IEE Representation Form.pdf

This is an Indian Health Service (IHS) Indian Economic Enterprise Representation Form used to certify an offeror's eligibility status under the Buy Indian Act (25 U.S.C. 47) in response to solicitations issued by the Department of Health & Human Services.

The form requires the offeror to self-certify whether the business meets the definition of an "Indian Economic Enterprise" with "Indian Ownership" under the Buy Indian Act authority. The enterprise must maintain this eligibility status throughout three critical time periods: (1) when the offer is submitted in response to the solicitation, (2) at the time of contract award, and (3) during the full term of contract performance. If the contractor loses eligibility at any point, immediate written notification to the Contracting Officer is required. The form includes representations with checkboxes for the offeror to indicate whether it does or does not meet the Indian Economic Enterprise definition. Required information includes the name of the federally recognized tribal entity, the 51% owner of the Indian Economically Disadvantaged (IEE) firm, business name, certifying signature, unique entity identifier (UEI) number, and print name. The document warns that false or misleading information submitted in an offer constitutes a violation of law punishable under 18 U.S.C. 1001, and false claims submitted as part of contract performance are subject to penalties under 31 U.S.C. 3729 and 18 U.S.C. 287. Individual Contracting Officers may require documentation of eligibility before awarding set-aside or sole source contracts under the Buy Indian Act, and awards may be protested if the successful offeror's eligibility is questioned.