RFQ 75H70624Q00028 PKG 08.04.2024.pdf

A. This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Federal Acquisition Regulation (FAR) Subpart 12.6, as supplemented with additional information included in this notice, FAR Part 12, Acquisition of Commercial Items (Title VIII of the

Federal Acquisition Streamlining Act of 1994) (Public Law 103-355). This announcement constitutes the only solicitation; quotes are being requested and a written solicitation will not be issued.

B. The Great Plains Area Indian Health Service (IHS) intends to award a Firm-Fixed Price, Commercial

Item, Purchase Order in response to Request for Quote (RFQ) #75H70624Q00028.

C. This solicitation document and incorporated provisions and clauses are those in effect through

Federal Acquisition Circular 2024-05.

D. This RFQ is issued as 100% Small Business Set-Aside, and the associated NAICS Code is #334510, which has a small business standard size of 1,250 employees.

E. The quoted unit pricing must be all inclusive (to include but not be limited to travel, lodging, per diem, fringe benefits, federal, state and local taxes) plus all other costs pertinent to the performance of this contract. Utilize your most competitive and reasonable rates.

BRAND NAME / EQUAL

Complete the attached RFQ # 75H70624Q00028.

F. To be provided for the Pine Ridge Hospital-Indian Health Service, 607 Indian Health Road-E, Hwy

18, Pine Ridge, South Dakota 57770 and the Kyle Service Unit-Indian Health Service, 1000 Health

Center Road, PO Box 540, Kyle, South Dakota 57752.

The Period of Performance will be Date of Award through 45 days.

G. FAR 52.212-1 Instructions to Offerors-Commercial Products and Commercial Services (SEP

2023).

Quotes shall be submitted on company letterhead stationery, signed, dated and it shall include:

1. RFQ Number: 75H70624Q00028

2. Closing Date: August 15, 2024 at 12PM CT

3. Name, address, and telephone number of company. Email address of a contact person.

4. Technical description of the item/service being offered in sufficient detail to evaluate compliance with the requirements of the solicitation. This may include product literature, or other documents if necessary.

5. Terms of any express warranty.

6. Price and any discount terms.

7. Remit to address, if different than mailing address.

8. A completed copy of the representations and certifications at FAR 52.212-3. (See FAR 52.212-

3(b) for those representations and certifications that the offeror shall complete electronically.)

9. Acknowledgement of Solicitation Amendments, if any issued.

10. Past Performance information, when included as an evaluation factor, to include recent and relevant contracts for the same or similar items and other references including; contract numbers, points of contact with telephone numbers, and other relevant information.

11. A statement specifying the extent of agreement with all terms, conditions, and provisions included in the solicitation. Offerors that fail to furnish representations or information, or reject the terms and conditions of the solicitation may be excluded from consideration.

H. FAR 52.212-2 Evaluation-Commercial Products and Commercial Services (NOV 2021)

Basis of Award is Lowest Price, Technically Acceptable “LPTA” factors determining the successful contractor. The Government will not use the formal source selection process described in FAR Part 15.

I. FAR 52.212-3 Offeror Representations and Certifications-Commercial Products and Commercial

Services (MAY 2024)

See attachment for full text. The Offeror shall complete only paragraphs (b) of this provision if the

Offeror has completed the annual representations and certifications electronically via the System for Award Management (SAM) website accessed through http://www.acquisition.gov. IF the

Offeror has not completed the annual representations and certifications electronically, the

Offeror shall complete only paragraphs (c) through (p) of this provision.

J. FAR 52.212-4 Contract Terms and Conditions-Commercial Products and Commercial Services

(NOV 2023). Applied to this acquisition and is by reference.

K. FAR 52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive

Orders-Commercial Products and Commercial Services (MAY 2024) See attachment for full text.

L. Attached are the Federal Acquisition Regulations (FAR) and Health & Human Services Acquisition

Regulation (HHSAR) clauses that are applicable including below.

M. Special Contract Requirements

IT Equipment and Software Acquisitions

The Contractor must provide only new equipment and new parts for the required products described herein; no used, refurbished, or remanufactured equipment or parts shall be provided under any circumstances. Absolutely no "Gray Market Goods" or "Counterfeit Electronic Parts" shall be provided. Gray Market Goods are defined as genuine branded goods intentionally or unintentionally sold outside of an authorized sales-territory or by non-authorized dealers in an authorized territory. All equipment shall be accompanied by the Original Equipment

Manufacturers (OEM's) warranty. Counterfeit Electronic Parts are defined as unlawful or unauthorized reproduction, substitution, or alteration that has been knowingly mismarked, misidentified, or otherwise misrepresented to be an authentic, unmodified electronic part from the original manufacturer, or a source with the express written authority of the original manufacturer or current design activity, including an authorized aftermarket manufacturer.

http://www.acquisition.gov/

Unlawful or unauthorized substitution includes used electronic parts represented as new, or the false identification of grade, serial number, lot number, date code, or performance characteristics.

"The Office of Management and Budget (OMB) mandates that U.S. federal agencies use the

Internet Protocol version 6 (IPv6). In November 2020, OMB issued memorandum M-21-07

"Completing the Transition to IPv6", which outlines the Federal government's strategic intent "to deliver its information services, operate its networks, and access the services of others using only

IPv6". The IHS requires all new IT systems (hardware and software) to operate in a pure IPv6 network environment. This includes on-premises services or third-party hosted services that require network integration into the IHS network. The Offeror's solution shall comply with the

IPv6 standards profile as defined by the NIST USGv6 Program: https://www.nist.gov/programs-projects/usgv6-program.

