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Purchase Order Surgeon in Netherlands Amsterdam –Free Word Template Download with AI

Medical Surgical Services Procurement — Netherlands Amsterdam Purchase Order No.: PO-AMS-2025-04872
Date of Issue: 14 June 2025
Valid Until: 14 September 2025
Issuing Entity: Amsterdam Universitair Medisch Centrum (AMC)
Address: Meibergdreef 9, 1105 AZ Amsterdam, Netherlands
KvK No.: 34021876
Supplier / Surgeon: Dr. Hendrik van der Berg, MD, FACS
Specialty: General & Vascular Surgery
License No.: BIG-2019-44871 (Netherlands)

This Purchase Order is issued by the Amsterdam Universitair Medisch Centrum (hereinafter referred to as the "Purchasing Authority") to formally engage the services of a qualified Surgeon for the provision of surgical procedures, pre-operative consultations, and post-operative care within the facilities located in Netherlands Amsterdam. This Purchase Order constitutes a binding contractual instrument under Dutch civil law (Burgerlijk Wetboek, Book 7) and governs all terms, conditions, deliverables, and compensation arrangements between the parties for the duration specified herein.

The engagement of the Surgeon under this Purchase Order is specifically scoped to the surgical wing and associated operating theatres of the AMC hospital complex situated in the Amsterdam-Zuid district of Netherlands Amsterdam. All clinical activities, patient interactions, and medical documentation arising from this Purchase Order shall be conducted in compliance with the Dutch Medical Treatment of Patients Act (Wet medisch treatment naar overeenkomst, Wmo) and the regulations of the Dutch Health and Youth Care Inspectorate (IGJ).

Item No. Description of Surgeon Service Quantity / Duration Unit Rate (EUR) Amount (EUR)
01 Pre-operative patient assessment and surgical planning consultation (per patient, Netherlands Amsterdam facility) 120 patients € 185.00 € 22,200.00
02 Primary surgical procedure — laparoscopic cholecystectomy (per procedure, operating theatre, Amsterdam) 85 procedures € 2,450.00 € 208,250.00
03 Primary surgical procedure — open vascular bypass surgery (per procedure, Netherlands Amsterdam) 30 procedures € 4,800.00 € 144,000.00
04 Post-operative ward rounds and wound management (per day, Surgeon on-site in Amsterdam) 90 days € 620.00 € 55,800.00
05 Emergency call-out availability — 24/7 standby for the Netherlands Amsterdam surgical unit 12 months € 3,200.00 € 38,400.00
06 Medical documentation, operative reports, and discharge summaries (per patient file) 150 files € 95.00 € 14,250.00
07 Continuing medical education and surgical technique certification (annual, Netherlands) 1 year € 5,500.00 € 5,500.00
TOTAL PURCHASE ORDER VALUE (excl. 21% BTW / VAT) € 488,400.00
VAT (21% — Netherlands) € 102,564.00
GRAND TOTAL (incl. VAT) € 590,964.00
  1. Governing Law and Jurisdiction: This Purchase Order shall be governed by and construed in accordance with the laws of the Kingdom of the Netherlands. Any disputes arising from or in connection with this Purchase Order shall be subject to the exclusive jurisdiction of the District Court of Amsterdam, Netherlands Amsterdam.
  2. Surgeon Qualifications and Licensing: The Surgeon engaged under this Purchase Order must hold a valid BIG registration (Beroepsregister Ingeschreven Gezondheidszorg) issued by the Dutch Ministry of Health, Welfare and Sport. The Surgeon must maintain full professional indemnity insurance with a minimum coverage of € 5,000,000 per claim, as required for all medical practitioners operating in Netherlands Amsterdam.
  3. Payment Terms: Invoices issued by the Surgeon in connection with this Purchase Order are payable within thirty (30) calendar days of receipt by the Purchasing Authority. Payment shall be made via SEPA bank transfer to the account designated by the Surgeon. Late payments shall accrue interest at the statutory rate as defined in Article 6:119a of the Dutch Civil Code.
  4. Performance Period: The services described in this Purchase Order shall be rendered over a period of twelve (12) months commencing on 1 July 2025 and concluding on 30 June 2026, unless terminated earlier in accordance with Clause 8.
  5. Confidentiality and Data Protection: The Surgeon shall comply with the General Data Protection Regulation (GDPR) and the Dutch Implementation Act (UAVG) in handling all patient records and medical data generated during the performance of this Purchase Order. All patient information shall be stored on servers physically located within the Netherlands.
  6. Working Location: All surgical and clinical services under this Purchase Order shall be performed exclusively at the AMC hospital premises in Amsterdam-Zuid, Netherlands Amsterdam, or at such other approved medical facility within the municipality of Amsterdam as mutually agreed in writing.
  7. Quality Assurance: The Surgeon shall participate in the quarterly surgical audit programme mandated by the Dutch Society of Surgeons (Nederlandse Vereniging van Chirurgen) and shall submit all operative outcome data to the national surgical registry maintained in the Netherlands.
  8. Termination: Either party may terminate this Purchase Order with a written notice period of sixty (60) days. In the event of gross professional misconduct, violation of Dutch medical ethics, or loss of BIG registration, the Purchasing Authority may terminate this Purchase Order immediately without notice.
  9. 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 pandemics, natural disasters, or government-mandated closures of medical facilities in the Netherlands.

By signing below, both parties acknowledge that they have read, understood, and agree to all terms and conditions set forth in this Purchase Order for the engagement of the Surgeon in the Netherlands Amsterdam medical facility. This Purchase Order becomes effective upon the signature of both authorized representatives.

For the Purchasing Authority:

Amsterdam Universitair Medisch Centrum

Name: Prof. Dr. Maria de Vries, Chief Medical Officer
Signature: _________________________
Date: _________________________

For the Surgeon / Supplier:

Dr. Hendrik van der Berg, MD, FACS

Name: Dr. Hendrik van der Berg
Signature: _________________________
Date: _________________________

Purchase Order PO-AMS-2025-04872 — Surgeon Services Engagement — Netherlands Amsterdam
This document is the property of Amsterdam Universitair Medisch Centrum. Unauthorized reproduction or distribution is prohibited under Dutch copyright law (Auteurswet 1912).
Document generated on 14 June 2025 | Version 1.0 | Page 1 of 1

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