IHS IEE Representation Form_Jan 2022_508 Compliant 04.24.pdf
PDF 174 KB Posted
- Attached to
- Sources Sought - GSU THC Pharmaceutical Waste
- Solicitation number
- 1514417
About this file
This document is an Indian Health Service (IHS) Buy Indian Act Indian Economic Enterprise (IEE) Representation Form for a Sources Sought Notice related to pharmaceutical waste services. The form requires self-certification that an offeror meets the definition of an "Indian Economic Enterprise" with at least 51% Indian ownership, which must be maintained throughout the solicitation, contract award, and entire contract performance period.
The associated Sources Sought Notice is for the Gallup Service Unit - Tohatchi Health Center, seeking capabilities for pharmaceutical waste services from September 2025 to August 2029. The procurement uses NAICS code 562112 (Hazardous Waste Collection) with a potential value of $47.0 million. Interested vendors must submit a capabilities package by August 09, 2025 at 10:00 a.m. MDT, including confirmation of Buy-Indian set-aside status, intention to submit a quote, Unique Entity ID, and evidence of recent similar work experience. The government will use the responses to determine the acquisition strategy, which may include Indian-owned enterprise set-asides, small business set-asides, or other socio-economic set-asides.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| SOW 08.25 A.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
Unique Entity ID (UEI)
File details come from the government source that posted it. Updated .