Purchase Order Surgeon in Venezuela Caracas –Free Word Template Download with AI
Centro Médico Quirúrgico del Caribe, S.A. de C.V.
Av. Francisco de Miranda, Torre Médica, Piso 12, Venezuela Caracas, 1080
Tel: +58 (212) 555-0147 | Email: [email protected]
RIF: J-45871236-9
1. BUYER INFORMATIONCentro Médico Quirúrgico del Caribe, S.A. de C.V.
Address: Av. Francisco de Miranda, Torre Médica, Piso 12, Venezuela Caracas, 1080, Venezuela
Authorized Representative: Dr. María Elena Rodríguez, Director of Procurement
Contact: +58 (212) 555-0147 | [email protected]
Bank: Banco Mercantil, C.A. | Account: 0104-0234-56-7890123456 | IBAN: VE0401040000000000000000
2. SELLER / SERVICE PROVIDER INFORMATIONDr. Alejandro Fernando Gutiérrez Márquez, M.D., F.A.C.S.
Specialty: General and Laparoscopic Surgeon
Professional License: Cédula Profesional No. 2014-08876, issued by the Colegio de Médicos de Venezuela, Caracas
Address: Consultorio Médico, Edificio San Rafael, Piso 8, Av. Páez, Venezuela Caracas, 1060
Contact: +58 (212) 555-0293 | [email protected]
RIF: V-12345678-5
3. Download and customize a professional Purchase Order Surgeon Venezuela Caracas Word template. Perfect for business, legal, and personal use. Editable and ready to boost your productivity. OF GOODS AND SERVICESThis Purchase Order is issued by Centro Médico Quirúrgico del Caribe, S.A. de C.V., located in Venezuela Caracas, to formally request and authorize the procurement of professional surgical services rendered by the designated Surgeon, Dr. Alejandro Fernando Gutiérrez Márquez, along with the associated surgical instruments, consumables, and post-operative care packages as detailed below. The Surgeon shall perform all procedures in accordance with the clinical protocols established by the hospital and in compliance with the regulations set forth by the Ministerio del Poder Popular para la Salud of Venezuela.
| Item | Description | Qty | Unit Price (USD) | Total (USD) | Deadline |
|---|---|---|---|---|---|
| 1 | Laparoscopic Cholecystectomy – Full surgical procedure performed by the Surgeon, including pre-operative consultation, anesthesia coordination, intra-operative care, and immediate post-operative monitoring (minimum 48 hours) at the Venezuela Caracas facility. | 1 | $4,200.00 | $4,200.00 | Jun 28, 2025 |
| 2 | Open Appendectomy with peritoneal lavage – Surgical intervention by the Surgeon for acute appendicitis with perforation, including all intra-operative supplies, sutures, and drain placement. | 1 | $3,800.00 | $3,800.00 | Jun 30, 2025 |
| 3 | Post-operative follow-up consultations by the Surgeon – Three (3) scheduled follow-up visits for wound assessment, suture removal, and clinical evaluation at the Venezuela Caracas surgical center. | 3 | $150.00 | $450.00 | Jul 10, 2025 |
| 4 | Surgical instrument package – Reusable laparoscopic instrument set (trocars, graspers, scissors, needle holders) sterilized and prepared for the Surgeon's use during the procedures listed above. | 1 | $1,200.00 | $1,200.00 | Jun 27, 2025 |
| 5 | Consumable surgical supplies – Sterile drapes, gauze, surgical gloves, suture materials (absorbable and non-absorbable), hemostatic agents, and disposable laparoscopic accessories for the Surgeon's operative sessions. | 1 | $850.00 | $850.00 | Jun 27, 2025 |
| 6 | Emergency on-call availability – The Surgeon shall maintain 24/7 on-call status for emergency surgical interventions at the Venezuela Caracas hospital for a period of thirty (30) days from the date of this Purchase Order. | 30 | $75.00 | $2,250.00 | Jul 12, 2025 |
| SUBTOTAL | $12,750.00 | ||||
| Applicable Tax (IVA 16% – Venezuela) | $2,040.00 | ||||
| GRAND TOTAL | $14,790.00 | ||||
- Scope of Services: The Surgeon agrees to perform all surgical procedures listed in this Purchase Order at the Centro Médico Quirúrgico del Caribe facility located in Venezuela Caracas. All procedures shall be conducted in strict adherence to the hospital's clinical protocols, the Venezuelan Ministry of Health regulations, and the ethical standards of the Colegio de Médicos de Venezuela.
- Payment Terms: Payment shall be made within fifteen (15) business days from the date of invoice submission. The total amount of this Purchase Order is USD $14,790.00 (Fourteen Thousand Seven Hundred Ninety U.S. Dollars and 00/100). Payment shall be processed via wire transfer to the bank account designated by the Surgeon in accordance with Venezuelan foreign exchange regulations (BCV).
- Delivery and Execution: All surgical services and supplies must be delivered and executed at the hospital premises in Venezuela Caracas. The Surgeon shall report to the operating theater no later than thirty (30) minutes prior to the scheduled procedure time. Any delay exceeding sixty (60) minutes without prior written notification to the hospital administration shall be subject to a penalty of 5% of the affected line item.
- Quality Assurance: The Surgeon warrants that all surgical instruments and consumables provided under this Purchase Order shall be of the highest quality, properly sterilized, and within their expiration dates. The hospital reserves the right to inspect all materials prior to use in the operating room.
- Confidentiality: The Surgeon shall maintain strict confidentiality regarding all patient information in compliance with Venezuelan data protection laws. No patient records, images, or clinical data shall be disclosed to any third party without written consent from the patient and the hospital administration in Venezuela Caracas.
- Liability and Insurance: The Surgeon shall maintain valid professional medical malpractice insurance with a minimum coverage of USD $1,000,000 per occurrence throughout the duration of this Purchase Order. A certificate of insurance shall be provided to the hospital prior to the first scheduled procedure.
- Cancellation and Modification: Either party may cancel or modify this Purchase Order by providing written notice at least seventy-two (72) hours prior to the scheduled procedure date. Cancellations made within seventy-two (72) hours shall incur a fee of 25% of the affected line item. Modifications must be approved in writing by both the hospital procurement department and the Surgeon.
- Governing Law: This Purchase Order shall be governed by and construed in accordance with the laws of the Bolivarian Republic of Venezuela. Any disputes arising from this agreement shall be resolved through arbitration in Venezuela Caracas in accordance with the rules of the Centro de Arbitraje y Mediación de la Cámara de Comercio de Caracas.
- Validity: This Purchase Order is valid for thirty (30) days from the date of issue. If the Surgeon does not accept the terms within this period, the Purchase Order shall automatically become null and void.
By signing below, both parties acknowledge and agree to all terms, conditions, and specifications outlined in this Purchase Order. The Surgeon confirms availability and willingness to perform the requested surgical services at the designated facility in Venezuela Caracas within the stipulated timelines.
FOR THE BUYERDr. María Elena Rodríguez
Director of Procurement
Centro Médico Quirúrgico del Caribe
Venezuela Caracas
Date: _______________ FOR THE SURGEON / SELLER
Dr. Alejandro Fernando Gutiérrez Márquez, M.D.
General and Laparoscopic Surgeon
Cédula Profesional No. 2014-08876
Venezuela Caracas
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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