CSS - EOY SUPPLIES.pdf

Combined Synopsis/Solicitation RFQ # IHS15146-53-61-87-95

This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Federal Acquisition Regulation (FAR) Subpart 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; quotes are being requested in response to this notice and a written solicitation will NOT be issued. This solicitation is being issued as a Request for Quote (RFQ) # IHS15146-53-61-87-95. Submit only written quotes for this RFQ. This solicitation is 100% ISBEE BUY INDIAN SET ASIDE. This solicitation document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular 2025-05. The associated NAICS codes are 339114, 322211.

This RFQ contains fifty (50) line items:

CLIN MFR # ITEM DESCRIPTION QTY U/M

UNIT

PRICE

TOTAL

05A0003 ‐

OR‐ 50227‐

1080‐5

MEPIVACAINE (POLOCAINE) HYDROCHLORIDE

3% INJECTION, 1.7 ML 50' S

40 BX/50

0002 0362‐0557‐05

MARCAINE BUPIVACAINE HCL 0.5% &

EPINEPHRINE 1:200,000 INJECTION BOX OF 50

75 BX/50

1875‐545

‐OR‐ 24680

APPLICATOR DISPOSABLE (DENTAL) FOR USE

WITH OPTI‐BOND, 200/PK

60 PK/200

2810083 ‐

OR‐

30049533

FLOSS WAXED DENTAL MEDIUM (J&J) 200

YARDS PER ROLL

25 RL/1

33122

‐OR‐ 5202

CANNULA, NASAL OXYGEN CANNULA CUSHION

TIP 7' (2.1M), CRUSH RESISTANT TUBING,

PEDIATRIC / STANDARD CONNECTOR, 50 PER

CASE

8 CA/50

70406306 ‐

OR‐

1042350

MIRROR, MOUTH, CONE SOCKET FRONT

SURFACE, GLASS, #4

18 BX/12

7070034 ‐

OR‐ 600010

PROPHY PASTE, ZOOBY, WITH XYLITOL, BOX OF

28 BX/100

4817‐549 ‐

OR‐ D002‐

009‐P

I‐PAK, 3‐IN‐1 INTRAORAL STERILE EXAM PAK,

INCLUDES DISPOSABLE MIRROR + PROBE +

EXPLORER, INDIVIDUALLY SEALED &

STERILIZED, 50/BX

60 BX/50

0009 1956

FINISHING STRIP WIDE FINE/ SUPERFINE GRIT,

120/BX

2 BX/120

0010 12627

SEALANT (CLINPRO), REFILL, CONTAINS 1‐1.2

ML SYRINGE, 10‐SEALANT SYRINGE TIPS, BLACK

50 EA/1

B07HT8DJN6

‐OR‐

CPB68

BAG, SHIPPING/MAILING, POLYETHYLENE, 10"

X 13", WHITE, SELF‐SEALING, 1000 COUNT

5 CT/1000

0012 USPP‐13812

BAG, SHIPPING/MAILING, POLYETHYLENE, 7.5"

X 10.5", WHITE, SELF‐SEALING, 1000 COUNT.

25 CT/1000

018264U0

‐OR‐

2811.31.033

BUR DIAMOND BARRELL, FRICTION GRIP, 5/PK 80 PK/5

6831025

‐OR‐

6713091

FILE ENDODONTIC, SIZE 010 25MM, READY

STEEL, FLEX‐O‐FILE, PRE‐STERILIZED, 6/BX

60 BX/6

6834025

‐OR‐

6713151

FILE ENDODONTIC, SIZE 040 25MM, READY

STEEL, FLEX‐O‐FILE, PRE‐STERILIZED, 6/BX

30 BX/6

812501‐

OFD755388

‐OR‐

812501‐ 5770212

BOTTLE SPRAY PLASTIC 32OZ W/ADJUSTABLE

SPRAY TRIGGER. BOTTLE MARKED ON 1 OR 2

OZ GRADATIONS.

12 EA/1

0017 8125004887952

BOTTLE SPRAY PLASTIC 16OZ W/ TRIGGER

SPRAY, ADJUSTABLE

15 EA/1

0018 1915A

BARRIER COVER FOR DIGITAL X‐RAY SENSOR

SLEEVE, 2‐1/2" X 10" , BOX OF 500

80 BX/500

4625315160

‐OR‐ 65702‐

0128‐10

STRIP, TEST PROTIME W/ON BOARD CONTROLS

(COAGUCHEK XS) 48 PER BOX.

40 BX/48

0020 1331

SLIDE MICROSCOPE GLASS 75 MM LENGTH X

25MM WIDTH, 72/BX

10 GR/144

0021 6230007813671

FLASHLIGHT, GENERAL SERVICE, USES 2 CELL

SIZE D BATTERIES.

25 EA/1

530‐060801

‐OR‐ 10‐

DETERGENT, EMPOWER DUAL ENZYMATIC

DETERGENT SOLUTION, BREEZE, 1 GALLON.

25 GA/1

0023 6815192

TENDERS, INFANT PRE‐TOOTHBRUSHES, SINGLE

FINGER SWABS GREEN OR YELLOW INDV.

