75H71422C00008.pdf

IHSALBUQUERQUE

Albuquerque NM 87110 4101 Indian School Rd NE, Suite 225

IHSALBUQUERQUE

520-8847131

127957

SEE ADDENDUMIS CHECKED

CODE 18a. PAYMENT WILL BE MADE BY

CODE

FACILITYCODE

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

OFFEROR

Tucson AZ 85746 7900 S. J Stock Road Tucson Area Office

IHSTUCSON CODE 16. ADMINISTERED BYCODE

X

SIZE STANDARD:

% FOR:SET ASIDE:UNRESTRICTED OR39

RFPIFB

10. THIS ACQUISITION ISCODE

RFQ

14. METHOD OF SOLICITATION

13b. RATING

NAICS:

SMALL BUSINESS

520-295-2445MICHAEL THORNE

08/26/2022 (No collect calls)

INFORMATION CALL:

FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBER a. NAME

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION 5. SOLICITATION NUMBER

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF

1 3 IHS1456168OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

TUCSON AZ 857011502

160 N STONE AVE

AMERICAN INDIAN ASSOCIATION OF TUCS

Attn: JACOB BERNAL

AMERICAN INDIAN ASSOCIATION OF TUCSON 127957

17a. CONTRACTOR/

TUCSON AZ 85746

7900 S. J STOCK ROAD

TUCSON AREA OFFICE

15. DELIVER TO

Tucson AZ 85746 7900 S. J Stock Road

9. ISSUED BY

7.

75H71422C00008

2. CONTRACT NO.

EFFECTIVE DATE

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW

ISSUE DATE

DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

11.

SEE SCHEDULEX

12. DISCOUNT TERMS

THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

8(A)

Tucson Area Office

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

1. The American Indian Association of Tucson dba Tucson Indian Center is allocated $1,653,945.00 for necessary expenses to Maintain Operations of the Urban Indian Health Program activities and shall use such funds in accordance with Section 11001(a)(1)(F), which may include using funds for the purposes set forth in ARPA Sections 11001(a)(1)(E) & (G).

2. Payments have been authorized for this firm-fixed-price contract. Payment in the amount

(Use Reverse and/or Attach Additional Sheets as Necessary)

$1,653,945.00

HEREIN, IS ACCEPTED AS TO ITEMS:

X X

DATED

SUSAN M. PROTHO

. YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ARE

ARE

31c. DATE SIGNED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print)

ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

26. TOTAL AWARD AMOUNT (For Govt. Use Only)

OFFER

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED.

ARE NOT ATTACHED.

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

30b. NAME AND TITLE OF SIGNER (Type or print)

30a. SIGNATURE OF OFFEROR/CONTRACTOR

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

25. ACCOUNTING AND APPROPRIATION DATA

2022.J421AOU.25837

29. AWARD OF CONTRACT:

REF.

9/1/22Jacob Bernal/Executive Director

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

40. PAID BY39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER

37. CHECK NUMBER

FINALPARTIAL

36. PAYMENT

FINALPARTIAL

35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER33. SHIP NUMBER

COMPLETE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)

42b. RECEIVED AT (Location)

42a. RECEIVED BY (Print)

41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

STANDARD FORM 1449 (REV. 2/2012) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

of $1,653,945.00 shall be paid by the Albuquerque

Area Finance Office upon receipt of payment request from the contractor.

3. The total amount of this award is

$1,653,945.00.

COR: Loretta Billie-Encinas, Loretta.Billie-Encinas@ihs.gov, 520-295-2421.

All other terms and conditions shall remain unchanged.

Delivery: 09/30/2025

Appr. Yr.: 2022 CAN: J421AOU Object Class: 25837

1 Obligate and disburse funds for Tucson Indian 1,653,945.00

Center to support COVID-19 Maintaining Operations of the Indian Health Program authorized by

American Rescue Plan Act (ARPA)

Obligated Amount: $1,653,945.00

This Award transfers $1,653,945.00 in funding that was appropriated under the American Rescue

Plan Act (ARPA), Pub. L. No. 117-2, Title XI, Sec. 11001 Indian Health Service. The parties agree to the following conditions regarding these funds: 1.) the funds are transferred to the

Continued ...

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

3 2 of

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

3 3

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

AMERICAN INDIAN ASSOCIATION OF TUCSON 127957

(A) (B) (C) (D) (E) (F)

75H71422C00008

American Indian Association of Tucson dba Tucson

Indian Center on a one-time basis and shall not recur in any subsequent year; 2.) the funds may be used only for the purposes identified in Pub.

L. No. 117-2, Title XI, Sec. 11001 Indian Health

Service, including costs incurred for those purposes to prevent, prepare for, and respond to

COVID-19 from January 31, 2020 to March 11, 2021;

3.) the funding is inclusive of all costs for such activities, is consistent with the scope of work and budget submitted by the American Indian

Association of Tucson dba Tucson Indian Center, and no additional amounts incurred by the

American Indian Association of Tucson dba Tucson

Indian Center will be reimbursed by HHS or IHS;

and 4.) in the event the American Indian

Association of Tucson dba Tucson Indian Center does not use the funds consistent with all conditions outlined above, it agrees it must return the funds to IHS.

The American Indian Association of Tucson dba

Tucson Indian Center is allocated $1,653,945.00 for maintaining the operations of the Urban

Indian health program and shall use such funds in accordance with ARPA Section 11001(a)(1)(D).

The total amount of award: $1,653,945.00. The obligation for this award is shown in box 26.

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

Sponsored by GSA

FAR (48 CFR) 53.110