IHS1527363_IEE Representation.pdf
PDF 46 KB Posted
- Attached to
- PINE RIDGE IHS LAB-ISTAT REAGENT SUPPLIES
- Solicitation number
- 75H70626Q00212
About this file
This is a self-certification form used by the Indian Health Service (IHS) to verify that offerors meet the eligibility requirements of the Buy Indian Act (25 U.S.C. 47) for set-aside or sole source contracts. The form requires offerors to certify whether they qualify as an "Indian Firm" with "Indian Ownership" as defined in HHSAR 326.602 and 326.603, respectively. Offerors must complete the form by entering the solicitation number, project title, date, business name, DUNS number, and provide a certifying signature with printed name.
The certification requirements mandate that enterprises meet the "Indian Firm" definition at three critical junctures: at the time of offer submission, at contract award, and throughout the full contract performance period. Contractors must immediately notify the Contracting Officer in writing if they cease to meet eligibility requirements at any point. Individual Contracting Officers may require supporting documentation of eligibility before awarding contracts, and awards are subject to protest if the successful offeror's eligibility is questioned. Successful offerors must maintain current registration with Dun and Bradstreet (D&B) and the System of Award Management (SAM). The form emphasizes that false or misleading information submitted in connection with Buy Indian Act awards constitutes a federal crime under 18 U.S.C. 1001, while false claims during contract performance are subject to penalties under 31 U.S.C. 3729-3731 and 18 U.S.C. 287.
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Other files
| File | Type | Posted |
|---|---|---|
| New Delivery Schedule..pdf | ||
| RFQ_75H70626Q00212.pdf | ||
| IHS1527363_PWS.pdf | ||
| ISTAT Delivery Schedule.xlsx | XLSX spreadsheet | |
| RFQ_75H70626Q00212.pdf |
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Text version
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.
Business Name Certifying Signature
DUNS Number Print Name
| SOLICITATION NUMBER: |
| PROJECT TITLE: |
| DATE: |
| Business Name: |
| DUNS Number: |
| Print Name: |
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