Indian Firm Representation Form-26Q00233.pdf
PDF 73 KB Posted
- Attached to
- ISBEE Set-Aside: Exercise Equipment for the Great Plains Area IHS Youth Regional Treatment Center
- Solicitation number
- 75H70626Q00233
About this file
This is an Indian Firm Representation Form for the Indian Health Service Buy Indian Act solicitation 75H70626Q00233 for Exercise equipment for YTRC, dated 8/27/2026. The form is a self-certification document that offerors must complete to verify their eligibility as an "Indian Firm" with "Indian Ownership" under the authority of 25 U.S.C. 47 and HHSAR regulations 326.602 and 326.603.
Offerors must meet the definition of "Indian Firm" at three critical junctures: at the time of offer submission, at the time of contract award, and during the full term of contract performance. Any changes in eligibility status during these periods require immediate written notification to the Contracting Officer. Successful offerors must also maintain registration with Dun and Bradstreet and the System of Award Management (SAM). The form requires offerors to certify whether they do or do not meet the eligibility criteria and to provide their business name, SAM UEI number, certifying signature, and print name. False or misleading information submitted in connection with a Buy Indian Act award set-aside constitutes a violation under 18 U.S.C. 1001 and is subject to civil and criminal penalties. Contracting Officers may require documentation of eligibility before award, and awards may be subject to protest if the offeror's eligibility is questioned.
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Other files
| File | Type | Posted |
|---|---|---|
| 26Q00233_Amend 1_QA doc.pdf | ||
| Past_Performance_Questionnaire.pdf | ||
| SOW_YRTC_Fitness_Equipment.pdf | ||
| Sol_75H70626Q00233.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.
Certifying Signature
Business Name
_________________________________________s SAM UEI Number Print Name
| SOLICITATION NUMBER: 75H70626Q00233 |
| PROJECT TITLE: Exercise equipment for YRTC |
| DATE: 8/27/2026 |
| Business Name: |
| DUNS Number: |
| Print Name: |
| Check Box1: Off |
| Check Box2: Off |
File details come from the government source that posted it. Updated .