Quotation Estimate Surgeon in Peru Lima –Free Word Template Download with AI
Professional Surgeon Services — Peru Lima
OFFICIAL ESTIMATE
1. Client InformationClient / Institution
Name: Hospital Nacional Dos de Mayo
Address: Av. 28 de Julio 1001, Cercado de Lima, Peru
Contact Person: Lic. Carmen Torres Vega
Phone: +51 1 460-7000
Service Provider
Name: Dr. Ricardo Mendoza Salazar, M.D., FACS
Address: Jr. de la Unión 456, Miraflores, Lima, Peru
Contact Person: Dr. R. Mendoza
Phone: +51 987-654-321
2. Scope of Services — Surgeon Engagement in Peru LimaThis Quotation Estimate is issued by Dr. Ricardo Mendoza Salazar, a board-certified Surgeon registered with the Colegio Médico del Perú, to provide comprehensive surgical services at the client facility located in Peru Lima. The Surgeon shall perform, supervise, and manage all aspects of surgical procedures as outlined below. All services are rendered in compliance with the regulations established by the Ministry of Health of Peru (MINSA) and the applicable standards of the Colegio Médico del Perú.
3. Itemized Cost Breakdown| # | Service Description | Quantity / Duration | Unit Price (USD) | Subtotal (USD) | Notes |
|---|---|---|---|---|---|
| 1 | General Surgical Consultation & Pre-Operative Assessment | 12 sessions | $350.00 | $4,200.00 | Per patient evaluation |
| 2 | Minimally Invasive Laparoscopic Surgery (Cholecystectomy, Appendectomy, Hernia Repair) | 20 procedures | $1,800.00 | $36,000.00 | Includes Surgeon fee only |
| 3 | Open Abdominal Surgery (Colectomy, Gastrectomy, Complex Resections) | 8 procedures | $3,200.00 | $25,600.00 | Surgeon fee only |
| 4 | Post-Operative Follow-Up & Wound Management | 40 sessions | $120.00 | $4,800.00 | Per patient visit |
| 5 | Emergency Surgical Call-Out (24/7 Availability in Peru Lima) | 3 months | $2,500.00 | $7,500.00 | Monthly retainer |
| 6 | Surgical Training & Mentorship for Resident Surgeons | 6 weeks | $1,500.00 | $9,000.00 | Group of up to 5 residents |
| 7 | Medical Report Writing & Documentation | 30 reports | $85.00 | $2,550.00 | Per detailed report |
| 8 | Travel & Accommodation Allowance (within Peru Lima metropolitan area) | 3 months | $800.00 | $2,400.00 | Monthly allowance |
| Subtotal | $92,050.00 |
| IGV (18% Tax - Peru) | $16,569.00 |
| GRAND TOTAL (USD) | $108,619.00 |
| Equivalent in PEN (approx. 3.75) | S/ 407,321.25 |
- This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. After this period, all prices are subject to revision based on market conditions in Peru Lima.
- The Surgeon shall maintain full professional liability insurance coverage as required by the Colegio Médico del Perú throughout the duration of the engagement.
- Payment terms: 40% upon contract signing, 40% at the midpoint of the service period, and 20% upon completion of all services. Payments shall be made in US Dollars or Peruvian Soles (PEN) via bank transfer to the account specified in the final contract.
- All surgical procedures shall be performed in accordance with the ethical guidelines of the World Medical Association and the specific regulations of the Ministry of Health of Peru.
- The Surgeon reserves the right to decline any procedure that falls outside the scope of his board certification or that presents an unacceptable risk profile, in which case an alternative specialist in Peru Lima shall be recommended.
- Any additional procedures, extended hospital stays, or complications requiring re-intervention shall be subject to a supplementary Quotation Estimate issued within 48 hours.
- This Quotation Estimate does not constitute a binding contract. A formal service agreement must be executed by both parties before any services commence.
- All medical records and patient data shall be handled in strict compliance with Peru's Data Protection Law (Ley N° 29733) and institutional confidentiality policies.
- Disputes arising from this Quotation Estimate or the subsequent contract shall be resolved through arbitration in Lima, Peru, in accordance with the rules of the Centro de Arbitraje de la Cámara de Comercio de Lima.
By signing below, both parties acknowledge that this Quotation Estimate accurately reflects the scope, cost, and terms of the Surgeon services to be provided in Peru Lima. This document serves as the basis for the definitive service contract.
Dr. Ricardo Mendoza Salazar, M.D.Surgeon / Service Provider
Date: _______________ Lic. Carmen Torres Vega
Authorized Representative, Client
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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