3_IA_IEE_Representation_Form.pdf
PDF 1 MB Posted
- Solicitation number
- 140A0125Q0004
About this file
This is an Indian Affairs Indian Economic Enterprise (IEE) Representation Form, which serves as a self-certification document for businesses participating in acquisitions under the Buy Indian Act (25 U.S.C. 47). The form is associated with a solicitation for propane supply and delivery services for the Bureau of Indian Affairs, Cheyenne River Agency in Eagle Butte, South Dakota.
The form requires businesses to certify their status as an Indian Economic Enterprise as defined in DIAR Part 1480, with eligibility requirements that must be maintained at three critical points: when making an offer, at contract award, and throughout the contract term. The form collects essential business information including the federally recognized tribal entity name, legal business name, Unique Entity ID (UEI), and details of the 51% or greater Indian owner. False representations are subject to penalties under 18 U.S.C. 1001 and false claims during contract performance face penalties under 31 U.S.C. 3729-3731 and 18 U.S.C. 287. The form displays the official seals of the Department of Interior, Bureau of Indian Affairs, and Bureau of Indian Education.
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Other files
| File | Type | Posted |
|---|---|---|
| 1_Request_for_Quotes_(RFQ)_-_ISBEE.pdf | ||
| 2_Statement_of_Work_v1.pdf | ||
| 4_Provisions_and_Clauses_-_ISBEE.pdf | ||
| Sol_140A0125Q0004.pdf |
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(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:
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:
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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