IHS IEE Form.pdf

PDF 185 KB Posted

Attached to
Sources Sought: Fragmentation Sets for Pine Ridge Comprehensive Health Care Facility
Solicitation number
IHS1502870
Issued by

About this file

This document is an Indian Economic Enterprise (IEE) Representation Form for a federal contract opportunity. It is related to a Sources Sought notice issued by the Indian Health Service (IHS) for Fragmentation Sets for the Pine Ridge Comprehensive Health Care Facility.

The document outlines the requirements for a contractor to self-certify as an "Indian Economic Enterprise" eligible for a set-aside contract under the Buy Indian Act. It specifies that the enterprise must meet the definition of an IEE at the time of offer, award, and throughout contract performance. The contractor must register in the System for Award Management (SAM) and notify the Contracting Officer if they no longer meet the eligibility requirements. The Sources Sought notice provides details on the required supplies, delivery timeframe, and instructions for responding, including capability statements, references, and supporting documentation. The opportunity is open to all capable parties, with a preference for American Indian/Native American owned small businesses. No award date is specified.

View the file

Other files

File Type Posted
Specification Sheet 2_Redacted.pdf PDF
Specification Sheet_Redacted_Sheet 1.pdf PDF
Specification Sheet 3_Redacted.pdf 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

DUNS Number

DATE:
DUNSnumber:
BusinessName:
NameOfTribalEntity:
OwnerName:
PrintName:
SOLICITATION_NUMBER:
PROJECT_TITLE:
DoesNot: 0
Does: Off

File details come from the government source that posted it. Updated .