Attachment_2_IEE_Reps.pdf

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Fort Peck JDC Fire Alarm System Upgrade
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140A1626Q0070
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This is the Indian Affairs Indian Economic Enterprise Representation Form, a self-certification document required for enterprises seeking to compete for contract awards set aside under the Buy Indian Act (25 U.S.C. 47). The form establishes eligibility requirements that must be met at three critical points: when an offer is submitted in response to a written solicitation, at the time of contract award, and throughout the full contract term. Contracting Officers retain the authority to request additional eligibility documentation at any point in the acquisition life-cycle, including during pre-award and proposal evaluation phases.

Offerors must complete the form by providing their Name of Federally Recognized Tribal Entity, Unique Entity ID (UEI), Legal Business Name, and the name of the 51% (or greater) owner of the Indian Economic Enterprise firm. By signing the form, the offeror self-certifies compliance with the definition of an "Indian Economic Enterprise" as established in Department of the Interior Acquisition Regulation (DIAR) Part 1480. The document warns that false or misleading information submitted in offers is punishable under 18 U.S.C. 1001, while false claims made during contract performance are subject to penalties under 31 U.S.C. 3729-3731 and 18 U.S.C. 287. The form requires the certifying signature and printed name of an authorized representative.

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

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

(3) During the full term of the contract.

Contracting Officers may require additional information or documentation of eligibility at any time in the acquisition life-cycle, including pre-award/proposal evaluation.

Any false or misleading information submitted by an enterprise when submitting an offer in consideration for an award set aside under the Buy Indian Act is a violation of the law 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.

Indian Affairs Indian Economic Enterprise Representation Form

Solicitation/Sources Sought/RFI Number:

Project Title:

Date of Form Submission:

In accordance with 25 U.S.C. 47 of the Buy Indian Act, the signature in the Offeror Section below constitutes self-certification that the Offeror meets the definition of an "Indian Economic Enterprise (IEE)" as defined in Department of the Interior Acquisition Regulation (DIAR) Part 1480 titled, "Acquisitions Under the Buy Indian Act."

The enterprise must meet the requirements of (i) through (iii) throughout the following time periods:

OFFEROR REPRESENTATION

By filling out the information below, the Offeror represents that it does meet the definition of an "Indian Economic Enterprise" as defined in DIAR Part 1480.

Name of Federally Recognized Tribal Entity:

Unique Entity ID (UEI):

Legal Business Name:

Name of the 51% (or greater) Owner of the IEE Firm:

Certifying Signature:

Printed Name:

Blank Page
R
Notice Number:
Project Title:
Date:
Tribal Entity:
UEI:
Business Name:
Owner:
Name:

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