WRAPPED 12/PK

25 PK/12

0024 370111

BRUSH BENDABLE TIP FINE ASST. COLORS, BOX

OF 144

4 BX/144

0025 6314397

SEPTOCAINE, CARTRIDGES 4% W/EPI

1:200,000, BOX OF 50

40 BX/50

0026 5700360

BENZOCAINE, STRAWBERRY BENZO‐JEL

TOPICAL ANESTHETIC GEL, 1 OZ/JR, BOTTLE.

50 BT/1

0027 1001350

BIB, (TIDI), PATIENT, PAPER, DISPOSABLE,

GREEN, 2PLY +POLY 13 X 18, PACK OF 500

60 PK/500

0028 3000031

COMPOSI‐TIGHT 3D SECTIONAL MATRICES 5.5

MM MOLAR, 100 PER PACK

5 PK/100

0029 3000027

COMPOSI‐TIGHT 3D SECTIONAL MATRICES 4.6

MM BICUSPID, PACK OF 100

4 PK/100

0030 2220239

FLUOROCORE 2+ CORE BUILDUP TOOTH

COLORED SYRINGE REFILL BOX OF 4

3 BX/4

0031 2260056

NEOMTA 2 CEMENT FILLING MATERIAL 2.5 GM,

ROOT & PULP TREATMENT MATERIAL, NON‐

STAINING BIOACTIVE BIOCERAMIC, KIT

2 KT/1

0032 1128757

WEDGE DENTAL WIZARD SMALL ANATOMICAL

NATURAL 400' S

5 BX/400

0033 1000934

TRAY COVER, PAPER, WHITE, STANDARD

WEIGHT 8‐1/2 X 12‐1/4", CARTON OF 1000

50 CT/1000

0034 5478310

POINTS, ENDODONTIC, ABSORBENT, MEDIUM,

CELL PACK, BOX OF 200

5 BX/200

0035 7776083

GLASS IONOMER LINER/BASE LIGHT CURE

(VITREBOND), W/9 G POWDER & 5.5 ML LIQUID

10 EA/1

0036 1005205

SALIVA EJECTOR DISP. VINYL FLEXIBLE, WHITE,

W/NON‐ CLOGGING TIP, 100' S

80 BG/100

0037 75021159

FINISHING STRIP, (SOF‐LEX), POLISHING,

NARROW COARSE/MEDIUM, LATEX FREE,

100/BOX

5 BX/100

0038 2220506

MATRIX BAND (AUTOMATRIX) REFILL, MEDIUM

THIN, BOX OF 72

4 BX/72

01A1400 ‐

OR‐

0362‐9049‐02

SEPTOCAINE, CARTRIDGES 4% W/EPI

1:100,000, 50/BX

250 BX/50

1012270

‐OR‐ 101‐

SUCTION TIPS, SURGICAL, WHITE ORAL

EVACUATOR, 6.5" LONG 1/8" SIZE, NOT

VENTED, DISPOSABLE, LATEX FREE, 25/PK

140 PK/25

08‐1644

‐OR‐

1125999

VARNISH, ACCLEAN FLUORIDE VARNISH CUPS

UNIT DOSE 5% NAF 0.5ML BUBBLEGUM, BOX

OF 200.

45 BX/200

0042 1126519

FLOSSER, ACCLEAN FLOSSER KIDS ASSORTED

SEA CREATURES, 3 FLOSSERS PER PACK AND 48

PACKS PER BOX

115 BX/48

2883203 ‐

OR‐ ASC‐S‐

LAC2

TRAY MINOR LACERATION REPAIR SET STERILE 12 CA/20

87‐

AF5140MBEA

RESUSCITATION BAG ADULT, MANUAL

CUSHIONED MASK OXYGEN RESERVIOR

DISPOSABLE (VENTLAB)

8 CA/10

083‐0281

‐OR‐

4000006

AMALGAM, ADMIX ALLOY CAPSULES, REGULAR

SET, BLACK/GRAY, 2 SPILL, 600MG, PACK OF 50

4 PK/50

0046 306200

CATHETER, PROTECTIV PLUS PERIPHERAL

SAFETY IV CATHETERS W/ WINGED HUB, 16G X

1‐1/4", POLYURETHANE, CA/200

3 CA/200

7774272 ‐

OR‐ 2382C

FINISHING DISC 1/2" EXTRA THIN COARSE GRIT

SOF‐LEX POP‐ON, LATEX FREE, 85

3 BX/85

0048 L200‐1

LOOPS INOCULATING CLEAR OR BLUE, 1 UL,

POLYSTRENE, DISPOSABLE, 25/PK.

2 CA/1000

0049 PIL44102

MARKER LAB BLACK EXTRA FINE POINT FIBER

TIP WATER RESISTANT, PK/12.

20 PK/12

0050 4599P‐1

ARTERIAL BLOOD GAS SAMPLING KIT 23GAX1"

NEEDLE PRO SAFETY DEVICE IODOPHOR PAD,

2X2 GAUZE, PATIENT LABEL, POLYBAG

PACKAGING

2 CA/100

PERIOD OF PERFORMANCE: 30 days from the receipt of the award

The estimated value of the Purchase Order is $87,000.00.

Vendor Requirements: SEE ATTACHED STATEMENT OF WORK SPECIFICATIONS

Submit Quotes no later than: 09/05/2025 04:30 PM. CDT to the Following Point of Contact:

Carlene Prince, Contract Specialist, via email: carlene.prince@ihs.gov.

