Buy Indian Act Form.pdf

PDF 182 KB Posted

Attached to
Ophthalmic Equipment Service Federal contract opportunity
Solicitation number
RFQ24626Q0013
Issued by
Department of Health and Human Services Indian Health Service

About this file

This is an Indian Economic Enterprise Representation Form used by the Indian Health Service (IHS) under the Buy Indian Act authority. The form serves as a self-certification document for offerors responding to IHS solicitations, including Sources Sought Notices, Requests for Information (RFI), and formal solicitations. Offerors must certify whether they meet the definition of an "Indian Economic Enterprise" with "Indian Ownership" as defined in EHSAR 326.601. The form requires completion of key fields including the solicitation/sources sought number, project title, date, name of the federally recognized tribal entity, name of the 51% owner of the Indian Economic Enterprise (IEE) firm, business name, UEI number, and a certifying signature with printed name.

Offerors must meet the Indian Economic Enterprise definition at three critical junctures: when submitting an offer, at the time of contract award, and throughout the entire contract performance period. Any loss of eligibility during these periods requires immediate written notification to the Contracting Officer. Contracting Officers may request documentation of eligibility before awarding set-aside or sole source contracts, and awards are subject to protest if the offeror's eligibility is questioned. Successful offerors must also maintain registration with the System of Award Management (SAM). False or misleading information carries severe penalties under 18 U.S.C. 1001, while false claims during contract performance are subject to penalties under 31 U.S.C. 3729-3731 and 18 U.S.C. 287.

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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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