document is the property of Bay Area Medical Imaging & Diagnostics Group, Inc. Unauthorized reproduction or distribution is prohibited. For questions regarding this Purchase Order, contact the Procurement Department at (415) 555-0192 or [email protected]. This Purchase Order is valid for acceptance until June 26, 2025.

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