IHS IEE Representation Form_Jan 2022_508 Compliant.pdf
PDF 135 KB Posted
- Attached to
- Lagoon Rehabilitation Mayetta, Kansas Federal contract opportunity
- Solicitation number
- 246-25-Q-0073
About this file
This document is an Indian Health Service (IHS) Buy Indian Act Indian Economic Enterprise (IEE) Representation Form for Solicitation Number 246-25-Q-0073, which concerns a Lagoon Rehabilitation project in Mayetta, Kansas. The solicitation is a 100% Indian Owned set-aside under NAICS code 237110, with a size standard of $45.0 million, seeking a contractor to furnish and install lagoon rehabilitation services within a 60-calendar day performance period.
Key details include a quote submission deadline of July 2, 2025 at 5:00 p.m. CST, with quotes to be received via email or sealed envelope. The estimated award amount is less than $25,000, and offers will be evaluated on an acceptable/non-acceptable basis, prioritizing lowest price and technical acceptability. Contractors must provide a firm fixed-price quote, technical specifications, relevant past performance, and complete the IEE Representation Form. The solicitation requires quotes to demonstrate compliance with technical specifications and Buy Indian Act requirements, with contract award going to the most responsive, responsible offeror meeting all technical specifications at the lowest reasonable price.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| SR573 Drawing.pdf | ||
| ks152.txt | TXT text file | |
| RFQ246-25-Q-0073-SF18 and Clauses.pdf | ||
| SR573 Bid Sheet.pdf | ||
| SR573 SOW.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: 246-25-Q-0073 |
| PROJECT_TITLE: Lagoon Rehabilitiation Mayetta, KS |
| DoesNot: 0 |
| Does: Off |
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