B08_Attachment_DIAR_1452_280-4_IBEE_CERT_FORM.pdf

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Attached to
Minnesota Agency's Fuels Slip-On Pump For UTV
Solicitation number
140A0623Q0004
Issued by

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This document contains an Indian Owned Economic Enterprise Representation form and details of a related federal contract opportunity. The form requires the offeror to self-certify that they meet the definition of an Indian Owned Economic Enterprise as defined in federal regulations throughout the period from offer submission, through contract award, and during full contract performance. Any false or misleading information is a violation of law.

The related federal contract opportunity is solicitation number 140A0623Q0004 from the Department of the Interior Bureau of Indian Affairs Southern Plains Region to provide a Minnesota agency with a fuels slip-on pump for their UTV. Offerors must meet the definition of an Indian Owned Economic Enterprise to be considered for this set-aside opportunity. The solicitation includes details on the required product and the involved federal agency but does not specify pricing terms or response dates.

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Text version

UNITED STATES

DEPARTMENT OF THE INTERIOR

Indian Owned Economic Enterprise Representation

(FEB 2021)

Solicitation/Contract No.:

Project No./Project Title:

Date:

In accordance with 1452.280-4, INDIAN ECONOMIC ENTERPRISE REPRESENTATION, the signature below constitutes self-certification that the offeror meets the definition of “Indian Owned Economic Enterprise”, as defined in 1480.201, in response to the solicitation and resultant contract, in accordance with 25 USC 47 the Buy-Indian Act. The enterprise must meet the definition of “Indian-Owned Economic Enterprise” throughout the following time periods: (1) At the time an offer is made in response to a solicitation; (2) At the time of contract award; and (3) During the full term of the contract performance period. At any point during these time periods, if the contractor no longer meets the eligibility requirements, the contractor must provide immediate written notification to the Contracting Officer.

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

1452.280-4 INDIAN ECONOMIC ENTERPRISE REPRESENTATION (FEB 2021)

Prescription: 1480.801(a) Insert the following provision in each written solicitation for supplies, services, or covered construction.

Provision: The offeror represents as part of its offer that it does, does not meet the definition of Indian economic enterprise as defined in 1480.201.

(End of provision)

(Business Name) (Certifying Signature)

(DUNS No.) (Print Name)

SolicitationContract No: 140A0623Q0004
Project NoProject Title: Minnesota Agency Fuels Slip-on Unit
Date: 06/22/2023
Business Name:
DUNS No:
Print Name:
does: Off
doesnot: Off

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