Additional Applicable Published Policy & Procedure

These referenced published policies and procedures are applicable to any contractor personnel providing services in accordance with this contract and are hereby incorporated by reference.

The contractor is responsible for ensuring that all applicable contractor and subcontractor employees engaged in the direct delivery of services for this contract are aware of the applicable terms and conditions that apply and have read and familiarized themselves with the content.

• Indian Health Service Circular 2016-04, Mandatory Seasonal Influenza Immunizations for the Civilian Health Care Personnel https://www.ihs.gov/ihm/circulars/2016/mandatory-seasonal-influenza-immunizations-for-civilian-health- care-personnel/.

• IHS Special General Memorandum No. 95-04, Workplace Violence https://www.ihs.gov/ihm/sgm/1995/sgm-9504/.

• HHS Residual Standards of Conduct https://ethics.od.nih.gov/lawreg/hhs-resid-std.htm

• CFR Title 5, Chapter XLV-DHHS, Part 5501, Supplemental Standards of Ethical Conduct for Employees of the Department of Health and Human Services https://ethics.od.nih.gov/lawreg/5-CFR-5501-Unofficial-Compilation.pdf

• CFR Title 5, Part 2635.101, Basic Obligation of Public Service https://www.govinfo.gov/app/details/CFR-2019-title5-vol3/CFR-2019-title5-vol3-sec2635-101

Service Contract Labor Standards

The Wage Determination, WD 2015-5373 Revision 24 dated April 30, 2024, is hereby incorporated by reference. The full text of the referenced wage determination can be accessed at https://sam.gov/content/wage-determinations.

Other Terms and Conditions

Contractors will provide the facility Clinical Engineering department copies of training certificates and/or a statement of competency for the specific makes/models of equipment their employees will be working on under the subsequent purchase order.

https://www.nist.gov/programs-projects/usgv6-program https://www.nist.gov/programs-projects/usgv6-program https://www.ihs.gov/ihm/circulars/2016/mandatory-seasonal-influenza-immunizations-for-civilian-health-care-personnel/ https://www.ihs.gov/ihm/circulars/2016/mandatory-seasonal-influenza-immunizations-for-civilian-health-care-personnel/ https://www.ihs.gov/ihm/circulars/2016/mandatory-seasonal-influenza-immunizations-for-civilian-health-care-personnel/ https://www.ihs.gov/ihm/sgm/1995/sgm-9504/ https://ethics.od.nih.gov/lawreg/hhs-resid-std.htm https://ethics.od.nih.gov/lawreg/5-CFR-5501-Unofficial-Compilation.pdf https://www.govinfo.gov/app/details/CFR-2019-title5-vol3/CFR-2019-title5-vol3-sec2635-101 https://www.govinfo.gov/app/details/CFR-2019-title5-vol3/CFR-2019-title5-vol3-sec2635-101 https://sam.gov/content/wage-determinations

Contractors performing preventive maintenance (PM) on medical equipment shall provide the facility Clinical Engineering department a copy of that checklist prior to the work being performed, and a copy of the completed checklist after work is performed. The PM checklist shall follow the original equipment manufacturer's prescribed checks at the OEMs prescribed intervals.

Any parts replaced during repair or during routine maintenance that result in a separate charge to the IHS, shall be given to the facility Clinical Engineering department for inspection and will not be removed from the facility without express written consent of clinical engineering.

Security Clearance

Performance of this contract will require routine access by employees of the Contractor or its subcontractors to facilities or systems controlled by the Indian Health Service (I.H.S.). Before starting work requiring routine access to I.H.S. facilities or systems, each person must complete a FBI National Criminal History Check (Fingerprint Check) adjudicated by an I.H.S. employee using the Office of Personnel Management Personnel Investigations Processing System. Contractors shall allow five business days for I.H.S. processing of fingerprints taken electronically at an I.H.S.

site and thirty business days for non-electronic processing of fingerprints using FBI Form FD-258. A list of I.H.S. sites with electronic fingerprint capability is available from the Contracting Officer.

In addition, no Contractor or subcontractor employee shall be permitted to perform work under this contract if listed on the HHS Office of Inspector General List of Excluded Individuals/Entities (LEIE), http://exclusions.oig.hhs.gov. As soon as practicable, prior to the performance of the work, the Contractor shall provide to the Contracting Officer the names of all individuals to be used in performance of work for screening against the LEIE. During the performance, the Contractor shall provide the Contracting Officer the names of any additional or substitute employees for screening before they begin work.

The Contractor is responsible for conducting security preclearance investigations in sufficient depth to ensure that each Contractor or subcontractor employee referred to I.H.S. is not on the LEIE and can obtain a favorable fingerprint clearance. Each security preclearance shall be conducted sufficiently in advance of the start of performance to avoid delays caused by denial of access. If this is a Time and Materials, Labor-Hour or Cost Reimbursement contract, the contractor shall not charge for or be reimbursed for labor hours or other costs incurred for employees who are unable to perform due to denial or access or the excess time required to resolve and clear unfavorable security clearance findings. If this is a Fixed-Price contract, denial of access due to security clearance findings shall not be a basis for excusable delay or an increase to the contract amount.

Government will pay for the cost to process the contractor's suitability clearances.

However, multiple investigations for the same position may, at the Contracting http://exclusions.oig.hhs.gov/

Officer's discretion, lead to reduction(s) in the contract price of no more than the cost of the extra investigation(s).

