IHS IEE Representation Form_GP24WB303C06.pdf
PDF 2 MB Posted
- Solicitation number
- IHS1507709
About this file
The document is an Indian Health Service (IHS) Buy Indian Act Indian Economic Enterprise (IEE) Representation Form for solicitation IHS1507709, related to a project at the Wanblee IHS Health Center in South Dakota. The solicitation, set for March 31, 2025, with a closing date of April 21, 2025, is a 100% Indian Small Business Economic Enterprise (ISBEE) set-aside for installing artificial turf and a block retaining wall. The project falls under NAICS code 561730 (Landscaping Services) with a small business size standard of $8.5 million and will be performed at the Wanblee Public Health Center located at 210 1st Street in Wanblee, South Dakota.
The representation form requires offerors to self-certify as an Indian Economic Enterprise meeting specific ownership and eligibility criteria throughout the solicitation, award, and contract performance periods. Offerors must be registered in the System of Award Management (SAM) and disclose their tribal entity affiliation. The form emphasizes that providing false or misleading information is punishable under federal law, and contractors must immediately notify the Contracting Officer if they no longer meet the Indian Economic Enterprise requirements during the contract term.
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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: March 12, 2025 |
| DUNSnumber: |
| BusinessName: |
| NameOfTribalEntity: |
| OwnerName: |
| PrintName: |
| SOLICITATION_NUMBER: IHS1507709 |
| PROJECT_TITLE: Wanblee IHS Turf and Retaining Wall: GP24WB303C06 |
| DoesNot: 0 |
| Does: Off |
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