Evaluation: FAR 52.212-2 Evaluation -- Commercial Items (completed as follows):

(a) The Government will award a firm fixed price contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be most advantageous to the Government, with the technical requirements and delivery time being more important than pricing.

The following factors shall be used to evaluate offers:

Best Value (see criteria below)

Technical

- Vendor shall provide the instruments as outlined in the item listing with specified unit of measure. All items shall be brand new. Vendors submitting like or equal items must submit photograph with descriptive literature showing how their product meets or exceeds the requirements being solicited.

- Vendor shall provide readily available customer support representative via phone or email with a response time of 8 hours or less.

- Vendor shall provide a warranty for one year from the date of the invoice on products when given normal, proper, and intended usage.

- Vendor shall have the ability to deliver products within 30 days from the receipt of the award to the National Supply Service Center Distribution Facility at 501 NE 122nd Street, Suite F in Oklahoma City, OK 73114 with all installation instructions, warranty documents, and specifications.

- Vendor shall provide one designated point of contact (POC) to the government’s designated representative for coordination of supplies, delivery, and/or maintenance. The POC will be empowered to make daily decisions to ensure that the contract implementation and day-to-day maintenance meet the terms and conditions of this contract.

- Vendor shall provide a toll-free number for service calls, which must be answered during at least eight (8) working hours, between 7 AM and 3:30 PM, Monday through Friday.

- Vendor shall provide required personnel, materials, supplies, and equipment required to perform work under this contract, including but not limited to equipment and shipping.

Delivery

- Vendor shall provide the instruments as outlined in the item listing within 30 days from the receipt of the award to the National Supply Service Center Distribution Facility at 501 NE 122nd Street, Suite F in Oklahoma City, OK 73114 with all installation instructions, warranty documents, and specifications.

Pricing

- Pricing will be evaluated according to the cumulative price by ranking from lowest to highest.

REQUIRED FEATURES

Items must be acceptable under 52.225-1, Buy American Act—Supplies (OCT 2022) and 52.225- 3, Buy American-Free Trade Agreement-Israeli Act (NOV 2023).

VENDORS SHALL SUBMIT THE FOLLOWING:

- COMPLETED PRICE LIST AND UNIT OF MEASURE FOR EACH ITEM OUTLINED IN

THE ITEM LISTING

- TECHNICAL SPECIFICATIONS FOR EACH ITEM

- ESTIMATED DELIVERY DATE

- WARRANTY INFORMATION

- Combined Synopsis/Solicitation: BUY INDIAN SET-ASIDE EOY SUPPLIES FOR NSSC

- INDIAN ECONOMIC ENTERPRISE FORM

VENDORS SUBMITTING LIKE OR EQUAL ITEMS MUST SUBMIT PHOTO WITH DESCRIPTIVE

LITERATURE SHOWING HOW THEIR PRODUCT MEETS OR EXCEEDS THE

REQUIREMENTS BEING SOLICITED.

This solicitation will result in a firm fixed price purchase order pursuant to the terms and conditions below. Terms and conditions other than those stated will not be accepted. The above pricing is all inclusive.

PROVISIONS: The following FAR provisions apply to this solicitation:

FAR 52.252-1, Solicitation Provisions Incorporated by Reference. (FEB 1998).

This solicitation incorporates one or more solicitation provisions by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. The offeror is cautioned that the listed provisions may include blocks that must be completed by the offeror and submitted with its quotation or offer. In lieu of submitting the full text of those provisions, the offeror may identify the provision by paragraph identifier and provide the appropriate information with its quotation or offer. Also, the full text of a solicitation provision may be accessed electronically at this/these address(es):

https://www.acquisition.gov/browse/index/far and https://www.acquisition.gov/hhsar

FAR 52.204-7, System for Award Management (Nov 2024);

FAR 52.204-16, Commercial and Government Entity Code Reporting (Aug 2020);

FAR 52.204-22, Alternative Line-Item Proposal (Jan 2017);

FAR 52.204-24, Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (Nov 2021);

FAR 52.204-29, Federal Acquisition Supply Chain Security Act Orders-Representation and Disclosures (Dec 2023);

FAR 52.211-6, Brand name or equal to (Aug 1999) FAR 52.252-3, Alterations in Solicitation (Apr 1984) FAR 52.252-6, Authorized Deviations in Clauses (Nov 2020);

HHSAR 352.226-4, Notice of Indian Small Business Economic Enterprise set-aside;

HHSAR 352.226-5, Notice of Indian Economic Enterprise set-aside;

HHSAR 352.226-7, Indian Economic Enterprise Representation;

HHSAR 352.239-78, Information and Communication Technology Accessibility Notice. (Deviation)

(FEB 2024)

(a) Any offeror responding to this solicitation must comply with established HHS Information and Communication Technology (ICT) accessibility standards. Information about Section 508 is available at https://www.hhs.gov/web/section-508/index.html.

