Attachment 1-IEE Rep Form.pdf
PDF 1 MB Posted
- Solicitation number
- 75H70425Q00028
About this file
This document is an Indian Economic Enterprise (IEE) Representation Form for the Indian Health Service (IHS) related to a pre-solicitation opportunity for Accusoft ImageGear Licensing. The solicitation (Number 75H70425Q00028) seeks to identify Indian Small Business Economic Enterprises (ISBEEs) capable of providing brand name Accusoft ImageGear Licensing, with a NAICS code of 541519 and a size standard of 150 employees. Interested parties are required to submit a capability statement and IEE Representation Form via email to Javier.medina-velazquez@ihs.gov by 12:00pm EST on July 11, 2025, with a maximum submission of five pages.
The form emphasizes compliance with the Buy Indian Act (25 U.S.C. 47), which requires IHS to give preference to Indian Economic Enterprises when practicable. Respondents must self-certify their status as an Indian Economic Enterprise, meet eligibility requirements throughout the solicitation, award, and contract performance periods, and be registered in the System of Award Management (SAM). The opportunity is a Sources Sought Notice aimed at gathering information about potential vendors' capabilities, with no guarantee of contract award, and requires vendors to be Accusoft authorized resellers.
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Other files
| File | Type | Posted |
|---|---|---|
| SS 75H70425Q00028-Accusoft ImageGear.pdf | ||
| Attachment 2-Requirement Doc_CLIN.pdf |
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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: 75H70425Q00028 |
| PROJECT_TITLE: Acussoft ImageGear Licensing (Base + 4) |
| DoesNot: 0 |
| Does: Off |
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