Buy Indian Compliant Form IHS1503446.pdf
PDF 131 KB Posted
- Attached to
- Janitorial Supplies
- Solicitation number
- IHS1503446
About this file
This is a Buy Indian Act Indian Economic Enterprise Representation Form issued by the Indian Health Service (IHS), Department of Health and Human Services, for solicitation IHS1503446 regarding Janitorial Supplies. The form serves as a self-certification document for vendors to declare their status as an Indian Economic Enterprise under the Buy Indian Act (25 U.S.C. 47).
The form requires vendors to maintain Indian Economic Enterprise eligibility throughout three key periods: when submitting their offer, at contract award, and during the entire contract performance period. Vendors must notify the Contracting Officer immediately if they lose eligibility. The form requires specific details including the name of the 51% owner of the IEE firm, business name, UEI number, and the name of the Federally Recognized Tribal Entity. Vendors must be registered in the System for Award Management (SAM) and false certifications are subject to penalties under 18 U.S.C. 1001 and other relevant statutes. The form is part of a Sources Sought notice with responses due by 5:00 PM MST on November 21, 2024, with submissions limited to five pages and to be sent to karen.james@ihs.gov.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| SPECIFICATION -LIST F SUPPLIES.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
DEPARTMENT OF HEALTH & HUMAN SERVICES
Indian Health Service
Office of Management Services Division of Acquisition Policy (DAP)
5600 Fishers Lane Rockville, MD 20857
INDIAN HEALTH SERVICE
BUY INDIAN ACT
INDIAN ECONOMIC ENTERPRISE
REPRESENTATION FORM
SOLICITATION/SOURCES SOUGHT/RFI #: _________________________________________________
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 Economic Enterprise” (HHSAR 326.601) in response to this Sources Sought Notice, Request for Information (RFI) or Solicitation and resultant contract.
The enterprise must meet the definition of “Indian Economic Enterprise” 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 Economic Enterprise” with “Indian Ownership” under the authority of the Buy Indian Act.
Name of the 51% owner of IEE Firm
Certifying Signature
Print Name
Name of Federally Recognized Tribal Entity
Business Name
UEI Number
| DATE: NOVEMBER 13, 2024 |
| DUNSnumber: |
| BusinessName: |
| NameOfTribalEntity: |
| OwnerName: |
| PrintName: |
| SOLICITATION_NUMBER: IHS1503446 |
| PROJECT_TITLE: JANITORIAL SUPPLIES |
| DoesNot: 0 |
| Does: Off |
File details come from the government source that posted it. Updated .