Quotation Estimate Surgeon in Indonesia Jakarta –Free Word Template Download with AI
MediSurge Professional Services Indonesia
Jl. Jend. Sudirman Kav. 52-53, SCBD District, Jakarta Selatan 12190, Indonesia Jakarta
Tel: +62-21-5790-1234 | Email: [email protected]
NPWP: 01.234.567.8-011.000 | Business License: 11.00.1.03.74.0001234
1. Purpose and Scope of This Quotation EstimateThis Quotation Estimate is formally issued by MediSurge Professional Services Indonesia to PT. Nusantara Medika Hospital, located in Indonesia Jakarta, for the professional engagement of a qualified and board-certified Surgeon. The purpose of this document is to provide a comprehensive, transparent, and itemized financial breakdown for the surgical services, staffing, and associated professional support that will be delivered to the client facility. All pricing contained within this Quotation Estimate reflects current market rates for surgical professionals operating in the Indonesia Jakarta metropolitan area and is subject to the terms and conditions outlined herein.
The Surgeon engagement described in this Quotation Estimate encompasses general surgical procedures, specialized surgical consultations, operative room supervision, post-operative patient management, and ongoing clinical mentorship to the hospital's resident surgical team. The Surgeon will be based at the client's facility in Indonesia Jakarta and will operate in accordance with the Indonesian Ministry of Health regulations, the Indonesian Medical Council (IDI) ethical guidelines, and all applicable local healthcare legislation.
2. Itemized Cost Breakdown| No. | Description of Surgeon Service | Duration | Unit Rate (IDR) | Amount (IDR) | Remarks |
|---|---|---|---|---|---|
| 1 | Senior Surgeon – General Surgery (Full-Time Engagement) | 12 months | 85,000,000 / month | 1,020,000,000 | Includes 5-day work week, 40 hrs/week |
| 2 | Surgeon – Specialized Laparoscopic & Minimally Invasive Surgery | 12 months | 45,000,000 / month | 540,000,000 | On-call basis, max 12 procedures/month |
| 3 | Surgeon – Emergency & Trauma Surgical Coverage | 12 months | 30,000,000 / month | 360,000,000 | 24/7 on-call rotation, Indonesia Jakarta |
| 4 | Pre-Operative & Post-Operative Patient Consultations | 12 months | 15,000,000 / month | 180,000,000 | Included in Surgeon retainer |
| 5 | Operative Room Supervision & Surgical Team Leadership | 12 months | 20,000,000 / month | 240,000,000 | Includes OR scheduling coordination |
| 6 | Clinical Mentorship & Training for Resident Surgeons | 12 months | 12,000,000 / month | 144,000,000 | Weekly seminars, hands-on training |
| 7 | Medical Malpractice & Professional Liability Insurance (Surgeon) | 12 months | 25,000,000 / year | 25,000,000 | Coverage up to IDR 5,000,000,000 |
| 8 | Administrative & Licensing Support (Surgeon Registration in Indonesia Jakarta) | One-time | 8,000,000 | 8,000,000 | IDI registration, STR, SIP processing |
| 9 | Annual Continuing Medical Education (CME) Allowance for Surgeon | 12 months | 10,000,000 / year | 10,000,000 | Conferences, workshops, certifications |
| 10 | Transportation & Accommodation Allowance (Surgeon, Indonesia Jakarta) | 12 months | 15,000,000 / month | 180,000,000 | For non-local Surgeon placement |
| Subtotal (IDR) | 2,717,000,000 | ||||
| VAT (PPN) 11% | 298,870,000 | ||||
| TOTAL QUOTATION ESTIMATE AMOUNT | 3,015,870,000 | ||||
Amount in words: Three Billion, Fifteen Million, Eight Hundred Seventy Thousand Indonesian Rupiah.
3. Terms and Conditions of This Quotation Estimate- Validity: This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. After the expiration date, pricing for the Surgeon engagement may be revised to reflect current market conditions in Indonesia Jakarta.
- Payment Terms: Payment shall be made in monthly installments within fourteen (14) business days of invoice issuance. A 2% late payment penalty shall apply to overdue balances exceeding the stipulated period.
- Surgeon Qualifications: The Surgeon assigned under this Quotation Estimate must hold a valid Specialist Surgeon (Sp.B) certification, an active Surat Tanda Registrasi (STR), and a Surat Izin Praktik (SIP) registered in Indonesia Jakarta. All credentials will be verified prior to commencement of services.
- Contract Duration: The Surgeon engagement period is twelve (12) months, renewable upon mutual written agreement. Early termination requires a sixty (60) day written notice from either party.
- Scope Modification: Any changes to the scope of Surgeon services, additional surgical specialties, or extended working hours must be documented in a formal amendment to this Quotation Estimate and signed by both parties.
- Confidentiality: All patient data, surgical records, and proprietary hospital information accessed by the Surgeon during the engagement period in Indonesia Jakarta shall remain strictly confidential in accordance with Indonesian data protection regulations.
- Dispute Resolution: Any disputes arising from this Quotation Estimate shall be resolved through mediation in Indonesia Jakarta in accordance with the laws of the Republic of Indonesia.
- Tax Compliance: All amounts stated in this Quotation Estimate are subject to applicable Indonesian tax regulations, including PPN (VAT) at 11% and PPh (income tax) as mandated by the Directorate General of Taxes.
By signing below, both parties acknowledge that they have read, understood, and agree to the terms, conditions, and financial figures presented in this Quotation Estimate for the Surgeon services to be provided in Indonesia Jakarta.
For: MediSurge Professional Services Indonesia
Name: Dr. Anisa Rahmawati, M.Kes.
Title: Director of Professional Services
Date: _______________
For: PT. Nusantara Medika Hospital
Name: Dr. Hendra Wijaya, Sp.B
Title: Chief Medical Officer
Date: _______________
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