Indian Health Service Buy Indian Act Indian Economic Enterprise Representation Form.pdf
PDF 726 KB Posted
- Attached to
- S. DeGoede Well (COW)
- Solicitation number
- 75H70126Q00030
About this file
This is an Indian Health Service Buy Indian Act Indian Economic Enterprise Representation Form required for federal contract solicitations.
The form serves as a self-certification document for offerors responding to Indian Health Service solicitations under the Buy Indian Act authority (25 U.S.C. 47). The specific solicitation referenced is 75H70126Q00030 for the S. DeGoede Well (COW) project. Offerors must certify whether they meet the definition of an "Indian Economic Enterprise" with "Indian Ownership" as defined in EHSAR 326.601. The certification must be valid at three critical time periods: when the offer is submitted, at the time of contract award, and throughout the entire contract performance period. Any contractor that no longer meets eligibility requirements during these periods must provide immediate written notification to the Contracting Officer. Successful offerors must also be registered with the System of Award Management (SAM), and contracting officers may require documentation of eligibility before making awards. The form requires disclosure of the Federally Recognized Tribal Entity name, the 51% owner of the Indian Economic Enterprise firm, business name, DUNS number, and the certifying signature of the owner. Submitting 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.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| A10 Sources Sought Template.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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
(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.
SOLICI ATION : __75H70126Q00030_________
PROJECT TITLE: _S. DeGoede Well (COW)_____________
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:
File details come from the government source that posted it. Updated .