Indian Firm Representation Form IHS1497904.pdf
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- Solicitation number
- 75H70624Q00065
About this file
This document is an Indian Firm Representation Form for a federal contract opportunity. The form outlines the requirements for an "Indian Firm" to self-certify that it meets the definition under the Buy Indian Act in order to be eligible for a set-aside or sole-source contract. The form must be completed and signed, and the firm must also be registered with DUNS and SAM. Providing false or misleading information is subject to penalties under federal law.
The related federal contract opportunity is a small business set-aside solicitation for two NuStep recumbent training bikes for the Woodrow Wilson Keeble Memorial Healthcare Center in Sisseton, South Dakota. The period of performance is from date of award with delivery required within 60 days. Award will be made to the lowest price technically acceptable offer. Quotes must include a completed SF-18, the Indian Firm Representation Form (if applicable), specifications for the required items, and meet the 60-day delivery schedule. Trade-in valuations will be considered first. Any questions must be submitted by September 6, 2024 before noon CDT.
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Other files
| File | Type | Posted |
|---|---|---|
| SF18-75H70624Q00065.pdf | ||
| Sol_75H70624Q00065.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: IHS1497904 |
| PROJECT TITLE: NuStep Recumbent Bikes for WWKMHC in Sisseton, South Dakota |
| DATE: 08/29/2024 |
| Business Name: |
| DUNS Number: |
| Print Name: |
| Check Box1: Off |
| Check Box2: Off |
File details come from the government source that posted it. Updated .