IHS IEE Form.pdf
PDF 185 KB Posted
- Solicitation number
- IHS1505997
About this file
This is an Indian Economic Enterprise (IEE) representation form required for participation in Indian Health Service (IHS) Buy Indian Act procurement opportunities. The form is specifically tied to a pre-solicitation notice for Commercial Reflective Security Window Tint Purchase for the Monacan Health Center under NAICS code 238150 (Glass and Glazing Contractors).
The form requires vendors to self-certify their status as an Indian Economic Enterprise, which requires 51% Indian ownership, receipt of 51% of contract earnings, and Indian control of daily operations. Vendors must maintain IEE eligibility throughout the entire procurement process and contract period. The associated opportunity is being evaluated for an Indian Small Business Economic Enterprise (ISBEE) set-aside, and interested vendors must submit capability statements, contact information, DUNS/UEI numbers, and completed IEE forms to velvett.cummins@ihs.gov to participate in this market research phase. The IHS will use responses to determine if there are at least two qualified IEE vendors to proceed with a set-aside acquisition.
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| File | Type | Posted |
|---|---|---|
| PWS - MHC window tinting-1.pdf |
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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 |
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