N. Invoice Submission and Payment

In compliance with the Office of Management and Budget (OMB) M-15-19 memorandum

Improving Government Efficiency and Saving Taxpayer Dollars Through Electronic Invoicing directing Federal agencies to adopt electronic invoicing as the primary means to disburse payment to vendors. Invoices submitted under any award resulting from this solicitation will be required to utilize the Invoice Processing Platform (IPP) in accordance with HHSAR 352.232-71, Electronic

Submission and Processing of Payment Requests.

IPP is a secure, web-based electronic invoicing system provided by the U.S. Department of the

Treasury’s Bureau of the Fiscal Service, in partnership with the Federal Reserve Bank of St. Louis

(FRSTL). Respondents to this solicitation are encouraged to register an account with IPP if they have not already done so. If your organization is already registered to use IPP, you will not be required to re-register, however, we encourage you make sure your organization and designated

IPP user accounts are valid and up to date.

The IPP website address is: https://www.ipp.gov.

If you require assistance registering or IPP account access, please contact the IPP Helpdesk at

(866) 973-3131 (M-F 8AM to 6PM ET), or IPPCustomerSupport@fiscal.treasury.gov.

The Contractor shall submit a signed and approved invoice to request payment. For services, it should be submitted at least on a monthly basis.

The Contractor shall include the following information on each invoice in accordance with the

Prompt Payment Act (5 CFR Part 1315.9(b)):

1. Contractor's name;

2. Invoice number and date;

3. Entire award number (Purchase Order Number/Delivery Order Number/Contract

Number) or other authorization number for delivery of goods or services;

4. Description (including dates of service), price, and quantity of goods and services rendered;

5. Shipping and payment terms;

6. SAM Unique Entity ID and Taxpayer Identifying Number (TIN); and

7. Contact name (where practicable), title and telephone number.

Payment shall be made by the:

GREAT PLAINS AREA

INDIAN HEALTH SERVICE

DIVISION OF FINANCIAL MANAGEMENT

114 5TH AVE SE

ROOM 309 FEDERAL BUILDING

https://www.ipp.gov/ mailto:IPPCustomerSupport@fiscal.treasury.gov

ABERDEEN, SOUTH DAKOTA 57401.

The Government reserves the right to accept or reject services if the level of work is unsatisfactory.

O. Offers will be accepted electronically only. Submit via to the following:

Great Plains Area Indian Health Service

Attn: William Kohl, Contract Specialist

115 4th Ave SE – Room 309

Aberdeen, SD 57401

EMAIL: William.Kohl@ihs.gov

Any questions, please submit by email to: William.Kohl@ihs.gov before August 13, 2024 by 12PM

CT.

Contractors will need a Unique Entity ID (UEI) number, TIN number, and be registered with www.sam.gov.

The contractor must provide only new equipment and new parts for the required products described herein; no used, refurbished, or remanufactured equipment or parts shall be provided under any circumstances.

mailto:William.Kohl@ihs.gov mailto:William.Kohl@ihs.gov http://www.sam.gov/

75H70624Q00028

1. REQUEST NO.

5a. ISSUED BY

NAME

a. NAME

c. STREET ADDRESS

d. CITY

10. PLEASE FURNISH QUOTATIONS TO

THE ISSUING OFFICE IN BLOCK 5a ON

OR BEFORE CLOSE OF BUSINESS (Date)

2. DATE ISSUED 3. REQUISITION/PURCHASE REQUEST NO. 4. CERT. FOR NAT. DEF.

UNDER BDSA REG. 2

AND/OR DMS REG.1

RATING

6. DELIVERY BY (Date)

7. DELIVERY

9. DESTINATION

a. NAME OF CONSIGNEE

b. STREET ADDRESS

PAGE OF PAGES

5b. FOR INFORMATION CALL: (No collect calls)

TELEPHONE NUMBER

AREA CODE NUMBER

8. TO:

b. COMPANY

e. STATE f. ZIP CODE

c. CITY

d. STATE e. ZIP CODE

IMPORTANT: This is a request for information, and quotations furnished are not offers. If you are unable to quote, please so indicate on this form and return it to the address in Block 5a. This request does not commit the Government to pay any costs incurred in the preparation of the submission of this quotation or to contract for supplies or services. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for Quotations must be completed by the quoter.

11. SCHEDULE (Include applicable Federal, State and local taxes)

THIS RFQ

REQUEST FOR QUOTATION

(THIS IS NOT AN ORDER)

IS IS NOT A SMALL BUSINESS SET ASIDEX

08/04/2024 IHS1491120

1 8

INDIAN HEALTH SERVICE

Division of Acquisition Management Aberdeen SD 57401

Great Plains Area 10/04/2024

WILLIAM KOHL

08/15/2024 1200 CT

FOB DESTINATION

OTHER

(See Schedule)X

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

CALLTSK0099967

*** This is a 100% Indian Small Business Economic Enterprise Set-Aside ***

Solicitation for Firm, fixed-price, commercial item electrocardiogram (EKG or ECG) equipment, accessories, and installation for the Pine Ridge Hospital, Pine Ridge, SD and the Kyle Service Unit, Kyle, SD.

Period of Performance will be date of award with delivery no later than 45 days after receipt of order.

BASIS FOR AWARD: Quoters are advised that award Continued ...

