Attachment 1 - IHS IEE Form.pdf
PDF 192 KB Posted
- Attached to
- Mid-Atlantic Service Unit Office Furniture
- Solicitation number
- 75H71525R00002
About this file
The document is an Indian Health Service (IHS) Buy Indian Act Indian Economic Enterprise (IEE) Representation Form for Solicitation #75H71525R00002, titled "Mid-Atlantic Service Unit Office Furniture". The form requires self-certification that an offeror meets the definition of an Indian Economic Enterprise under 25 U.S.C. 47, with requirements to maintain IEE status at offer submission, contract award, and throughout contract performance.
The associated pre-solicitation opportunity seeks furniture for a new clinic serving Pamunkey and other Virginia tribal populations, with specific furniture requirements including 18 left return L-shaped desks, 11 right return L-shaped desks, 95 task chairs, 59 visitor chairs, conference tables, lobby furniture, and other office and waiting area items. The procurement is set aside for Indian Economic Enterprise/Indian Small Business Economic Enterprise, with a planned performance period from 21APR25 to 01SEP25. Responses are due by 19MAR25 at 1700 ET, and interested vendors must be registered in SAM.gov and submit capability data for similar work completed within the past 3 years.
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Other files
| File | Type | Posted |
|---|---|---|
| 75H71525R00002 Amendment 1.pdf | ||
| Attachment 1 - IHS IEE Form.pdf | ||
| 75H71525R00002.pdf | ||
| Attachment 2 - MATHC 1st and 2nd Floor Plans.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: 75H71525R00002 |
| PROJECT_TITLE: Mid-Atlantic Service Unit Office Furniture |
| DoesNot: 0 |
| Does: Off |
File details come from the government source that posted it. Updated .