A10 Attachment 3 Sources Sought IEE Self-Performance Worksheet.docx

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Attached to
Kayenta Staff Quarters Abatement and Demolition
Solicitation number
75H70123R00063
Issued by

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This document contains a sources sought notice and questionnaire from the Department of Health and Human Services Indian Health Service regarding a contract opportunity for the abatement and demolition of staff quarters in Kayenta, Arizona. The notice seeks information from small businesses including Native American/Indian-owned, 8(a), HUBZone, women-owned, veteran-owned, and small disadvantaged firms to determine if the requirement can be set aside for Indian Economic Enterprises or small businesses. Interested firms must submit responses utilizing the attached questionnaire by June 5, 2023 to be considered, providing company information, point of contact, confirmation of proposal submission if solicited, business type and documentation, bonding capacity, and up to three relevant past project descriptions. The project scope involves hazardous material verification and abatement, demolition of concrete slabs and utilities, site restoration, and has an estimated value between $1-5 million.

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Indian Economic Enterprise Self-Performance Worksheet

IEE REPRESENTATION SELF-PERFORMED CALCULATION SHEET

Prospective Offerors that self-certify as an Indian Economic Enterprise (IEEs) and Indian Economic Small Business Enterprises (ISBEEs) are required to meet the definition of an Indian Economic Enterprise (HHSAR 326.601). The full definition of an IEE and an ISBEE are provided on page 2.

IEEs/ISBEEs shall list the work activities below that they are self-performing along with the remaining percentages of work proposed with each subcontractors’ SBA concern status in the table below. Percentages of proposed work shall come to a sum equal to 100%.

List of Proposed Prime Contractor and Subcontractors, their work activities and value:

Prime Contractor/Subcontractor/ Tribal Entity
Concern Status

(i.e., IEE/ISBEE, SB, 8(a), SDB, SDVOSB, HUBZone, etc.)

Work Activities
Percentage of Work Proposed (%)

Signed at submission of Sources Sought notice:

Name: ___________________________________ Title: ______________________________________ Signature: _________________________________ Date: ______________________________________

Definitions (HHSAR 326.601):

Indian Economic Enterprise (IEE) means any business activity owned by one or more Indians or Indian Tribes that is established for the purpose of profit provided that: The combined Indian or Indian Tribe ownership must constitute not less than 51 percent of the enterprise; the Indians or Indian Tribes must, together, receive at least a majority of the earnings from the contract; and the management and daily business operations of an enterprise must be controlled by one or more individuals who are Indians. To ensure actual control over the enterprise, the individuals must possess requisite management or technical capabilities directly related to the primary industry in which the enterprise conducts business. The enterprise must meet these requirements throughout the following time periods:

(1) At the time an offer is made in response to a written solicitation;

(2) At the time of the contract award; and

(3) During the full term of the contract.

Indian Small Business Economic Enterprise (ISBEE) means an IEE that is also a small business concern established in accordance with the criteria and size standards of 13 CFR part 121.

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