(b) The Section 508 accessibility standards applicable to this solicitation are stated in the clause at 352.239-79 Information and Communication Technology Accessibility. In order to facilitate the Government’s determination whether proposed ICT supplies, products, platforms, information, and documentation meet applicable Section 508 accessibility standards, offerors must submit an appropriate HHS Section 508 Accessibility Conformance Checklist (see https://www.hhs.gov/web/section-508/accessibilitychecklists/index.html) or an Accessibility Conformance Report (ACR) (based on the Voluntary Product Accessibility Template (VPAT) see https://www.itic.org/policy/accessibility/vpat), in accordance with the completion instructions. The purpose of the checklists and conformance reports are to assist HHS acquisition and program officials in determining whether proposed ICT supplies, products, platforms, information, and documentation conform to applicable Section 508 accessibility standards. Checklists and ACRs evaluate—in detail—whether the ICT conforms to specific Section 508 accessibility standards and identifies remediation efforts needed to address conformance issues.

(c) If an offeror claims its supplies or services meet applicable Section 508 accessibility standards, and it is later determined by the Government, i.e., after award of a contract or order, that supplies, products, platforms, information, documentation, or services support delivered do not conform to the described accessibility standards, remediation of the supplies, products, platforms, information, documentation, or services support to the level of conformance specified in the contract will be the responsibility of the Contractor at its expense.

(d) In order to facilitate the Government's determination whether proposed ICT supplies meet applicable Section 508 accessibility standards, offerors must submit an Accessibility Conformance Report, in accordance with its completion instructions and tailored to the requirements in the solicitation. The purpose of the Report is to assist HHS acquisition and program officials in determining whether proposed ICT supplies conform to applicable Section 508 accessibility standards. The template allows offerors or developers to self-evaluate their supplies and document, in detail, whether they conform to a specific Section 508 accessibility standard, and any underway remediation efforts addressing conformance issues. Instructions for preparing the HHS Section 508 Evaluation Template are available at https://Section508.gov/.

(e) In order to facilitate the Government's determination whether proposed ICT services meet applicable Section 508 accessibility standards, offerors must provide enough information to assist the Government in determining that the ICT services conform to Section 508 accessibility standards, including any underway remediation efforts addressing conformance issues.

(f) Respondents to this solicitation must identify any inability to conform to Section 508 requirements. If an offeror claims its supplies or services meet applicable Section 508 accessibility standards, and it is later determined by the Government, i.e., after award of a contract or order, that supplies or services delivered do not conform to the described accessibility standards, remediation of the supplies or services to the level of conformance specified in the contract will be the responsibility of the Contractor at its expense.

(g) Items delivered as electronic content must be accessible to HHS acceptance criteria. Checklist for various formats are available at http://508.hhs.gov/. Materials, other than items incidental to contract management, that are final items for delivery should be accompanied by the appropriate checklist, except upon approval of the Contracting Officer or Contracting Officer’s Representative.

(the offeror should include a completed copy of these provisions with their quote).

CLAUSES: The following FAR clauses apply to this solicitation:

FAR 52.252-2, Clauses Incorporated by Reference (FEB 1998). This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es):

https://www.acquisition.gov/browse/index/far and https://www.acquisition.gov/hhsar

FAR 52.203-17, Contractor Employee Whistleblower Rights (Nov 2023);

FAR 52.204-10, Reporting Executive Compensation and First-Tier Subcontract Awards (Jun 2020);

FAR 52.204-13, System for Award Management Maintenance (Oct 2018);

FAR 52.204-18, Commercial and Government Entity Code Maintenance (Aug 2020);

FAR 52.204-19, Incorporation by Reference of Representations and Certifications (Dec 2014);

FAR 52.204-27, Prohibition on a ByteDance Covered Application (Jun 2023);

FAR 52.209-9, Updates of Publicly Available Information Regarding Responsibility Matters (Oct 2018);

FAR 52.212-4, Contract Terms and Conditions-Commercial Products and Commercial Services (Nov 2023);

FAR 52.212-5, Contract Terms and Conditions Required to Implement Statues or Executive Orders-Commercial Products and Commercial Services (Jan 2025)(DEVIATION FEB 2025);

FAR 52.217-8, Option to Extend Services (Nov 1999);

FAR 52.217-9, Option to Extend the Term of the Contract (MAR 2000);

FAR 52.219-6, Notice of Total Small Business Set-Aside (Nov 2020) FAR 52.219-14, Limitations on Subcontracting (Oct 2022);

FAR 52.219-28, Post Award Small Business Program Rerepresentation (Feb 2024);

FAR 52.219-33, Nonmanufacturer Rule (Sep 2021);

FAR 52.222-3, Convict Labor (JUN 2003);

FAR 52.222-35, Equal Opportunity for Veterans (Jun 2020);

FAR 52.222-36, Equal Opportunity for Workers with Disabilities (JUN 2020);

FAR 52.222-37, Employment Reports on Veterans (Jun 2020);

FAR 52.222-50, Combating Trafficking in Persons (Nov 2021);

FAR 52.223-20, Aerosols (May 2024);

FAR 52.223-23, Sustainable Products and Services (May 2024)(Deviation Feb 2025);

FAR 52.225-13, Restrictions of Certain Foreign Purchases (FEB 2021);

FAR 52.226-8, Encouraging Contractor Policies to Ban text Messaging While Driving (MAY 2024);

FAR 52.232-33, Payment by Electronic Funds Transfer- System for Award Management (Oct 2018);

FAR 52.240-1, Prohibition on Unmanned Aircraft Systems Manufactured or Assembled by American Security Drone Act-Covered Entities (Nov 2024);