12. DISCOUNT FOR PROMPT PAYMENT

a. 10 CALENDAR DAYS (%) b. 20 CALENDAR DAYS (%) c. 30 CALENDAR DAYS (%) d. CALENDAR DAYS

NUMBER PERCENTAGE

NOTE: Additional provisions and representations

13. NAME AND ADDRESS OF QUOTER

b. STREET ADDRESS

c. COUNTY

d. CITY e. STATE f. ZIP CODE

14. SIGNATURE OF PERSON AUTHORIZED TO

SIGN QUOTATION

16. SIGNER

a. NAME (Type or print)

c. TITLE (Type or print)

a. NAME OF QUOTER

AREA CODE

NUMBER

15. DATE OF QUOTATION

b. TELEPHONE are are not attached

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition not usable

STANDARD FORM 18 (REV. 6-95)

Prescribed by GSA - FAR (48 CFR) 53.215-1(a)

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

2 8

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H70624Q00028 shall be made to the Lowest Price Technically

Acceptable (LPTA) offer. Quotes will also include the following to be considered acceptable.

1. Complete and signed SF-18, Request for

Quotations

2. Complete Indian Health Service Buy-Indian Form

3. Provide Items per Specifications

4. Meet 45 day or less delivery schedule

Any questions regarding this solicitation shall be requested before Aug 13, 2024, before 12PM CT in writing by email to William Kohl, at

William.Kohl@ihs.gov.

The quoted unit price is an all-inclusive cost.

All-inclusive is defined to include travel, lodging, per diem, fringe benefits, Federal/State/Local taxes, plus any other costs pertinent to the performance of this contract.

Period of Performance: 08/20/2024 to 10/04/2024

1 GE MAC VU360 ECG, 15-lead, 12SL LAN 5 EA

Part No: 2030360-020

Pine Ridge Service Unit

Delivery: 10/04/2024

Delivery Location Code: IHSPINERIDGE

IHSPINERIDGE

607 Indian Health Road

E. Hwy 18

PINE RIDGE SD 57770 US

2 GE MAC VU360 CAM w/Integrated Barcode Mounting 5 EA

Arm

Part No: 2030360-203

Pine Ridge Service Unit

Delivery: 10/04/2024

Delivery Location Code: IHSPINERIDGE

IHSPINERIDGE

607 Indian Health Road

E. Hwy 18

PINE RIDGE SD 57770 US

Continued ...

