Attachment_3_IEE_Representation_Form.pdf
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- Solicitation number
- 140A1626Q0034
About this file
This is an Indian Affairs Indian Economic Enterprise Representation Form used for the Buy Indian Act set-aside program. The form is a self-certification document that offerors must complete to establish eligibility for contracts reserved exclusively for Indian Economic Enterprises (IEEs) as defined in the Department of the Interior Acquisition Regulation (DIAR) Part 1480.
The form requires offerors to provide the solicitation/sources sought/RFI number, project title, and date of form submission. In the offeror representation section, applicants must declare the name of the federally recognized tribal entity with which they are affiliated, their unique entity ID (UEI), legal business name, and the name of the individual or entity holding 51 percent or greater ownership of the IEE firm. The certifying official must sign the form and print their name. The document emphasizes that enterprises must meet IEE eligibility requirements at three critical points: when submitting an offer in response to a written solicitation, at the time of contract award, and throughout the full contract term. Contracting officers retain the authority to request additional documentation of eligibility at any point during the acquisition lifecycle. The form warns that false or misleading information constitutes a violation of federal law subject to penalties under 18 U.S.C. § 1001, and false claims during contract performance are punishable under 31 U.S.C. §§ 3729–3731 and 18 U.S.C. § 287.
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Text version
In accordance with 25 U.S.C. 47 of the Buy Indian Act, the signature in the Offeror Section below constitutes self-certification that the Offeror meets the definition of an "Indian Economic Enterprise (IEE)" as defined in Department of the Interior Acquisition Regulation (DIAR) Part 1480 titled, "Acquisitions Under the Buy Indian Act."
The enterprise must meet the requirements of (i) through (iii) throughout the following time periods:
(1) At the time an offer is made in response to a written solicitation;
(2) At the time of contract award; and,
(3) During the full term of the contract.
Contracting Officers may require additional information or documentation of eligibility at any time in the acquisition life-cycle, including pre-award/proposal evaluation.
Any false or misleading information submitted by an enterprise when submitting an offer in consideration for an award set aside under the Buy Indian Act is a violation of the law punishable under 18 U.S.C. 1001.
False claims submitted as part of contract performance are subject to the penalties enumerated in 31 U.S.C.
3729 to 3731 and 18 U.S.C. 287.
Indian Affairs Indian Economic Enterprise Representation Form
Solicitation/Sources Sought/RFI Number:
Project Title:
Date of Form Submission:
OFFEROR REPRESENTATION
By filling out the information below, the Offeror represents that it does meet the definition of an "Indian Economic Enterprise" as defined in DIAR Part 1480.
Name of Federally Recognized Tribal Entity:
Unique Entity ID (UEI):
Legal Business Name:
Name of the 51% (or greater) Owner of the IEE Firm:
Certifying Signature:
Printed Name:
| Blank Page |
| R |
| Notice Number: |
| Project Title: |
| Date: |
| Tribal Entity: |
| UEI: |
| Business Name: |
| Owner: |
| Name: |
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