Purchase Order Surgeon in Chile Santiago –Free Word Template Download with AI
Surgical Services Procurement — Santiago, Chile
| Purchase Order Number: | CL-SGO-2025-04782 |
| Date of Issue: | 14 June 2025 |
| Required Service Date: | 03 July 2025 |
| Place of Performance: | Santiago, Chile — Hospital Clínico Universidad de Chile, Santiago Metropolitan Region |
| Currency: | Chilean Peso (CLP) |
| Governing Jurisdiction: | Republic of Chile, Santiago Metropolitan Region |
Purchasing Entity (Buyer)
Name: Hospital Clínico Universidad de Chile
Address: Independencia 1027, Santiago, Chile
RUT: 80.000.000-0
Contact: Procurement Department, Ext. 4421
Email: [email protected]
Service Provider (Seller)
Name: Dr. Alejandro R. Fuentes, M.D., FACS
Specialty: Cardiothoracic Surgeon
Address: Av. Providencia 1250, Of. 804, Santiago, Chile
RUT: 12.345.678-9
Medical License: Nº 18.452, Colegio de Cirujanos de Chile
Contact: +56 2 2345 6789
This Purchase Order is issued by the Hospital Clínico Universidad de Chile, located in Santiago, Chile, to formally engage the services of a qualified Surgeon for the performance of specialized surgical procedures. The Surgeon, Dr. Alejandro R. Fuentes, is a board-certified Cardiothoracic Surgeon registered with the Colegio de Cirujanos de Chile and holds a valid medical practice license issued by the Superintendencia de Salud de Chile. The Surgeon shall perform all duties in accordance with the clinical protocols established by the purchasing institution and in full compliance with the health regulations of the Republic of Chile, specifically within the Santiago Metropolitan Region.
The engagement of the Surgeon under this Purchase Order is limited to the procedures and dates specified in Section 4 below. The Surgeon shall report to the designated operating theatre at the Hospital Clínico Universidad de Chile, Santiago, Chile, and shall be available for pre-operative consultations, the surgical procedure itself, and post-operative follow-up as outlined herein.
| Item | Description of Service | Quantity | Unit Price (CLP) | Total (CLP) |
|---|---|---|---|---|
| 01 | Pre-operative patient evaluation and surgical planning consultation by the Surgeon at the Santiago facility | 1 | 185.000 | 185.000 |
| 02 | Coronary Artery Bypass Graft (CABG) surgery performed by the Surgeon in Operating Theatre 3, Santiago, Chile | 1 | 2.850.000 | 2.850.000 |
| 03 | Intra-operative supervision and direct surgical execution by the Surgeon (estimated 4-hour procedure) | 1 | 1.200.000 | 1.200.000 |
| 04 | Post-operative intensive care monitoring and Surgeon-led wound assessment (Days 1–5) | 5 | 95.000 | 475.000 |
| 05 | Post-operative follow-up consultation by the Surgeon at the Santiago clinic (Week 2 and Week 6) | 2 | 120.000 | 240.000 |
| 06 | Emergency on-call availability of the Surgeon for 30 days post-discharge, Santiago, Chile | 1 | 350.000 | 350.000 |
| GRAND TOTAL (CLP) | 5.300.000 | |||
All prices are expressed in Chilean Pesos (CLP) and are inclusive of the Surgeon's professional fee. Applicable IVA (19%) shall be added as a separate line item on the final invoice. Total including IVA: CLP 6.307.000.
- Payment Terms: Payment shall be made within thirty (30) calendar days from the date of receipt of a valid invoice from the Surgeon. Payment shall be processed via bank transfer to the account designated by the Surgeon, domiciled in Santiago, Chile.
- Performance Location: All surgical and clinical services under this Purchase Order shall be performed exclusively at the Hospital Clínico Universidad de Chile, Santiago, Chile, or at such other facility within the Santiago Metropolitan Region as mutually agreed in writing.
- Surgeon Qualifications: The Surgeon warrants that he holds a current, unrestricted medical license to practice surgery in Chile, is registered with the Colegio de Cirujanos de Chile, and maintains professional liability insurance with a minimum coverage of CLP 500.000.000, valid throughout the duration of this Purchase Order.
- Compliance with Chilean Law: This Purchase Order and all services rendered hereunder shall be governed by and construed in accordance with the laws of the Republic of Chile. Any disputes arising from this Purchase Order shall be resolved in the competent courts of Santiago, Chile.
- Confidentiality: The Surgeon shall maintain strict confidentiality regarding all patient information in accordance with Chilean Law No. 20.587 on the Right to Personal Privacy and the regulations of the Superintendencia de Salud.
- Cancellation and Modification: Either party may cancel or modify this Purchase Order with a minimum of seven (7) business days' written notice. In the event of cancellation by the purchasing entity after the Surgeon has commenced pre-operative preparation, a cancellation fee of 25% of the total Purchase Order value shall apply.
- Force Majeure: Neither party shall be liable for failure to perform obligations under this Purchase Order due to events beyond reasonable control, including but not limited to natural disasters, pandemics, or government-mandated closures affecting healthcare facilities in Santiago, Chile.
- Warranty of Service: The Surgeon warrants that all surgical procedures shall be performed with the degree of skill, care, and diligence expected of a reasonably competent Cardiothoracic Surgeon practicing in Santiago, Chile, in accordance with internationally recognized surgical standards.
By signing below, both parties acknowledge and agree to all terms, conditions, and obligations set forth in this Purchase Order. This document constitutes a binding agreement for the procurement of surgical services by the designated Surgeon in Santiago, Chile, effective from the date of the last signature.
For the Purchasing Entity
Director of Procurement
Hospital Clínico Universidad de Chile
Santiago, Chile
Date: _______________
For the Surgeon / Service Provider
Dr. Alejandro R. Fuentes, M.D., FACS
Cardiothoracic Surgeon
Santiago, Chile
Date: _______________
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