FAR 52.222-51, Exemption from Application of the Service Contract Labor Standards to Contract for Maintenance, Calibration, or Repair of Certain Equipment-Requirements (MAY 2014) FAR 52.222-53, Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services-Requirements (MAY 2014);

FAR 52.252-4, Alterations in Contracts (Apr 1984):

HHSAR CLAUSES:

HHSAR 352.223-70, Safety and Health (Dec 2015);

HHSAR 352.226-1, Indian Preference (Dec 2015);

HHSAR 352.226-6, Indian Economic Enterprise Subcontracting Limitations;

HHSAR 352.232-71, Electronic submission of payment requests (FEB 2022);

HHSAR 352.239-79, Information and Communication Technology Accessibility (Feb 2024)

“System updates may lag policy updates. The System for Award Management (SAM) may continue to require entities to complete representations based on provisions that are not included in agency solicitations. Examples include 52.222- 25, Affirmative Action Compliance, and paragraph (d) of 52.212-3, Offeror Representations and Certifications—Commercial Products and Commercial Services. Contracting officers will not consider these representations when making award decisions or enforce requirements. Entities are not required to, nor are they able to, update their entity registration to remove these representations in SAM.”

Miscellaneous:

NO FAX QUOTATIONS

ELECTRONIC SUBMISSIONS – SUBMISSION VIA EMAIL IS THE ONLY ACCEPTABLE

ELECTRONIC SUBMISSION. (carlene.prince@ihs.gov)

All contractors must be registered in the System for Award Management database located at https://www.sam.gov/sam/ prior to any contract award. Please submit the following information with each quote: Vendor Name, Cage Code, DUNS number, Tax Identification Number, Prompt Payment Terms, Delivery Time, GSA Contract Number (if applicable), Date quote expires, warranty, total price for each line item, total quote price, and technical documentation in sufficient detail to determine technical acceptability. Failure to provide sufficient technical detail may result in rejection of your quote.

Department of Health and Human Services Indian Health Service

National Supply Service Center (NSSC)

Specifications Dental Supplies

1. PURPOSE OF THE PROJECT

The National Supply Service Center (NSSC), Indian Health Services (IHS), has a need for specialized dental supplies. This will allow them to provide dental care for Native Americans and Alaskan Natives. The quality of equipment and instruments impacts the delivery of the highest quality of patient dental care.

2. DETAILED DESCRIPTION OF THE TECHNICAL REQUIREMENTS

The contractor shall provide the following, as listed:

Quantity Unit Catalog Number Description 25 Pk/12 6815192 TENDERS, INFANT PRE-TOOTHBRUSHES 4 Bx/144 370111 BRUSH BENDABLE TIP FINE ASST. CO 40 Bx/50 631-4397 SEPTOCAINE, CARTRIDGES 4% W/EPI 50 Bt/1 5700360 BENZOCAINE, STRAWBERRY BENZO-JEL 60 Pk/500 1001350 BIB, (TIDI), PATIENT, PAPER, DIS 5 Pk/100 3000031 COMPOSI-TIGHT 3D SECTIONAL MATRI 4 Pk/100 3000027 COMPOSI-TIGHT 3D SECTIONAL MATRI 3 Bx/4 2220239 FLUOROCORE 2+ CORE BUILDUP TOOTH 2 Kt/1 2260056 NEOMTA 2 CEMENT FILLING MATERIAL 5 Bx/400 1128757 WEDGE DENTAL WIZARD SMALL ANATOM 50 Ct/1000 1000934 TRAY COVER, PAPER, WHITE, STANDA 5 Bx/200 5478310 POINTS, ENDODONTIC, ABSORBENT, M 10 Ea/1 7776083 GLASS IONOMER LINER/BASE LIGHT C 80 Bg/100 1005205 SALIVA EJECTOR DISP. VINYL FLEXI 5 Bx/100 75021159 FINISHING STRIP, (SOF-LEX), POLI 4 Bx/72 2220506 MATRIX BAND (AUTOMATRIX) REFILL 80 Pk/5 018264U0 BUR DIAMOND BARRELL, FRICTION GR 60 Bx/6 6831025 FILE ENDODONTIC, SIZE 010 25MM 30 Bx/6 6834025 FILE ENDODONTIC, SIZE 040 25MM 12 Ea/1 812501-OFD755388 BOTTLE SPRAY PLASTIC 32 OZ W/ADJU 15 Ea/1 8125004887952 BOTTLE SPRAY PLASTIC 16 OZ W/TRIG 80 Box/500 1915A BARRIER COVER FOR DIGITAL X-RAY 40 Box/48 4625315160 STRIP, TEST PROTIME W/ ON BOARD 10 Gr/144 1331 SLIDE MICROSCOPE GLASS 75 MM LEN 25 Ea/1 6230007813671 FLAHSLIGH, GENERAL SERVICE, USES 25 Ga/1 530-060801 DETERGENT, EMPOWER DUAL ENZYMATIC