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

3 8

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H70624Q00028

3 Extra Battery 5 EA

Part No: 2030360-046

Pine Ridge Service Unit

Delivery: 10/04/2024

Delivery Location Code: IHSPINERIDGE

IHSPINERIDGE

607 Indian Health Road

E. Hwy 18

PINE RIDGE SD 57770 US

4 Easy Clean Variable Height Trolly 5 EA

Part No: 2086800-001

Pine Ridge Service Unit

Delivery: 10/04/2024

Delivery Location Code: IHSPINERIDGE

IHSPINERIDGE

607 Indian Health Road

E. Hwy 18

PINE RIDGE SD 57770 US

5 ECG WIFI LAN GE, Installed 5 EA

Part No: 2091358-001

Pine Ridge Service Unit

Delivery: 10/04/2024

Delivery Location Code: IHSPINERIDGE

IHSPINERIDGE

607 Indian Health Road

E. Hwy 18

PINE RIDGE SD 57770 US

6 DCAR Installation

Part No: 2083083-003

Pine Ridge Service Unit

Delivery: 10/04/2024

Delivery Location Code: IHSPINERIDGE

IHSPINERIDGE

607 Indian Health Road

E. Hwy 18

PINE RIDGE SD 57770 US

4 8

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H70624Q00028

7 Paper A Red Grid 5 EA

Part No: 2104770-001

Pine Ridge Service Unit

Delivery: 10/04/2024

Delivery Location Code: IHSPINERIDGE

IHSPINERIDGE

607 Indian Health Road

E. Hwy 18

PINE RIDGE SD 57770 US

8 DCAR One Day On-Site Clinical Applications

Product Training

Part No: 20911267-001

Pine Ridge Service Unit

Delivery: 10/04/2024

Delivery Location Code: IHSPINERIDGE

IHSPINERIDGE

607 Indian Health Road

E. Hwy 18

PINE RIDGE SD 57770 US

9 MAC VU360 Online Service Training

Part No: 2020786-413

Pine Ridge Service Unit

Delivery: 10/04/2024

Delivery Location Code: IHSPINERIDGE

IHSPINERIDGE

607 Indian Health Road

E. Hwy 18

PINE RIDGE SD 57770 US

10 GE MAC VU360 ECG, 15-Lead, 12SL LAN 1 EA

Part No: 2030360-020

Kyle Service Unit

Delivery: 10/04/2024

Delivery Location Code: IHSKYLE

IHSKYLE

1000 HEALTH CENTER ROAD

PO BOX 540

5 8

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H70624Q00028

KYLE SD 57752 US

11 GE MAC VU360 CAM w/Integrated Barcode Mounting 1 EA

Arm

Part No: 2030360-203

Kyle Service Unit

Delivery: 10/04/2024

Delivery Location Code: IHSKYLE

IHSKYLE

1000 HEALTH CENTER ROAD

PO BOX 540

KYLE SD 57752 US

12 Extra Battery 1 EA

Part No: 2030360-046

Kyle Service Unit

Delivery: 10/04/2024

Delivery Location Code: IHSKYLE

IHSKYLE

1000 HEALTH CENTER ROAD

PO BOX 540

KYLE SD 57752 US

13 Easy Clean Variable Height Trolly 1 EA

Part No: 2086800-001

Kyle Service Unit

Delivery: 10/04/2024

Delivery Location Code: IHSKYLE

IHSKYLE

1000 HEALTH CENTER ROAD

PO BOX 540

KYLE SD 57752 US

14 ECG WIFI LAN GE Installed 1 EA

Part No: 2091358-001

Kyle Service Unit

Delivery: 10/04/2024

Delivery Location Code: IHSKYLE

IHSKYLE

6 8

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H70624Q00028

1000 HEALTH CENTER ROAD

PO BOX 540

KYLE SD 57752 US

15 DCAR Installation

Part No: 2083083-003

Kyle Service Unit

Delivery: 10/04/2024

Delivery Location Code: IHSKYLE

IHSKYLE

1000 HEALTH CENTER ROAD

PO BOX 540

KYLE SD 57752 US

16 Paper A Red Grid 1 EA

Part No: 2104770-001

Kyle Service Unit

Delivery: 10/04/2024

Delivery Location Code: IHSKYLE

IHSKYLE

1000 HEALTH CENTER ROAD

PO BOX 540

KYLE SD 57752 US

Quotation must set forth, full, accurate and complete information as required by the Request for Quotation (RFQ) and be returned no later than the date referenced in Block #10 of the Request for Quotation form SF-18. All required Quotation must set forth, full, accurate and complete information as required by the Request for

Quotation (RFQ) and be returned no later than the date referenced in Block #10 of the Request for

Quotation form SF-18. All required information must be submitted in order to be considered responsive and eligible for award.

ACCEPTANCE PERIOD: Your proposal must stipulate that it is predicated upon all the terms and conditions of this RFQ. In addition, it must contain a statement to the effect that it is firm for a period of at least 30 days from the date of receipt by the Government. Quotation must set forth full, accurate and complete information as required by the Request for Quotation (RFQ) and

7 8

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H70624Q00028 be returned no later than the date reference in

Block #10 of the Request for Quotation Form

SF-18. All required information must be submitted in order to be considered responsive and eligible for award.

No contract award shall be made to any vendor or provider listed on the OIG Exclusion List http://exclusions.oig.hhs.gov throughout the duration of the contract. It shall be the responsibility of the contractor to notify the acquisition official if there is a change in provider.

Contractor must be registered with the System for

Award Management (SAM) before award can be made.

The website to register at is:

www.sam.gov.

INVOICE SUBMISSION AND PAYMENT

In compliance with the Office of Management and

Budget (OMB) M-15-19 memorandum Improving

Government Efficiency and Saving Taxpayer Dollars

Through Electronic Invoicing directing Federal agencies to adopt electronic invoicing as the primary means to disburse payment to vendors.

Invoices submitted under any award resulting from this solicitation will be required to utilize the

Invoice Processing Platform (IPP) in accordance with HHSAR 352.232-71, Electronic Submission and

Processing of Payment Requests.

IPP is a secure, web-based electronic invoicing system provided by the U.S. Department of the

Treasury?s Bureau of the Fiscal Service, in partnership with the Federal Reserve Bank of St.

Louis (FRSTL). Respondents to this solicitation are encouraged to register an account with IPP if they have not already done so. If your organization is already registered to use IPP, you will not be required to re-register, however, we encourage you make sure your organization and designated IPP user accounts are valid and up to date.

The IPP website address is: https://www.ipp.gov.

If you require assistance registering or IPP account access, please contact the IPP Helpdesk at (866) 973-3131 (M-F 8AM to 6PM ET), or

IPPCustomerSupport@fiscal.treasury.gov.

8 8

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H70624Q00028

The Contractor shall submit a signed and approved invoice to request payment. For services, it should be submitted at least on a monthly basis.

The Contractor shall include the following information on each invoice in accordance with the Prompt Payment Act (5 CFR Part 1315.9(b)):

1. Contractor's name;

2. Invoice number and date;

3. Entire award number (Purchase Order

Number/Delivery Order Number/Contract Number) or other authorization number for delivery of goods or services;

4. Description (including dates of service), price, and quantity of goods and services rendered;

5. Shipping and payment terms;

6. SAM Unique Entity ID and Taxpayer Identifying

Number (TIN); and

7. Contact name (where practicable), title and telephone number.

Payment shall be made by the:

GREAT PLAINS AREA

INDIAN HEALTH SERVICE

DIVISION OF FINANCIAL MANAGEMENT

114 5TH AVE SE

ROOM 309 FEDERAL BUILDING

ABERDEEN, SOUTH DAKOTA 57401.

The Government reserves the right to accept or reject services if the level of work is unsatisfactory.

DEPARTMENT OF HEALTH & HUMAN SERVICES

Indian Health Service Division of Acquisition Policy (DAP)

5600 Fishers Lane Rockville, MD 20857

INDIAN HEALTH SERVICE

BUY INDIAN ACT

INDIAN FIRM REPRESENTATION FORM

SOLICIATION NUMBER: _________________________________________________

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 Firm” (HHSAR 326.602) with “Indian Ownership” (HHSAR 326.603), in response to this solicitation and resultant contract.

The enterprise must meet the definition of “Indian Firm” 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 DUN and Bradstreet (D&B) and 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 Firm” with “Indian Ownership” under the authority of the Buy Indian Act.

