Quotation Estimate Doctor General Practitioner in Peru Lima –Free Word Template Download with AI

Quotation No.: QTE-LIM-2025-04782 Date of Issue: June 15, 2025 Valid Until: July 15, 2025 Currency: Peruvian Sol (PEN / S/) 1. Parties Involved

Service Provider

Healthcare Solutions S.A.C.

RUC: 20601234567

Av. Javier Prado Este 1250, Of. 804

San Isidro, Lima, Peru

Phone: +51 1 445-6789

Email: [email protected]

Client / Requesting Party

Corporativo Andino S.A.C.

RUC: 20509876543

Calle Los Pinos 456, Piso 12

La Molina, Lima, Peru

Phone: +51 1 332-4567

Email: [email protected]

2. Scope of Services — Doctor General Practitioner

This Quotation Estimate is issued by Healthcare Solutions S.A.C. to provide comprehensive medical services rendered by a licensed Doctor General Practitioner operating within the metropolitan area of Peru Lima. The Doctor General Practitioner engaged under this quotation holds a valid professional license issued by the Colegio Médico del Perú (CMP No. 28-45678) and is registered with the Superintendencia Nacional de Salud (SUSALUD). All services will be delivered in accordance with the Peruvian Health Law (Ley General de Salud, D.L. 790) and applicable regulations of the Ministry of Health (MINSA) in the Lima region.

The Doctor General Practitioner will provide primary care consultations, preventive health screenings, diagnosis and management of common acute and chronic conditions, prescription of medications, referral coordination to specialist services within Lima, and ongoing patient follow-up. The service is designed to meet the occupational health requirements of the client's workforce located in the Lima metropolitan area.

3. Itemized Cost Breakdown

No.	Description of Service	Quantity	Unit (PEN)	Subtotal (PEN)	Frequency
01	General Practitioner Consultation (in-office, Lima — San Isidro clinic)	120	S/ 185.00	S/ 22,200.00	Monthly
02	Preventive Health Screening & Annual Physical Examination	85	S/ 320.00	S/ 27,200.00	Annual
03	On-site Doctor General Practitioner Visit (client office, La Molina, Lima)	24	S/ 450.00	S/ 10,800.00	Bi-weekly
04	Urgent Medical Response & Home Visit (within Lima metropolitan area)	15	S/ 380.00	S/ 5,700.00	As needed
05	Medical Records Management & Digital Health File (per patient)	85	S/ 45.00	S/ 3,825.00	Annual
06	Referral Coordination to Specialists (Lima hospitals & clinics)	20	S/ 150.00	S/ 3,000.00	As needed
07	Occupational Health Report & MINSA Compliance Documentation	1	S/ 2,500.00	S/ 2,500.00	Annual
SUBTOTAL (before IGV)				S/ 75,225.00
IGV (18%) — Peruvian General Sales Tax				S/ 13,540.50
TOTAL AMOUNT (PEN)				S/ 88,765.50

Note: All prices are expressed in Peruvian Soles (PEN) and include the 18% IGV tax as mandated by the Peruvian tax authority (SUNAT). This Quotation Estimate does not include the cost of laboratory tests, imaging studies, or pharmaceuticals, which will be billed separately at cost. Travel within the Lima metropolitan area is included; travel to provinces outside Lima will be quoted separately. 4. Terms and Conditions

This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. After the expiration date, prices and availability of the Doctor General Practitioner may be subject to revision.
Payment terms: 50% advance payment upon contract signing and 50% upon completion of the service period. Payments shall be made via bank transfer to the account of Healthcare Solutions S.A.C. at BCP, Lima, Peru (Cuenta: 191-12345678-0-19).
The Doctor General Practitioner assigned to this contract shall maintain full professional liability insurance and shall comply with all ethical standards established by the Colegio Médico del Perú and the SUSALUD regulations applicable in Lima.
All medical records and patient data shall be handled in strict accordance with the Peruvian Personal Data Protection Law (Ley Nº 29733) and the regulations of the Data Protection Authority (Autoridad Nacional de Protección de Datos Personales).
The service period covered by this Quotation Estimate is twelve (12) months, commencing on the date of contract execution. Renewal terms shall be negotiated at least thirty (30) days prior to expiration.
Any modification to the scope of services, change in the number of patients, or relocation of the service site within Peru Lima must be communicated in writing and will be subject to a revised Quotation Estimate.
Disputes arising from this agreement shall be resolved through the competent courts of Lima, Peru, in accordance with Peruvian civil and commercial law.
This Quotation Estimate does not constitute a binding contract until formally accepted in writing by both parties and a definitive service agreement is executed.

5. Acceptance and Authorization

For Healthcare Solutions S.A.C.

Dr. Ricardo Mendoza Salazar

Medical Director & Doctor General Practitioner

CMP No. 28-45678

Signature & Date

For Corporativo Andino S.A.C.

_____________________________

Name & Position

RUC: 20509876543

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