Indian Health Service Buy Indian Act Indian Economic Enterprise Representation Form.pdf
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- Solicitation number
- SS-26-IHS1525040
- Issued by
- Not on record
About this file
This is an Indian Economic Enterprise Representation Form required by the Indian Health Service (IHS) under the authority of the Buy Indian Act (25 U.S.C. 47).
The form serves as a self-certification document that offerors must submit to confirm they meet the definition of an "Indian Economic Enterprise" (IEE) as defined in EHSAR 326.601 when responding to Sources Sought Notices, Requests for Information (RFI), or Solicitations issued by the IHS. Offerors must certify their eligibility at three critical junctures: at the time of offer submission, 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. Contracting Officers may require documentation of eligibility before awarding set-aside or sole source contracts, and awards are subject to protest if offeror eligibility is questioned. Successful offerors must also be registered in the System of Award Management (SAM). The form requires offerors to indicate whether they do or do not meet the IEE definition with Indian Ownership, and must include the name of the Federally Recognized Tribal Entity, business name, name and signature of the 51% owner, and the Unique Entity Identifier (UEI) number. False or misleading information is punishable under 18 U.S.C. 1001, and 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.
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