Certifying Signature

Business Name

SAM Unique Entity ID Number Print Name

CLAUSES INCORPORATED BY REFERENCE

Firm-Fixed Price, Commercial

FAR CITATION: 52.252-2 Clauses Incorporated by Reference (FEB 1998)

I. Federal Acquisition Regulations (FAR) (48 CFR Chapter 1) Clauses

No. FAR Citation Clause Title Clause Date

1. 52.204-7 System for Award Management OCT 2018

2. 52.204-10 Reporting Executive Compensation and First-Tier Subcontract Awards

JUN 2020

3. 52.204-13 System for Award Management Maintenance OCT 2018

4. 52.204-16 Commercial and Government Entity Code Reporting AUG 2020

5. 52.204-17 Ownership or Control of Offeror AUG 2020

6. 52.204-18 Commercial and Government Entity Code Maintenance AUG 2020

7. 52.204-19 Incorporated by Reference of Representations and Certifications DEC 2014

8. 52.204-21 Basic Safeguarding of Covered Contractor Information Systems NOV 2021

9. 52.209-6 Protecting the Government’s Interest When Subcontracting with Contractors Debarred, Suspended, or Proposed for Debarment

NOV 2021

10. 52.211-6 Brand Name or Equal AUG 1999

11. 52.211-17 Delivery of Excess Quantities SEP 1989

12. 52.212-1 Instructions to Offerors-Commercial Products and Commercial Services

SEP 2023

13. 52.212-4 Contract Terms and Conditions-Commercial Products and Commercial Services

NOV 2023

14. 52.223-1 BioBased Product Certification MAY 2024

15. 52.225-13 Restrictions on Certain Foreign Purchases FEB 2021

16. 52.225-25 Prohibition on Contracting with Entities Engaging in Certain Activities or Transactions Relating to Iran-Representation and Certifications

JUN 2020

17. 52.232-39 Unenforceability of Unauthorized Obligations JUN 2013

18. 52.232-40 Providing Accelerated Payments to Small Business Subcontractors MAR 2023

19. 52.247-34 F.o.b.-Destination NOV 1991

20. 52.253-1 Computer Generated Forms JAN 1991

CLAUSES INCORPORATED IN FULL TEXT

II. Federal Acquisition Regulations (FAR) (48 CFR Chapter 1) Clauses

No. FAR Citation Clause Title Clause Date

1. 52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment

NOV 2021

2. 52.212-3 Offeror Representations and Certifications-Commercial Products and Commercial Services

MAY 2024

3. 52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive Orders-Commercial Products and Commercial Services

MAY 2024

4. 52.252-1 Solicitation Provisions Incorporated by Reference FEB 1998

5. 52.252-2 Clauses Incorporated by Reference FEB 1998

52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or

Equipment.

As prescribed in 4.2105(a), insert the following provision:

Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment

(Nov 2021)

The Offeror shall not complete the representation at paragraph (d)(1) of this provision if the Offeror has represented that it "does not provide covered telecommunications equipment or services as a part of its offered products or services to the Government in the performance of any contract, subcontract, or other contractual instrument" in paragraph (c)(1) in the provision at 52.204-26, Covered

Telecommunications Equipment or Services—Representation, or in paragraph (v)(2)(i) of the provision at 52.212-3, Offeror Representations and Certifications-Commercial Products or Commercial Services.

The Offeror shall not complete the representation in paragraph (d)(2) of this provision if the Offeror has represented that it "does not use covered telecommunications equipment or services, or any equipment, system, or service that uses covered telecommunications equipment or services" in paragraph (c)(2) of the provision at 52.204-26, or in paragraph (v)(2)(ii) of the provision at 52.212-3.

(a) Definitions. As used in this provision—

Backhaul, covered telecommunications equipment or services, critical technology, interconnection arrangements, reasonable inquiry, roaming, and substantial or essential component have the meanings provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video

Surveillance Services or Equipment.

(b) Prohibition. (1) Section 889(a)(1)(A) of the John S. McCain National Defense Authorization Act for

Fiscal Year 2019 (Pub. L. 115-232) prohibits the head of an executive agency on or after August 13, 2019, from procuring or obtaining, or extending or renewing a contract to procure or obtain, any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. Nothing in the prohibition shall be construed to—

(i) Prohibit the head of an executive agency from procuring with an entity to provide a service that connects to the facilities of a third-party, such as backhaul, roaming, or interconnection arrangements;

or

(ii) Cover telecommunications equipment that cannot route or redirect user data traffic or cannot permit visibility into any user data or packets that such equipment transmits or otherwise handles.

(2) Section 889(a)(1)(B) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019

(Pub. L. 115-232) prohibits the head of an executive agency on or after August 13, 2020, from entering into a contract or extending or renewing a contract with an entity that uses any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. This prohibition applies to the use of covered telecommunications equipment or services, regardless of whether that use is in performance of work under a Federal contract. Nothing in the prohibition shall be construed to—

(i) Prohibit the head of an executive agency from procuring with an entity to provide a service that connects to the facilities of a third-party, such as backhaul, roaming, or interconnection arrangements;

or

(ii) Cover telecommunications equipment that cannot route or redirect user data traffic or cannot permit visibility into any user data or packets that such equipment transmits or otherwise handles.

(c) Procedures. The Offeror shall review the list of excluded parties in the System for Award

Management (SAM) ( https://www.sam.gov) for entities excluded from receiving federal awards for

"covered telecommunications equipment or services".