250 BX/50 01A1400 SEPTOCAINE, CARTRIDGES 4% W/EPI

140 PK/25 1012270 SUCTION TIPS, SURGICAL, WHITE OR

45 BX/200 08-1644 VARNISH, ACCLEAN FLUORIDE VARNIS

115 BX/48 1126519 FLOSSER, ACCLEAN FLOSSER KIDS AS

12 CA/20 2883203 TRAY MINOR LACERATION REPAIR SET

8 CA/10 87-AF5140MBEA RESUSCITATION BAG ADULT, MANUAL

4 PK/50 083-0281 AMALGAM, ADMIX ALLOY CAPSULES, R

3 CA/200 306200 CATHETER, PROTECTIV PLUS PERIPHE

National Supply Service Center (NSSC)

3 BX/85 7774272 FINISHING DISC ½” EXTRA THIN C

2 CA/1000 L200-1-LOOP LOOPS INOCULATING CLEAR OR BLUE

20 PK/12 PIL44102 MARKER LAB BLACK EXTRA FINE POIN

2 CA/100 4599P-1 ARTERIAL BLOOD GAS SAMPLING KIT

40 BX/50 05A0003 MEPIVACAINE (POLOCAINE) HYDROCHL

75 BX/50 0362-0557-05 MARCAINE BUPIVACAINE HCL 0.5%

60 PK/200 1875-545 APPLICATOR DISPOSABLE (DENTAL)

25 RL/1 2810083 FLOSS WAXED DENTAL MEDIUM (J&J)

8 CA/50 33122 CANNUAL, NASAL OXYGEN CANNULA

10 CS/1000 303390 IV NEEDLELESS CANNULA TWINPACK

18 BX/12 70406306 MIRROR, MOUTH, CONE SOCKET FRONT

28 BX/100 7070034 PROPHY PASTE, ZOOBY, WITH XYLITO

60 BX/50 4817-549 I-PAK, 3-IN-1 INTRAORAL STERILE

2 BX/120 1956 FINISHING STRIP WIDE FINE/SUPER

50 EA/1 12627 SEALANT (CLINPRO), REFILL, CONTA

5 CT/1000 B07HT8DJN6 BAG, SHIPPING/MAILING, POLYETHYL

25 CT/1000 USPP-13812 BAG, SHIPPING/MAILING, POLYETHYL

3. PERIOD OF PERFORMANCE

30 days from the date of the award

4. LEVEL OF EFFORT

4.1. The contractor shall provide the instruments as outlined in the Technical Requirements. Substitutes or comparable products will be accepted if the items meet or exceed the technical requirements being requested.

4.2. The contractor shall provide customer support with a representative readily available.

4.3. The contractor shall provide a warranty for one year from the date of invoice on products when given normal, proper, and intended usage.

4.4. The contractor shall deliver to the National Supply Service Center, Distribution Center, at 501 NE 122nd Street, Suite F, Oklahoma City, OK 73114, with all installation instructions, warranty documents, and specifications.

5. SPECIAL REQUIREMENTS

5.1. In accordance with HHSAR 304.1303, To ensure compliance with Homeland Security Presidential Directive-12: Policy for a Common Identification Standard for Federal Employees and Contractors (HSPD-12) It is the IHS policy that all staff and contractors who require physical access to federally controlled facilities and logical access to the IHS Information Technology (IT) networks and systems must obtain an HSPD-12-compliant access card. Individuals will be issued an access card upon meeting the HSPD-12 requirements and a favorable background investigation.

5.2. The US PHS National Supply Service Center (NSSC) is a tobacco/smoke-free environment (buildings and grounds). No tobacco/smoking use will be tolerated during service.

National Supply Service Center (NSSC)

5.3. Security Requirements: Contractor personnel will be required to contact the government-designated point of contact upon arrival when reporting for service calls or delivery supplies. The contractor shall be responsible for the security of all organizational information. Current rules and regulations applicable to the premises, where the work shall be performed, shall apply to the contractor and its employees while working on the premises. These regulations include, but are not limited to, escort by National Supply Service Center (NSSC) officials, presenting valid identification, smoking restriction, and any safety procedures.

5.4. The contractor shall not disclose or cause to disseminate any information concerning the operations of the National Supply Service Center (NSSC). Such action(s) could result in a violation of the contract and possible legal actions.

5.4.1. All inquiries, comments, or complaints arising from any matter observed, experienced, or learned of as a result of or in connection with the performance of the contract, the resolution of which may require the dissemination of official information, shall be directed to the government’s designated representative.

5.5. Termination Amortization Schedule: A termination amortization schedule shall be included as an attachment to the awarded contract. If the Government does not exercise any of the options listed in the price/cost schedule, the Government’s not exercising the options will have the same effect as if the Government terminated for convenience. All remedies afforded to the contractor in regard to a termination for convenience shall be available to the contractor.

6. DELIVERABLES AND REPORTING REQUIREMENTS

6.1. Delivery: The contractor will coordinate the delivery, installation, and training date with the designated government employee. The government will provide the contractor with dock access and building access for this sole purpose. The designated government employee will work with the pertinent government agency(ies) to secure the needed dock access. No deliveries can be made after 3:15 pm. Driver needs a valid ID.

6.2. Contractor Point of Contact: The contractor shall furnish one designated point of contact (POC) to the government’s designated representative for coordination of supplies, delivery, and/or maintenance.

The POC will be empowered to make daily decisions to ensure that the contract implementation and day-to-day maintenance meet the terms and conditions of this contract.

