B08_Attachment_2__IA_-_IEE_Representation_Form.pdf
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Indian Affairs Indian Economic Enterprise Representation Form
This is a self-certification form used by the Department of the Interior to verify that an offeror meets the definition of an "Indian Economic Enterprise" (IEE) as required under the Buy Indian Act (25 U.S.C. 47) and Department of the Interior Acquisition Regulation (DIAR) Part 1480. The form must be completed and submitted by enterprises seeking to compete for contract awards set aside under the Buy Indian Act provisions. Offerors are required to certify their IEE status at three critical points: when submitting an offer in response to a written solicitation, at the time of contract award, and during the full term of the contract. Contracting Officers retain the authority to request additional eligibility documentation at any point during the acquisition life-cycle, including during pre-award proposal evaluation.
The form requires offerors to provide the Solicitation/Sources Sought/RFI Number, Project Title, and Date of Form Submission, along with specific business information including the Name of the Federally Recognized Tribal Entity, Legal Business Name, Unique Entity ID (UEI), and the name of the 51% (or greater) owner of the IEE firm. The certifying official must sign and print their name on the form. The signature constitutes a legal self-certification that the enterprise meets all IEE requirements throughout the specified time periods. False or misleading information submitted with an offer is punishable 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.
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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:
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| Project Title: |
| Date: |
| Tribal Entity: |
| UEI: |
| Business Name: |
| Owner: |
| Name: |
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