(d) Representation. The Offeror represents that—

(1) It □ will, □ will not provide covered telecommunications equipment or services to the Government in the performance of any contract, subcontract or other contractual instrument resulting from this solicitation. The Offeror shall provide the additional disclosure information required at paragraph (e)(1) of this section if the Offeror responds "will" in paragraph (d)(1) of this section; and

(2) After conducting a reasonable inquiry, for purposes of this representation, the Offeror represents that—

It □ does, □ does not use covered telecommunications equipment or services, or use any equipment, system, or service that uses covered telecommunications equipment or services. The Offeror shall provide the additional disclosure information required at paragraph (e)(2) of this section if the Offeror responds "does" in paragraph (d)(2) of this section.

(e) Disclosures. (1) Disclosure for the representation in paragraph (d)(1) of this provision. If the Offeror has responded "will" in the representation in paragraph (d)(1) of this provision, the Offeror shall provide the following information as part of the offer:

(i) For covered equipment—

(A) The entity that produced the covered telecommunications equipment (include entity name, unique entity identifier, CAGE code, and whether the entity was the original equipment manufacturer (OEM) or a distributor, if known);

(B) A description of all covered telecommunications equipment offered (include brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); and

(C) Explanation of the proposed use of covered telecommunications equipment and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(1) of this provision.

(ii) For covered services—

(A) If the service is related to item maintenance: A description of all covered telecommunications services offered (include on the item being maintained: Brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); or

(B) If not associated with maintenance, the Product Service Code (PSC) of the service being provided;

and explanation of the proposed use of covered telecommunications services and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(1) of this provision.

(2) Disclosure for the representation in paragraph (d)(2) of this provision. If the Offeror has responded

"does" in the representation in paragraph (d)(2) of this provision, the Offeror shall provide the following information as part of the offer:

(i) For covered equipment—

(A) The entity that produced the covered telecommunications equipment (include entity name, unique entity identifier, CAGE code, and whether the entity was the OEM or a distributor, if known);

(B) A description of all covered telecommunications equipment offered (include brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); and

(C) Explanation of the proposed use of covered telecommunications equipment and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(2) of this provision.

(ii) For covered services—

(A) If the service is related to item maintenance: A description of all covered telecommunications services offered (include on the item being maintained: Brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); or

(B) If not associated with maintenance, the PSC of the service being provided; and explanation of the proposed use of covered telecommunications services and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(2) of this provision.

(End of provision)

52.212-3 Offeror Representations and Certifications—Commercial Products and Commercial Services.

As prescribed in 12.301(b)(2), insert the following provision:

Offeror Representations and Certifications—Commercial Products and Commercial Services (May 2024)

The Offeror shall complete only paragraph (b) of this provision if the Offeror has completed the annual representations and certification electronically in the System for Award Management (SAM) accessed through https://www.sam.gov. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (v) of this provision.

(a) Definitions. As used in this provision—

Covered telecommunications equipment or services has the meaning provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or

Equipment.

Economically disadvantaged women-owned small business (EDWOSB) concern means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United

States and who are economically disadvantaged in accordance with 13 CFR part 127, and the concern is certified by SBA or an approved third-party certifier in accordance with 13 CFR 127.300. It automatically qualifies as a women-owned small business eligible under the WOSB Program.

Forced or indentured child labor means all work or service—

(1) Exacted from any person under the age of 18 under the menace of any penalty for its nonperformance and for which the worker does not offer himself voluntarily; or

(2) Performed by any person under the age of 18 pursuant to a contract the enforcement of which can be accomplished by process or penalties.

Highest-level owner means the entity that owns or controls an immediate owner of the offeror, or that owns or controls one or more entities that control an immediate owner of the offeror. No entity owns or exercises control of the highest level owner.

Immediate owner means an entity, other than the offeror, that has direct control of the offeror.

Indicators of control include, but are not limited to, one or more of the following: ownership or interlocking management, identity of interests among family members, shared facilities and equipment, and the common use of employees.

Inverted domestic corporation, means a foreign incorporated entity that meets the definition of an inverted domestic corporation under 6 U.S.C. 395(b), applied in accordance with the rules and definitions of 6 U.S.C. 395(c).

Manufactured end product means any end product in product and service codes (PSCs) 1000-9999, except—

(1) PSC 5510, Lumber and Related Basic Wood Materials;

(2) Product or Service Group (PSG) 87, Agricultural Supplies;

(3) PSG 88, Live Animals;

(4) PSG 89, Subsistence;

(5) PSC 9410, Crude Grades of Plant Materials;

(6) PSC 9430, Miscellaneous Crude Animal Products, Inedible;

(7) PSC 9440, Miscellaneous Crude Agricultural and Forestry Products;

(8) PSC 9610, Ores;

(9) PSC 9620, Minerals, Natural and Synthetic; and

(10) PSC 9630, Additive Metal Materials.

Place of manufacture means the place where an end product is assembled out of components, or otherwise made or processed from raw materials into the finished product that is to be provided to the

Government. If a product is disassembled and reassembled, the place of reassembly is not the place of manufacture.

Predecessor means an entity that is replaced by a successor and includes any predecessors of the predecessor.

Reasonable inquiry has the meaning provided in the clause 52.204-25, Prohibition on Contracting for

Certain Telecommunications and Video Surveillance Services or Equipment.

Restricted business operations means business operations in Sudan that include power production activities, mineral extraction activities, oil-related activities, or the production of military equipment, as those terms are defined in the Sudan Accountability and Divestment Act of 2007 (Pub. L. 110-174).

