IHS IEE Representation Form_Jan 2022_508 Compliant.pdf
PDF 129 KB Posted
- Attached to
- Tucson Area OEH Copier Replacements Federal contract opportunity
- Solicitation number
- 75H71424Q00003
About this file
This federal solicitation requests offers for four color multifunction printers to replace copiers for the Tucson Area Indian Health Service. Offerors must provide specifications for all proposed equipment. Pricing is on a firm-fixed price basis. The North American Industry Classification code is 334111. The solicitation is set aside for Native-owned small businesses. If no reasonably priced offers are received, the opportunity may be opened to other small businesses. Questions are due by February 15, 2024 with all quotes due February 29, 2024. Offerors must register in the System for Award Management and use the Invoice Processing Platform for electronic invoicing. The Department of Health and Human Services Indian Health Service is the contracting agency.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 75H71424Q00003-0001.pdf | ||
| SOW - Multifunction Printer.docx | DOCX document | |
| 75H71424Q00003.pdf | ||
| copier info to trade in.xlsx | XLSX spreadsheet | |
| TERMS_AND_CONDITIONS_for_IT_Supplies -75H71424Q00003 SOL (2).docx | DOCX document |
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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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