6.3. Contractor’s Phone Numbers: The contractor shall provide a toll-free telephone number for service calls, which must be answered during at least eight working hours, between 7:00 am and 3:30 pm, Monday through Friday.

7. GOVERNMENT-FURNISHED PROPERTY, FACILITIES, AND SERVICES

7.1. The Government shall make no supply of property, facilities, and services.

National Supply Service Center (NSSC)

8. CONTRACTOR FURNISHED PROPERTY, FACILITIES, AND SERVICES

8.1. Required personnel, materials, supplies, and equipment: The contractor shall furnish all personnel, materials, supplies, and equipment required to perform work under the contract, including but not limited to equipment and shipping.

9. CHANGES TO THE SPECIFICATIONS

Any changes to these specifications shall be authorized and approved only through written correspondence from the Contracting Officer. Costs incurred by the contractor through the actions of parties other than the Contracting Officer shall be borne by the contractor.

10. DELIVERABLES/PERFORMANCE MATRIX

10.1. Did the vendor provide supplies in a timely manner: YES or NO

Program Manager Signature:________________________ Timothy A.

Cardenaz -S

Digitally signed by Timothy A. Cardenaz -S Date: 2025.08.20 14:15:00 -05'00'

LINE QUANTITY UNIT OF

MEASURE MFR # ITEM DESCRIPTION

1 40 BX/50

05A0003

-OR-

50227-1080-

MEPIVACAINE (POLOCAINE)

HYDROCHLORIDE 3% INJECTION, 1.7 ML 50'

S

2 75 BX/50 0362-0557-

MARCAINE BUPIVACAINE HCL 0.5% &

EPINEPHRINE 1:200,000 INJECTION BOX OF

3 60 PK/200

1875-545

-OR-

24680

APPLICATOR DISPOSABLE (DENTAL) FOR

USE WITH OPTI-BOND, 200/PK

4 25 RL/1

2810083

-OR-

30049533

FLOSS WAXED DENTAL MEDIUM (J&J) 200

YARDS PER ROLL

5 8 CA/50

33122

-OR-

CANNULA, NASAL OXYGEN CANNULA

CUSHION TIP 7' (2.1M), CRUSH RESISTANT

TUBING, PEDIATRIC / STANDARD

CONNECTOR, 50 PER CASE

6 18 BX/12

70406306

-OR-

1042350

MIRROR, MOUTH, CONE SOCKET FRONT

SURFACE, GLASS, #4

7 28 BX/100

7070034

-OR-

600010

PROPHY PASTE, ZOOBY, WITH XYLITOL, BOX

OF 100

8 60 BX/50

4817-549

-OR-

D002-009-P

I-PAK, 3-IN-1 INTRAORAL STERILE EXAM

PAK, INCLUDES DISPOSABLE MIRROR +

PROBE + EXPLORER, INDIVIDUALLY SEALED

& STERILIZED, 50/BX

9 2 BX/120 1956 FINISHING STRIP WIDE FINE/ SUPERFINE

GRIT, 120/BX

10 50 EA/1 12627

SEALANT (CLINPRO), REFILL, CONTAINS 1-

1.2 ML SYRINGE, 10-SEALANT SYRINGE TIPS,

BLACK

11 5 CT/1000

B07HT8DJN6

-OR-

CPB68

BAG, SHIPPING/MAILING, POLYETHYLENE,

10" X 13" , WHITE, SELF-SEALING, 1000

COUNT

12 25 CT/1000 USPP-13812

BAG, SHIPPING/MAILING, POLYETHYLENE,

7.5" X 10.5" , WHITE, SELF-SEALING, 1000

COUNT.

13 80 PK/5

018264U0

-OR-

2811.31.033

BUR DIAMOND BARRELL, FRICTION GRIP,

5/PK

14 60 BX/6

6831025

-OR-

6713091

FILE ENDODONTIC, SIZE 010 25MM, READY

STEEL, FLEX-O-FILE, PRE-STERILIZED, 6/BX

15 30 BX/6

6834025

-OR-

6713151

FILE ENDODONTIC, SIZE 040 25MM, READY

STEEL, FLEX-O-FILE, PRE-STERILIZED, 6/BX

16 12 EA/1

812501-

OFD755388

-OR-

812501- 5770212

BOTTLE SPRAY PLASTIC 32OZ

W/ADJUSTABLE SPRAY TRIGGER. BOTTLE

MARKED ON 1 OR 2 OZ GRADATIONS.

17 15 EA/1 8125004887

BOTTLE SPRAY PLASTIC 16OZ W/ TRIGGER

SPRAY, ADJUSTABLE

18 80 BX/500 1915A BARRIER COVER FOR DIGITAL X-RAY SENSOR

SLEEVE, 2-1/2" X 10" , BOX OF 500

19 40 BX/48

4625315160

-OR-

65702-0128-

STRIP, TEST PROTIME W/ON BOARD

CONTROLS (COAGUCHEK XS) 48 PER BOX.

20 10 GR/144 1331 SLIDE MICROSCOPE GLASS 75 MM LENGTH

X 25MM WIDTH, 72/BX

21 25 EA/1 6230007813

FLASHLIGHT,GENERAL SERVICE, USES 2 CELL

SIZE D BATTERIES.

