B03 Attachment 3 - SELF CERT BUY INDIAN ACT.pdf
PDF 48 KB Posted
- Attached to
- Dental Equipment
- Solicitation number
- 75H71326Q00068
About this file
This is an Indian Firm Representation Form required by the Indian Health Service (IHS) under the authority of the Buy Indian Act (25 U.S.C. 47) for solicitation number 75H71326Q00068 regarding Dental Equipment.
The form serves as a self-certification document that offerors must complete to demonstrate eligibility as an "Indian Firm" with "Indian Ownership" as defined under HHSAR 326.602 and 326.603. Offerors must certify their eligibility status at three critical points: at the time of offer submission, at contract award, and throughout the entire contract performance period. Any change in eligibility status during these periods requires immediate written notification to the Contracting Officer. The form requires the offeror to indicate whether it does or does not meet the Indian Firm definition, along with business name, DUNS number, certifying signature, and printed name. Contracting Officers may require supporting documentation of eligibility before making awards, and awards are subject to protest if the successful offeror's eligibility is questioned. Successful offerors must also maintain active registrations with Dun and Bradstreet (D&B) and the System of Award Management (SAM). The form includes warnings that false or misleading information constitutes violations under 18 U.S.C. 1001, while false claims during contract performance are subject to penalties under 31 U.S.C. 3729 to 3731 and 18 U.S.C. 287.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| B03 Attachment 1 - Schedule of Items SDVOSB.pdf | ||
| q_a.docx | DOCX document | |
| B03 Attachment 2 - Specs.docx | DOCX document | |
| B03 Attachment 1 - Schedule of Items.docx | DOCX document |
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Text version
DEPARTMENT OF HEALTH & HUMAN SERVICES
Indian Health Service
Division of Acquisition Policy (DAP) 5600 Fishers Lane
Rockville, MD 20857
INDIAN HEALTH SERVICE
BUY INDIAN ACT
INDIAN FIRM REPRESENTATION FORM
SOLICIATION NUMBER: _________________________________________________
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 Firm” (HHSAR 326.602) with “Indian Ownership” (HHSAR 326.603), in response to this solicitation and resultant contract.
The enterprise must meet the definition of “Indian Firm” 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 DUN and Bradstreet (D&B) and 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 Firm” with “Indian Ownership” under the authority of the Buy Indian Act.
Business Name Certifying Signature
DUNS Number Print Name
| SOLICITATION NUMBER: 75H71326Q00068 |
| PROJECT TITLE: Dental Equipment |
| DATE: |
| Business Name: |
| DUNS Number: |
| Print Name: |
| Check Box1: Off |
| Check Box2: Off |
File details come from the government source that posted it. Updated .