Indian Health Service Buy Indian Act Indian Economic Enterprise Representation Form.pdf
PDF 167 KB Posted
- Attached to
- Colton Heuker (COW)
- Solicitation number
- 75H70126Q00017
About this file
This document is an Indian Economic Enterprise Representation Form required by the Indian Health Service (IHS) under the Buy Indian Act authority for federal contract opportunities.
The form is a self-certification document that offerors must complete to represent their status as an "Indian Economic Enterprise" with Indian ownership under 25 U.S.C. 47. The solicitation reference number is 75H70126Q00017 for the Colton Heuker OSS and Community Water Connection project. Offerors must meet the Indian Economic Enterprise definition at three critical points: when submitting an offer, at the time of contract award, and throughout the entire contract performance period. Any change in eligibility status during these periods requires immediate written notification to the Contracting Officer. The form requires the offeror to indicate whether it meets or does not meet the definition of an Indian Economic Enterprise, and must include the name of the federally recognized tribal entity, the name of the 51% owner of the Indian Economic Enterprise (IEE) firm, business name, DUNS number, certifying signature, and printed name. Successful offerors must also be registered with the System of Award Management (SAM). The document warns that false or misleading information constitutes a violation 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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Text version
DEPARTMENT OF HEALTH & HUMAN SERVICES
Indian Health Servic
Division of Acquisition Policy 5600 Fishers Lane
Rockville, MD 20857
INDIAN HEALTH SERVICE
BUY INDIAN ACT
IN
REPRESENTATION FORM
SOLICI ATION : _________________________________________________
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 ” (HHSAR 326.60 ) in response to this olicitation and resultant contract.
The enterprise must meet the definition of “Indian ” 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 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 ” with “Indian Ownership” under the authority of the Buy Indian Act.
75H70126Q00017
Colton Heuker OSS and Community Water Connection
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