Purchase Order Surgeon in Italy Rome –Free Word Template Download with AI
Formal Purchase Order for Professional Surgeon Services — Issued for Execution in Italy Rome
| Entity: Ospedale San Raffaele del Tevere S.r.l. | VAT / P.IVA: IT01234567890 |
| Address: Via della Salute 42, 00185 Rome, Italy | Contact: Dr. Elena Marchetti, Procurement Director |
| Email: [email protected] | Phone: +39 06 5551 2340 |
| Professional: Prof. Dott. Marco Antonelli, MD, FACS | Specialty: Cardiothoracic Surgeon |
| Registration: Ordine dei Medici di Roma, Lic. No. RM-2003-11847 | VAT / P.IVA: IT09876543210 |
| Practice Address: Studio Medico, Via Appia Nuova 118, 00183 Rome, Italy | Contact: Prof. Dott. Marco Antonelli |
| Email: [email protected] | Phone: +39 06 7774 5521 |
This Purchase Order is issued by Ospedale San Raffaele del Tevere S.r.l. (hereinafter referred to as the "Buyer") to engage the services of Prof. Dott. Marco Antonelli, a licensed and board-certified Surgeon specializing in cardiothoracic procedures (hereinafter referred to as the "Surgeon" or "Contractor"), for the provision of surgical services, pre-operative consultations, and post-operative follow-up care to be performed at the Buyer's facility located in Italy Rome. This Purchase Order constitutes a binding contractual agreement between the parties and shall be governed by the civil and commercial laws of the Italian Republic, with specific reference to the regulations of the Lazio Region and the professional standards set forth by the Ordine dei Medici Chirodentisti di Roma.
| Item # | Description of Service / Deliverable | Qty | Unit Price (EUR) | Total (EUR) |
|---|---|---|---|---|
| 01 | Pre-operative cardiac assessment and consultation by the Surgeon, including review of diagnostic imaging (CT angiography, echocardiogram) and formulation of a detailed surgical plan for elective coronary artery bypass grafting (CABG) to be performed in Italy Rome. | 1 | € 1,850.00 | € 1,850.00 |
| 02 | Primary surgical procedure: Elective Coronary Artery Bypass Grafting (CABG) performed by the Surgeon in the operating theatre of the Buyer's facility, Rome, Italy. Includes anaesthetic coordination, intra-operative monitoring, and immediate post-operative recovery supervision (first 24 hours). | 1 | € 12,400.00 | € 12,400.00 |
| 03 | Post-operative follow-up consultations by the Surgeon (3 sessions at 7-day, 30-day, and 90-day intervals) conducted at the Buyer's outpatient clinic in Italy Rome, including wound inspection, ECG review, and medication adjustment. | 3 | € 450.00 | € 1,350.00 |
| 04 | Provision of a comprehensive written surgical report and operative notes to be filed in the patient's medical record, prepared by the Surgeon within 5 business days of the procedure, in compliance with Italian data protection regulations (GDPR / D.Lgs. 196/2003). | 1 | € 320.00 | € 320.00 |
| 05 | Emergency on-call availability by the Surgeon for a period of 14 consecutive days following the primary procedure, to be made available at the Buyer's facility in Rome, Italy, for any unforeseen post-operative complications requiring immediate surgical intervention. | 14 | € 180.00 | € 2,520.00 |
| 06 | Provision of specialized surgical instruments and single-use implants (sternal wires, vascular grafts, haemostatic agents) to be supplied by the Surgeon's contracted vendor and delivered to the Buyer's facility in Italy Rome prior to the scheduled procedure date. | 1 | € 4,750.00 | € 4,750.00 |
| TOTAL AMOUNT DUE (EUR): | € 23,190.00 | |||
- Governing Law: This Purchase Order shall be governed by and construed in accordance with the laws of the Italian Republic. Any disputes arising from this Purchase Order shall be subject to the exclusive jurisdiction of the competent courts of Rome, Italy.
- Professional Liability: The Surgeon warrants that he holds a valid, unrestricted licence to practise medicine and surgery in Italy Rome, issued by the Ordine dei Medici Chirodentisti di Roma, and that he maintains professional liability insurance with a minimum coverage of € 5,000,000 per claim, as required by Italian medical practice regulations.
- Schedule: The primary surgical procedure shall be performed on or before 22 August 2025 at the Buyer's facility in Italy Rome. The Surgeon shall confirm the exact date and time no later than 10 business days prior to the scheduled procedure.
- Payment: The Buyer shall remit payment of the total amount specified in this Purchase Order within thirty (30) calendar days of receipt of a valid invoice from the Surgeon. Payment shall be made via bank transfer to the account designated by the Surgeon. Late payments shall accrue interest at the rate prescribed by Article 1284 of the Italian Civil Code.
- Confidentiality and Data Protection: Both parties agree to maintain strict confidentiality regarding all patient information, surgical records, and proprietary medical data exchanged in connection with this Purchase Order. All data processing shall comply with Regulation (EU) 2016/679 (GDPR) and the Italian Data Protection Code (D.Lgs. 196/2003 as amended).
- Termination: Either party may terminate this Purchase Order with thirty (30) days' written notice. In the event of termination prior to the surgical procedure, the Buyer shall be liable for all non-recoverable costs incurred by the Surgeon up to the date of termination, including but not limited to instrument procurement and facility reservation fees.
- Force Majeure: Neither party shall be liable for failure to perform obligations under this Purchase Order if such failure is caused by events beyond reasonable control, including but not limited to natural disasters, pandemics, government-mandated closures, or acts of war affecting the Rome, Italy region.
- Amendments: No modification or amendment to this Purchase Order shall be valid unless made in writing and signed by both the Buyer's Procurement Director and the Surgeon.
By signing below, both parties acknowledge that they have read, understood, and agree to all terms, conditions, and specifications set forth in this Purchase Order. The Surgeon confirms his availability and professional capacity to deliver the services described herein at the Buyer's facility in Italy Rome. The Buyer confirms its authorization to release funds in accordance with the payment terms specified above.
For and on behalf of the Buyer:
Ospedale San Raffaele del Tevere S.r.l.
Procurement Director
Date: _______________
For and on behalf of the Surgeon:
Prof. Dott. Marco Antonelli, MD, FACS
Cardiothoracic Surgeon
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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