Manual_Exhibit_5-5_1A_IEERepresentationForm.pdf
PDF 129 KB Posted
- Attached to
- IHS1449677 - VoiP - PAO Federal contract opportunity
- Solicitation number
- IHS-22-PHX-006
About this file
This notice is seeking market research from interested vendors for a Voice over Internet Protocol (VoIP) project being undertaken by the Indian Health Service Phoenix Area Office. The project aims to consolidate and centralize existing IT VoIP systems across eleven regional service units located in central Arizona, northern Nevada and Northwestern Utah into a centralized Cisco Network Voice system using Cisco Unified Communications Manager, Cisco Unity Connection and Singlewire InformaCast for Paging. Interested vendors must be Cisco Gold Certified partners and able to meet the requirements for an Indian Economic Enterprise or Indian Small Business Economic Enterprise. Responses are requested by June 13, 2022 and must include company information, proof of Cisco partnership, and a completed Indian Economic Enterprise Representation form to certify eligibility. The notice will be used to determine if there is a reasonable expectation of obtaining offers from two or more Indian Economic Enterprises to set the opportunity aside before an acquisition decision is made.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Attm 2 Gray Market.pdf | ||
| BOM.pdf | ||
| Sources Sought.pdf | ||
| 1. PHX_AreaOffice-VoIP-SOW.docx | DOCX document |
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Text version
DEPARTMENT OF HEALTH & HUMAN SERVICES
Indian Health Service
Office of Management Services Division of Acquisition Policy (DAP)
5600 Fishers Lane Rockville, MD 20857
INDIAN HEALTH SERVICE
BUY INDIAN ACT
INDIAN ECONOMIC ENTERPRISE
REPRESENTATION FORM
SOLICITATION/SOURCES SOUGHT/RFI #: _________________________________________________
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 Economic Enterprise” (HHSAR 326.601) in response to this Sources Sought Notice, Request for Information (RFI) or Solicitation and resultant contract.
The enterprise must meet the definition of “Indian Economic Enterprise” 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 Economic Enterprise” with “Indian Ownership” under the authority of the Buy Indian Act.
Name of the 51% owner of IEE Firm
Certifying Signature
Print Name
Name of Federally Recognized Tribal Entity
Business Name
DUNS Number
| DATE: |
| DUNSnumber: |
| BusinessName: |
| NameOfTribalEntity: |
| OwnerName: |
| PrintName: |
| SOLICITATION_NUMBER: |
| PROJECT_TITLE: |
| DoesNot: 0 |
| Does: Off |
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