A10 Attachment 1 IHS IEE Representation Form.pdf
PDF 1 MB Posted
- Solicitation number
- 75H70124R00056
About this file
This document is an Indian Economic Enterprise (IEE) Representation Form related to a federal contract opportunity for the Indian Health Service (IHS). The IHS is conducting market research through a Sources Sought/Request for Information (RFI) for multiple Indefinite-Delivery/Indefinite-Quantity (IDIQ), Multiple Award Task Order Contracts (MATOC) to provide design-build, design-bid-build, and other construction services for medical facilities on tribal lands nationwide. The contract will include a base year and up to four option years, with a maximum task order value of $700,000 and a total contract value not to exceed $10 million. The IHS is seeking responses from Native American/Indian-Owned Businesses (IEEs), 8(a) Certified Small Businesses, HUBZone Small Businesses, Women Owned Small Businesses, Service Disabled Veteran-Owned Small Businesses, and other small businesses. Interested firms must provide their company information, bond capacity, preferred geographic areas, and relevant past performance by August 1, 2024. The IHS will use the Buy Indian Act to give preference to eligible IEEs.
View the file
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
DEPARTMENT OF HEALTH & HUMAN SERVICES
Indian Health Service
Office of Management Services Division of Acquisition Policy (DAP)
5600 Fishers Lane Rockville, MD 20857
INDIAN HEALTH SERVICE
BUY INDIAN ACT
INDIAN ECONOMIC ENTERPRISE
REPRESENTATION FORM
SOLICITATION/SOURCES SOUGHT/RFI #: _________________________________________________
PROJECT TITLE: ________________________________________________________
DATE: ___________________________________________________________________
In accordance with 25 U.S.C. 47 the Buy Indian Act, the signature below constitutes self-certification that the Offeror meets the definition of an “Indian Economic Enterprise” (HHSAR 326.601) in response to this Sources Sought Notice, Request for Information (RFI) or Solicitation and resultant contract.
The enterprise must meet the definition of “Indian Economic Enterprise” throughout the following time periods:
(1) At the time an offer is made in response to this solicitation;
(2) At the time of contract award; and
(3) During the full term of the contract performance period. At any point during these periods, if the Contractor no longer meets the eligibility requirements, the contractor must provide immediate written notification to the Contracting Officer.
Individual Contracting Officers may require documentation of eligibility before awarding a set-aside or sole source contracts under the Buy Indian Act and awards may be subject to protest if the eligibility of the successful Offeror is in question. In addition to the self-certification requirements, successful Offerors must also be registered with the System of Award Management (SAM).
Any false or misleading information submitted by an enterprise when submitting an offer in consideration of an award set-aside under the authority of the Buy Indian Act is a violation of the law and 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.
REPRESENTATION
The Offeror represents as part of its offer that it does _____, does not _____ meet the definition of an “Indian Economic Enterprise” with “Indian Ownership” under the authority of the Buy Indian Act.
Name of the 51% owner of IEE Firm
Certifying Signature
Print Name
Name of Federally Recognized Tribal Entity
Business Name
DUNS Number
| DATE: |
| DUNSnumber: |
| BusinessName: |
| NameOfTribalEntity: |
| OwnerName: |
| PrintName: |
| SOLICITATION_NUMBER: |
| PROJECT_TITLE: |
| DoesNot: 0 |
| Does: Off |
File details come from the government source that posted it. Updated .