Indian Firm Representation Form.pdf
PDF 49 KB Posted
- Solicitation number
- 75H70625Q00040
About this file
The Indian Firm Representation Form is a self-certification document for the Buy Indian Act, requiring businesses to confirm their status as an "Indian Firm" with "Indian Ownership" when responding to Indian Health Service (IHS) solicitations. The form mandates that businesses meet the Indian Firm definition at the time of offer, contract award, and throughout the entire contract performance period, with potential legal consequences for false representations.
Key requirements include mandatory registration with D-U-N-S Number and System of Award Management (SAM), and an obligation to immediately notify the Contracting Officer if the firm no longer meets eligibility criteria. The specific solicitation relates to a 100% Indian Small Business Economic Enterprise (ISBEE) set-aside for demolition and removal of an old dental clinic mobile home in Manderson, South Dakota. The project involves demolishing a 15x60' manufactured trailer, disposal, earthwork, and site cleanup, with a 180-day performance period under NAICS code 238910 for Site Preparation Contractors.
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Other files
| File | Type | Posted |
|---|---|---|
| APPENDIX_B_Property Pictures.pdf | ||
| APPENDIX_A_BID_SCHEDULE.pdf | ||
| Sol_75H70625Q00040.pdf | ||
| APPENDIX_B_Property Layout.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: IHS1506266 |
| PROJECT TITLE: Manderson IHS old dental clinic trailer demo |
| DATE: February 28, 2025 |
| Business Name: |
| DUNS Number: |
| Print Name: |
| Check Box1: Off |
| Check Box2: Off |
File details come from the government source that posted it. Updated .