Buy Indian Act Form.pdf
PDF 182 KB Posted
- Attached to
- Video Laryngoscope
- Solicitation number
- IHS1515775
About this file
This document is an Indian Health Service (IHS) Buy Indian Act Indian Economic Enterprise Representation Form for a Sources Sought notice related to a Video Laryngoscope procurement. The form requires potential vendors to self-certify as an "Indian Economic Enterprise" under 25 U.S.C. 47, with eligibility requirements that must be maintained from offer submission through contract performance.
The associated Sources Sought notice (Solicitation Number IHS1515775) seeks to identify Indian Small Business Economic Enterprises (ISBEEs) capable of providing a video laryngoscope for airway management and bronchoscopy procedures. Interested parties must submit a detailed capability statement by 3:00 PM CST on August 7, 2025, to Jarrod Prince via email, including specific company information such as SAM UEI number, contact details, socioeconomic status, and complete the attached Buy Indian Act representation form. The procurement is being conducted by the Department of Health and Human Services Indian Health Service, with the goal of giving preference to Indian Economic Enterprises when practicable.
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Other files
| File | Type | Posted |
|---|---|---|
| Specifications.pdf | ||
| SS - Video Laryngoscope.pdf |
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Text version
DEPARTMENT OF HEALTH & HUMAN SERVICES
Indian Health Servic
Division of Acquisition Policy 5600 Fishers Lane
Rockville, MD 20857
INDIAN HEALTH SERVICE
BUY INDIAN ACT
IN
REPRESENTATION FORM
SOLICI ATION : _________________________________________________
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 ” (HHSAR 326.60 ) in response to this olicitation and resultant contract.
The enterprise must meet the definition of “Indian ” 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 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 ” with “Indian Ownership” under the authority of the Buy Indian Act.
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