IEE Representation Form.pdf

This document is an Indian Health Service (IHS) Buy Indian Act Indian Economic Enterprise Representation Form for a solicitation or sources sought notice. The form requires offerors to self-certify whether they meet the definition of an "Indian Economic Enterprise" with Indian Ownership under the Buy Indian Act at three key points: when making an offer, at contract award, and during contract performance.

The form mandates that enterprises provide immediate written notification to the Contracting Officer if they no longer meet eligibility requirements. False or misleading information can result in legal penalties under 18 U.S.C. 1001. Offerors must check whether they do or do not meet the Indian Economic Enterprise definition, provide the name of a Federally Recognized Tribal Entity, business name, DUNS number, and include a certifying signature. This form is specifically related to the IHS 2025 National Cancer Prevention, Screening, and Care Conference solicitation, which will involve conference services and meeting space for approximately 250 participants.