Quotation Estimate Pharmacist in United States Los Angeles –Free Word Template Download with AI
1200 Wilshire Boulevard, Suite 450, Los Angeles, California 90017, United States
Phone: (213) 555-0187 | Email: [email protected] | CA License #PH-2024-88431
Quotation EstimateQuotation Details
Quotation No.: QTE-2025-LA-0472
Date Issued: June 12, 2025
Valid Until: July 12, 2025
Prepared By: Daniel R. Whitfield, Director of Operations
Client Information
Client Name: Pacific Coast Health Network, LLC
Address: 8800 Santa Monica Blvd, Los Angeles, CA 90069
Contact: Ms. Angela Torres, Procurement Manager
Phone: (310) 555-2241
This Quotation Estimate is formally issued by MediPharm Professional Services, Inc. to Pacific Coast Health Network, LLC, regarding the engagement of a licensed Pharmacist to provide comprehensive pharmaceutical services at the client's facility located in United States Los Angeles. This document outlines the full scope of services, associated costs, payment terms, and conditions governing the proposed professional arrangement. All pricing is presented in United States Dollars (USD) and reflects current market rates for qualified pharmaceutical professionals operating within the Los Angeles metropolitan area.
The Pharmacist engaged under this Quotation Estimate shall provide the following professional services at the client's primary facility in United States Los Angeles:
- Dispensing and verification of all prescribed medications in compliance with California Board of Pharmacy regulations and federal DEA requirements.
- Conducting patient medication reviews, drug interaction analyses, and therapeutic outcome monitoring for an estimated 120 patients per day.
- Managing the pharmacy inventory system, including ordering, stock rotation, expiration tracking, and controlled substance accountability per 21 CFR Part 1304.
- Providing immunization services, including influenza, pneumococcal, and hepatitis B vaccinations, in accordance with California Health and Safety Code Section 114735.
- Offering patient counseling on medication adherence, side effect management, and lifestyle modifications during scheduled consultation hours.
- Collaborating with the client's medical staff on formulary management, cost-containment strategies, and clinical protocol development.
- Maintaining all required documentation, including prescription records, adverse event reports, and annual compliance audits mandated by the Los Angeles County Department of Public Health.
| Item No. | Description of Service | Duration / Quantity | Unit Rate (USD) | Subtotal (USD) |
|---|---|---|---|---|
| 01 | Senior Pharmacist – Full-Time Clinical Services (40 hrs/week) | 12 months | $118,500 / yr | $118,500.00 |
| 02 | Pharmacist Onboarding, Licensing Verification & Credentialing | One-time | $2,400.00 | $2,400.00 |
| 03 | Continuing Education & Professional Development (CA CPE Credits) | 12 months | $1,800.00 / yr | $1,800.00 |
| 04 | Pharmacy Management Software License & Integration (Cerner / Epic) | 12 months | $4,200.00 / yr | $4,200.00 |
| 05 | Controlled Substance Compliance Auditing & DEA Reporting | Quarterly (4x) | $1,500.00 / audit | $6,000.00 |
| 06 | Immunization Program Setup & Ongoing Administration | 12 months | $3,600.00 / yr | $3,600.00 |
| 07 | Professional Liability Insurance (Pharmacist Malpractice Coverage) | 12 months | $5,200.00 / yr | $5,200.00 |
| 08 | Administrative Support & Scheduling Coordination | 12 months | $7,800.00 / yr | $7,800.00 |
| Subtotal | $149,500.00 | |||
| Applicable Taxes & Regulatory Fees (Los Angeles County) | $4,485.00 | |||
| TOTAL ESTIMATED COST (USD) | $153,985.00 | |||
The total amount specified in this Quotation Estimate shall be disbursed according to the following schedule, subject to the client's approval and execution of the master service agreement:
- Initial Deposit (25%): $38,496.25 – Due upon contract execution, no later than July 1, 2025.
- Quarterly Installments (25% each): $38,496.25 – Due on the first business day of October 2025, January 2026, and April 2026.
- Final Payment (25%): $38,496.25 – Due upon successful completion of the 12-month service period and final compliance audit.
All payments shall be made via wire transfer to the account designated by MediPharm Professional Services, Inc. Late payments exceeding fifteen (15) calendar days shall incur a penalty of 1.5% per month on the outstanding balance.
- This Quotation Estimate is valid for thirty (30) calendar days from the date of issuance. After the expiration date, all rates and availability of the Pharmacist candidate are subject to re-evaluation and potential revision.
- The Pharmacist engaged under this agreement must hold an active, unrestricted California Pharmacist License issued by the California Board of Pharmacy and a valid federal DEA registration. All licensure documents shall be verified prior to the commencement of services in United States Los Angeles.
- MediPharm Professional Services, Inc. reserves the right to substitute the assigned Pharmacist with a qualified equivalent should the original candidate become unavailable, provided the substitute meets or exceeds the same credentials and experience requirements.
- All services rendered shall comply with the Health Insurance Portability and Accountability Act (HIPAA), the California Confidentiality of Medical Information Act (CMIA), and all applicable Los Angeles municipal health ordinances.
- This Quotation Estimate does not constitute a binding contract until both parties have executed the formal Master Service Agreement. The terms herein serve solely as a good-faith estimate of costs and service parameters.
- Any modifications to the scope of services, additional clinical responsibilities, or changes in the operational location within United States Los Angeles must be documented in a written amendment signed by both parties prior to implementation.
- Disputes arising from this Quotation Estimate or the subsequent agreement shall be resolved through binding arbitration in Los Angeles, California, in accordance with the rules of the American Arbitration Association.
By signing below, the client acknowledges receipt of this Quotation Estimate and agrees to the terms, conditions, and cost structure outlined herein for the engagement of a Pharmacist to deliver professional pharmaceutical services in United States Los Angeles.
Authorized Representative – Client
Pacific Coast Health Network, LLC
Name / Title / Date / Signature
Authorized Representative – Provider
MediPharm Professional Services, Inc.
Name / Title / Date / Signature
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