Restricted business operations do not include business operations that the person (as that term is defined in Section 2 of the Sudan Accountability and Divestment Act of 2007) conducting the business can demonstrate—

(1) Are conducted under contract directly and exclusively with the regional government of southern

Sudan;

(2) Are conducted pursuant to specific authorization from the Office of Foreign Assets Control in the

Department of the Treasury, or are expressly exempted under Federal law from the requirement to be conducted under such authorization;

(3) Consist of providing goods or services to marginalized populations of Sudan;

(4) Consist of providing goods or services to an internationally recognized peacekeeping force or humanitarian organization;

(5) Consist of providing goods or services that are used only to promote health or education; or

(6) Have been voluntarily suspended. "Sensitive technology"—

Sensitive technology—

(1) Means hardware, software, telecommunications equipment, or any other technology that is to be used specifically—

(i) To restrict the free flow of unbiased information in Iran; or

(ii) To disrupt, monitor, or otherwise restrict speech of the people of Iran; and

(2) Does not include information or informational materials the export of which the President does not have the authority to regulate or prohibit pursuant to section 203(b)(3)of the International Emergency

Economic Powers Act (50 U.S.C. 1702(b)(3)).

Service-disabled veteran-owned small business (SDVOSB) concern means a small business concern—

(1) (i) Not less than 51 percent of which is owned and controlled by one or more service-disabled veterans or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more service-disabled veterans; and

(ii) The management and daily business operations of which are controlled by one or more service-disabled veterans or, in the case of a service-disabled veteran with permanent and severe disability, the spouse or permanent caregiver of such veteran; or

(2) A small business concern eligible under the SDVOSB Program in accordance with 13 CFR part 128

(see subpart 19.14).

(3) Service-disabled veteran, as used in this definition, means a veteran as defined in 38 U.S.C. 101(2), with a disability that is service connected, as defined in 38 U.S.C. 101(16), and who is registered in the

Beneficiary Identification and Records Locator Subsystem, or successor system that is maintained by the

Department of Veterans Affairs’ Veterans Benefits Administration, as a service-disabled veteran.

Service-disabled veteran-owned small business (SDVOSB) concern eligible under the SDVOSB Program means an SDVOSB concern that—

(1) Effective January 1, 2024, is designated in the System for Award Management (SAM) as certified by the Small Business Administration (SBA) in accordance with 13 CFR 128.300; or

(2) Has represented that it is an SDVOSB concern in SAM and submitted a complete application for certification to SBA on or before December 31, 2023.

Service-disabled veteran-owned small business (SDVOSB) Program means a program that authorizes contracting officers to limit competition, including award on a sole-source basis, to SDVOSB concerns eligible under the SDVOSB Program.

Small business concern—

(1) Means a concern, including its affiliates, that is independently owned and operated, not dominant in its field of operation, and qualified as a small business under the criteria in 13 CFR part 121 and size standards in this solicitation.

(2) Affiliates, as used in this definition, means business concerns, one of whom directly or indirectly controls or has the power to control the others, or a third party or parties control or have the power to control the others. In determining whether affiliation exists, consideration is given to all appropriate factors including common ownership, common management, and contractual relationships. SBA determines affiliation based on the factors set forth at 13 CFR 121.103.

Small disadvantaged business concern, consistent with 13 CFR 124.1001, means a small business concern under the size standard applicable to the acquisition, that—

(1) Is at least 51 percent unconditionally and directly owned (as defined at 13 CFR 124.105) by—

(i) One or more socially disadvantaged (as defined at13 CFR 124.103) and economically disadvantaged

(as defined at 13 CFR 124.104) individuals who are citizens of the United States; and

(ii) Each individual claiming economic disadvantage has a net worth not exceeding the threshold at 13

CFR 124.104(c)(2) after taking into account the applicable exclusions set forth at 13 CFR124.104(c)(2);

and

(2) The management and daily business operations of which are controlled (as defined at 13.CFR

124.106) by individuals, who meet the criteria in paragraphs (1)(i) and (ii) of this definition.

Subsidiary means an entity in which more than 50 percent of the entity is owned—

(1) Directly by a parent corporation; or

(2) Through another subsidiary of a parent corporation

Successor means an entity that has replaced a predecessor by acquiring the assets and carrying out the affairs of the predecessor under a new name (often through acquisition or merger). The term

"successor" does not include new offices/divisions of the same company or a company that only changes its name. The extent of the responsibility of the successor for the liabilities of the predecessor may vary, depending on State law and specific circumstances.

Veteran-owned small business concern means a small business concern—

(1) Not less than 51 percent of which is owned and controlled by one or more veterans (as defined at 38

U.S.C. 101(2)) or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more veterans; and

(2) The management and daily business operations of which are controlled by one or more veterans.

Women-owned business concern means a concern which is at least 51 percent owned by one or more women; or in the case of any publicly owned business, at least 51 percent of its stock is owned by one or more women; and whose management and daily business operations are controlled by one or more women

Women-owned small business concern means a small business concern—

(1) That is at least 51 percent owned by one or more women; or, in the case of any publicly owned business, at least51 percent of the stock of which is owned by one or more women; and

(2) Whose management and daily business operations are controlled by one or more women.

Women-owned small business (WOSB) concern eligible under the WOSB Program (in accordance with

13 CFR part 127), means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States, and the concern is certified by SBA or an approved third-party certifier in accordance with 13 CFR 127.300.

(b) (1) Annual…