22 25 GA/1

530-060801

-OR-

10-4100

DETERGENT, EMPOWER DUAL ENZYMATIC

DETERGENT SOLUTION, BREEZE, 1 GALLON.

23 25 PK/12 6815192

TENDERS, INFANT PRE-TOOTHBRUSHES,

SINGLE FINGER SWABS GREEN OR YELLOW

INDV. WRAPPED 12/PK

24 4 BX/144 370111 BRUSH BENDABLE TIP FINE ASST. COLORS,

BOX OF 144

25 40 BX/50 6314397 SEPTOCAINE, CARTRIDGES 4% W/EPI

1:200,000, BOX OF 50

26 50 BT/1 5700360 BENZOCAINE, STRAWBERRY BENZO-JEL

TOPICAL ANESTHETIC GEL, 1 OZ/JR, BOTTLE.

27 60 PK/500 1001350 BIB, (TIDI), PATIENT, PAPER, DISPOSABLE,

GREEN, 2PLY +POLY 13 X 18, PACK OF 500

28 5 PK/100 3000031 COMPOSI-TIGHT 3D SECTIONAL MATRICES

5.5 MM MOLAR, 100 PER PACK

29 4 PK/100 3000027 COMPOSI-TIGHT 3D SECTIONAL MATRICES

4.6 MM BICUSPID, PACK OF 100

30 3 BX/4 2220239 FLUOROCORE 2+ CORE BUILDUP TOOTH

COLORED SYRINGE REFILL BOX OF 4

31 2 KT/1 2260056

NEOMTA 2 CEMENT FILLING MATERIAL 2.5

GM, ROOT & PULP TREATMENT MATERIAL,

NON-STAINING BIOACTIVE BIOCERAMIC, KIT

32 5 BX/400 1128757 WEDGE DENTAL WIZARD SMALL

ANATOMICAL NATURAL 400' S

33 50 CT/1000 1000934 TRAY COVER, PAPER, WHITE, STANDARD

WEIGHT 8-1/2 X 12-1/4" , CARTON OF 1000

34 5 BX/200 5478310 POINTS, ENDODONTIC, ABSORBENT,

MEDIUM, CELL PACK, BOX OF 200

35 10 EA/1 7776083

GLASS IONOMER LINER/BASE LIGHT CURE

(VITREBOND), W/9 G POWDER & 5.5 ML

LIQUID

36 80 BG/100 1005205 SALIVA EJECTOR DISP. VINYL FLEXIBLE,

WHITE, W/NON- CLOGGING TIP, 100' S

37 5 BX/100 75021159

FINISHING STRIP, (SOF-LEX), POLISHING,

NARROW COARSE/MEDIUM, LATEX FREE,

100/BOX

38 4 BX/72 2220506 MATRIX BAND (AUTOMATRIX) REFILL,

MEDIUM THIN, BOX OF 72

39 250 BX/50

01A1400

-OR-

0362-9049-

SEPTOCAINE, CARTRIDGES 4% W/EPI

1:100,000, 50/BX

40 140 PK/25

1012270

-OR-

101-2270

SUCTION TIPS, SURGICAL, WHITE ORAL

EVACUATOR, 6.5" LONG 1/8" SIZE, NOT

VENTED, DISPOSABLE, LATEX FREE, 25/PK

41 45 BX/200

08-1644

-OR-

1125999

VARNISH, ACCLEAN FLUORIDE VARNISH

CUPS UNIT DOSE 5% NAF 0.5ML

BUBBLEGUM, BOX OF 200.

42 115 BX/48 1126519

FLOSSER, ACCLEAN FLOSSER KIDS ASSORTED

SEA CREATURES, 3 FLOSSERS PER PACK AND

48 PACKS PER BOX

43 12 CA/20

2883203

-OR-

ASC-S-LAC2

TRAY MINOR LACERATION REPAIR SET

STERILE

44 8 CA/10 87-

AF5140MBEA

RESUSCITATION BAG ADULT, MANUAL

CUSHIONED MASK OXYGEN RESERVIOR

DISPOSABLE (VENTLAB)

45 4 PK/50

083-0281

-OR-

4000006

AMALGAM, ADMIX ALLOY CAPSULES,

REGULAR SET, BLACK/GRAY, 2 SPILL,

600MG, PACK OF 50

46 3 CA/200 306200

CATHETER, PROTECTIV PLUS PERIPHERAL

SAFETY IV CATHETERS W/ WINGED HUB,

16G X 1-1/4" , POLYURETHANE, CA/200

47 3 BX/85

7774272

-OR-

2382C

FINISHING DISC 1/2" EXTRA THIN COARSE

GRIT SOF-LEX POP-ON, LATEX FREE, 85

48 2 CA/1000 L200-1 LOOPS INOCULATING CLEAR OR BLUE, 1 UL,

POLYSTRENE, DISPOSABLE, 25/PK.

49 20 PK/12 PIL44102 MARKER LAB BLACK EXTRA FINE POINT

FIBER TIP WATER RESISTANT, PK/12.

50 2 CA/100 4599P-1

ARTERIAL BLOOD GAS SAMPLING KIT

23GAX1" NEEDLE PRO SAFETY DEVICE

IODOPHOR PAD, 2X2 GAUZE,PATIENT

LABEL, POLYBAG PACKAGING

DEPARTMENT OF HEALTH & HUMAN SERVICES

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