Attachment C - SF-1449 - Sol_75H71026Q00078.pdf

PDF 98 KB Posted Mar 3, 2026

Attached to: Gallup Indian Medical Center Emergency Department Medical Equipment and Supplies
Solicitation number: 75H71026Q00078
Issued by: Department of Health and Human Services Indian Health Service

About this file

Written by GovTribe AI · Mar 3, 2026

This is a Solicitation/Contract/Order for Commercial Items (Standard Form 1449) issued by Gallup Indian Medical Center for a 100% Indian-Owned Small Business Economic Enterprise (ISBEE) set-aside acquisition. The solicitation number is 75H71026Q00078, with a requisition number of IHS1520136. The offer due date is March 10, 2026 at 1000 hours Mountain Daylight Time, with an issue date of March 3, 2026. The contracting officer is Misty J. Billy, with information calls directed to Rodney Brown at 505-387-2717. The NAICS code is 339113 with a size standard of 800 employees. Delivery is required 30 days after award to Gallup Indian Medical Center, 1808 W. Aztec Avenue, Gallup, NM 87301.

The acquisition specifies that this is a Request for Proposal (RFP) for unrestricted competition with 100% of the contract set aside for Indian-Owned Small Business Economic Enterprises. All invoices must be submitted through www.ipp.gov in compliance with the electronic payment process established by the Department of Treasury. The contract incorporates by reference FAR 52.212-1, 52.212-4, FAR 52.212-3, and FAR 52.212-5. The specific supplies or services required are detailed in the Combined Synopsis/Solicitation document, which is referenced for complete details and instructions. Payment will be made by the method indicated in Block 18a, with remittance address shown in the referenced blocks.

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Other files

File	Type	Posted
Sol_75H71026Q00078_Amd_0001.pdf	PDF	Mar 9, 2026
Attachment A - Statement of Work.pdf	PDF	Mar 3, 2026
75H71026Q00078 - Combined Synopsis-Solicitation.pdf	PDF	Mar 3, 2026
Attachment B - Specifications.pdf	PDF	Mar 3, 2026

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SEE ADDENDUMIS CHECKED

CODE 18a. PAYMENT WILL BE MADE BY

CODE

FACILITYCODE

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

OFFEROR

51CODE 16. ADMINISTERED BYCODE

339113

SIZE STANDARD:

100.00 % FOR:SET ASIDE:UNRESTRICTED OR51

REQUEST FOR

PROPOSAL

(RFP)

INVITATION

FOR BID (IFB)

10. THIS ACQUISITION ISCODE

REQUEST FOR

QUOTE (RFQ)

14. METHOD OF SOLICITATION

13b. RATING

NORTH AMERICAN INDUSTRY

CLASSIFICATION STANDARD

(NAICS):

SMALL BUSINESS

03/10/2026 1000 MD

03/03/2026

505-387-2717RODNEY BROWN

(No collect calls)

INFORMATION CALL:

FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBER a. NAME

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

75H71026Q00078

5. SOLICITATION NUMBER

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF

1 2 IHS1520136OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

15. DELIVER TO

Gallup NM 87301

1808 W. Aztec Avenue

Acquisition Department

9. ISSUED BY

2. CONTRACT NO.

EFFECTIVE DATE

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW

ISSUE DATE

DELIVERY FOR FREE ON BOARD

(FOB) DESTINATION UNLESS

BLOCK IS MARKED

11.

SEE SCHEDULEX

12. DISCOUNT TERMS THIS CONTRACT IS A RATED

ORDER UNDER THE DEFENSE

PRIORITIES AND ALLOCATIONS

SYSTEM - DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

(SDVOSB)

HUBZONE SMALL

BUSINESS

8(A)

Gallup Indian Medical Center WOMEN-OWNED SMALL

BUSINESS (WOSB)

ECONOMICALLY DISADVANTAGED

WOMEN-OWNED SMALL

BUSINESS (EDWOSB)

Gallup NM 87301

1808 W. Aztec Ave

Gallup Indian Medical Center

Gallup NM 87301

1808 W. Aztec Avenue

Acquisition Department

Gallup Indian Medical Center

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

***100% Indian-Owned Small Business Economic Enterprise (ISBEE) Set-Aside***

This contract is subject to the electronic payment process by the Department of Treasury.

All invoices complying to the requirements at 52.212-4(g) must be submitted through www.ipp.gov. For additional information, refer to the incorporated clause at 352.232-71 Electronic Submission of Payment Requests (FEB 2022).

(Use Reverse and/or Attach Additional Sheets as Necessary)

HEREIN, IS ACCEPTED AS TO ITEMS:

DATED

MISTY J. BILLY

. YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ARE

31c. DATE SIGNED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print)

ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

27a. SOLICITATION INCORPORATES BY REFERENCE (FEDERAL ACQUISITION REGULATION) FAR 52.212-1, 52.212-4. FAR 52.212-3

AND 52.212-5 ARE ATTACHED. ADDENDA

26. TOTAL AWARD AMOUNT (For Government Use Only)

OFFER

STANDARD FORM 1449 (REV. 11/2021)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED.

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

30b. NAME AND TITLE OF SIGNER (Type or print)

30a. SIGNATURE OF OFFEROR/CONTRACTOR

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

25. ACCOUNTING AND APPROPRIATION DATA

29. AWARD OF CONTRACT: REFERENCE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

40. PAID BY39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER

37. CHECK NUMBER

FINALPARTIAL

36. PAYMENT

FINALPARTIAL

35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER33. SHIP NUMBER

COMPLETE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)

42b. RECEIVED AT (Location)

42a. RECEIVED BY (Print)

41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

STANDARD FORM 1449 (REV. 11/2021) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

Refer to the Combined Synopsis/Solicitation for details/instructions.

Delivery: 30 Days After Award

1 Refer to the Combined Synopsis/Solicitation for details/instructions.

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

2 2 of

File details come from the government source that posted it. Updated Mar 3, 2026.