Indian Health Service Buy Indian Act Indian Economic Enterprise Representation Form.pdf
PDF 462 KB Posted
- Attached to
- Western Oregon Roofing Replacement
- Solicitation number
- 75H70126Q00020
About this file
This is an Indian Health Service Buy Indian Act Indian Economic Enterprise Representation Form for the Western Oregon Roofing Replacement project (Solicitation 75H70126Q00020). The form is a self-certification document that offerors must complete to demonstrate eligibility under the Buy Indian Act authority outlined in 25 U.S.C. 47 and EEHSAR 326.601.
Offerors must certify whether they meet the definition of an "Indian Economic Enterprise" with "Indian Ownership" at three critical points: when submitting an offer, at the time of contract award, and throughout the entire contract performance period. Contractors must immediately notify the Contracting Officer in writing if they no longer meet eligibility requirements at any point during these periods. The form requires documentation of the Federally Recognized Tribal Entity, the 51% owner of the Indian Economic Enterprise Firm, business name, DUNS number, and certifying signature. Individual Contracting Officers may require additional eligibility documentation before awarding set-aside or sole source contracts, and awards are subject to protest if the successful offeror's eligibility is questioned. Successful offerors must also maintain registration with the System of Award Management (SAM). False or misleading information submitted in offers is punishable under 18 U.S.C. 1001, and false claims during contract performance are subject to penalties under 31 U.S.C. 3729 to 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
(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 : __75H70126Q00020_________
PROJECT TITLE: _Western Oregon Roofing Replacement__________________________
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:
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