BuyIndianRepresentation.pdf

This is Form 1452.280-4, the Indian Economic Enterprise Representation form (July 2013 version) used by the Department of the Interior to certify compliance with the Buy Indian Act. The form requires businesses to certify whether they meet the definition of an Indian economic enterprise (IEE), which requires: 1) at least 51% ownership by Indians or Indian Tribes, 2) majority of earnings going to Indians or Indian Tribes, and 3) management and daily operations controlled by Indians.

The form includes specific timing requirements, stating that enterprises must maintain IEE eligibility at the time of offer submission, contract award, and throughout the full contract term. It requires the business name, DUNS number, certifying signature, and printed name/title of the signer. This particular form appears to be associated with a truck rental solicitation (140A0925Q0002) for the Department of the Interior Bureau of Indian Affairs Navajo Region.