Attachment_3_-_IEE_Representation_Form.pdf

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Attached to
PROPANE DELIVERY SERVICES FOR TRUXTON CANON AGENCY
Solicitation number
140A1126Q0029
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About this file

This is an Indian Affairs Indian Economic Enterprise Representation Form used to certify an offeror's eligibility as an Indian Economic Enterprise (IEE) under the Buy Indian Act (25 U.S.C. 47).

The form requires offerors to self-certify that they meet the IEE definition as outlined in the Department of the Interior Acquisition Regulation (DIAR) Part 1480. Certification must be valid at three critical points: when the offer is submitted in response to a solicitation, at the time of contract award, and throughout the full contract term. The form collects basic business information including the name of the federally recognized tribal entity affiliated with the firm, the legal business name, the Unique Entity ID (UEI), and the name of the 51% or greater owner of the IEE firm. An authorized representative must sign and print their name on the form. The document warns that false or misleading information submitted during the offer process violates 18 U.S.C. 1001 and is punishable by law. False claims submitted during contract performance are subject to penalties under 31 U.S.C. 3729 to 3731 and 18 U.S.C. 287. Contracting Officers retain the right to request additional documentation or information to verify eligibility at any point during the acquisition lifecycle, including during proposal evaluation.

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Sol_140A1126Q0029.pdf PDF
Attachment_1_-_Statement_of_Work.pdf PDF
Attachment_2_-_Pricing_Schedule.xlsx XLSX spreadsheet

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Text version

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:

(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:

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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