RFQ-22-168 - OEHE - IT.pdf

A. This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Federal Acquisition Regulation (FAR) Subpart 12.6, as supplemented with additional information included in this notice, FAR Part 12, Acquisition of Commercial Items (Title VIII of the Federal Acquisition Streamlining Act of 1994) (Public Law 103-355).

This announcement constitutes the only solicitation; quotes are being requested and a written solicitation will not be issued.

B. The Great Plains Area Indian Health Service (IHS) intends to award a Firm-Fixed Price, Commercial Item, Purchase Order in response to Request for Quote (RFQ) RFQ-22-168.

C. This solicitation document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular 2022-07/08/10/2022.

D. This RFQ is issued as 100% Buy-Indian, and the associated NAICS Code is 334118, which has a small business standard of

1,000 employees.

E. The quoted unit pricing must be all inclusive (to include but not be limited to travel, lodging, per diem, fringe benefits, federal, state and local taxes) plus all other costs pertinent to the performance of this contract. Utilize your most competitive and reasonable rates.

Complete the attached Price Schedule for:

1. IT Equipment – printers, phones, and licenses - total amount of all items requested $_____________.

F. To provide IT Equipment - printers, phones, and licenses.

G. To be provided for the GPA OEHE Department, Aberdeen, South Dakota, 57401. See Specifications attached and complete.

The period of performance will be Date of Award through 60 days.

H. FAR 52.212-1 Instructions to Offerors-Commercial Items (November 2021).

Quotes shall be submitted on company letterhead stationery, signed, dated and it shall include:

1. Solicitation number RFQ-22-168.

2. Closing Date: August 29, 2022 at 12:00 pm CST.

3. Name, address and telephone number of company and email address of contact person.

4. Technical description of the item/service being offered in sufficient detail to evaluate compliance with the requirements of the solicitation. This may include product literature, or other documents, if necessary.

5. Terms of any express warranty.

6. Price and any discount terms.

7. “Remit to” address, if different than mailing address.

8. A completed copy of the representations and certifications at FAR 52.212-3 (see FAR 52.212-3(b) for those representations and certifications that the offeror shall complete electronically).

9. Acknowledgment of Solicitation Amendments (if any issued)

10. Past performance information, when included as an evaluation factor, to include recent and relevant contracts for the same or similar items and other references (including contract numbers, points of contact with telephone numbers and other relevant information).

11. A statement specifying the extent of agreement with all terms, conditions, and provisions included in the solicitation.

Offerors that fail to furnish required representations or information, or reject the terms and conditions of the solicitation may be excluded from consideration.

I. Basis of award is Lowest Price, Technically Acceptable “LPTA” factors determining the successful contractor. The

Government will not use the formal source selection procedures described in FAR part 15. The Government will evaluate quotations utilizing the procedures of FAR 13.106-2 Evaluation of quotations or offers. Offers will be evaluated for acceptability, but not ranked using the non-price factors/sub-factors. All non-price factors and sub-factors will be rated as either “acceptable” or “unacceptable”. The Government intends to evaluate and make award without discussion with the offerors other than minor clarifications, unless discussions are determined to be necessary. A decision on the technical acceptability of each offeror’s quotations will be made. For those offeror’s which are determined to be technically acceptable, award will be made to that vendor with the lowest overall prices.

The LPTA evaluation process will be accomplished as follows - Technical Acceptability will be comprised of two subfactors:

1.) Meeting all areas under the “SOW/Specifications”; and, 2.) Price.

1.) Shall provide the items stated in the SOW/Specifications.

2.) Price: The Pricing Schedule must be completed for all line items and will be evaluated as to completeness and reasonableness. The offeror with the lowest technically acceptable prices represents the best value for the Government.

J. FAR 52.212-3 Offer Representations and Certifications-Commercial Items (May 2022) See attachment for full text. The

Offeror shall complete only paragraphs (b) of this provision if the Offeror has completed the annual representations and certification electronically via the System for Award Management (SAM) website accessed through http://www.acquisition.gov. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (p) of this provision.

K. FAR 52.212-4 Contract Terms and Conditions-Commercial Item (November 2021) – See attachment; in by reference.

L. FAR 52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive Orders-Commercial

Items (May 2022) - See attachment for full text.

M. Attached are the Federal Acquisition Regulations (FAR) & Health & Human Services Acquisition Regulation (HHSAR) clauses that are applicable including below.

N. Offers will be accepted electronically, Submit via e-mail to the following:

Great Plains Area Indian Health Service Attn: Wenda Wright, Contract Specialist 115 4th Ave. SE, Room 309 Aberdeen, SD 57401 Email: wenda.wright@ihs.gov

Any questions, please submit by August 24, 2022 by 10:00 am CST.

Contractors will need a UEI number, TIN number, and be registered with www.sam.gov.

No contract award shall be made to any vendor listed on the OIG Exclusions List at http://exclusions.org.hhs.gov throughout the duration of the contract.

Contractor must be registered with the System for Award Management (SAM) at www.sam.gov

The Government reserves the right to accept or reject services, if the level of performance is unacceptable.

The Contractor must provide only new equipment and new parts for the required products described herein; no used, refurbished, or remanufactured equipment or parts shall be provided under any circumstances. Absolutely no “Gray Market Goods” or “Counterfeit Electronic Parts” shall be provided. Gray Market Goods are defined as genuine branded goods intentionally or unintentionally sold outside of an authorized sales-territory or by non-authorized dealers in an authorized territory. All equipment shall be accompanied by the Original Equipment Manufacturers (OEM’s) warranty.

Counterfeit Electronic Parts are defined as unlawful or unauthorized reproduction, substitution, or alteration that has been knowingly mismarked, misidentified, or otherwise misrepresented to be an authentic, unmodified electronic part from the original manufacturer, or a source with the express written authority of the original manufacturer or current design activity, including an authorized aftermarket manufacturer. Unlawful or unauthorized substitution includes used electronic parts represented as new, or the false identification of grade, serial number, lot number, date code, or performance characteristics.

“The Office of Management and Budget (OMB) mandates that U.S. federal agencies use the Internet Protocol version 6 (IPv6). In November 2020, OMB issued memorandum M-21-07 "Completing the Transition to IPv6", which outlines the Federal government's strategic intent "to deliver its information services, operate its networks, and access the services of others using only IPv6". The IHS requires all new IT systems (hardware and software) to operate in a pure IPv6 network environment. This includes on-premises services or third-party hosted services that require network integration into the IHS network. The Offeror's solution shall comply with the IPv6 standards profile as defined by the NIST USGv6 Program:

https://www.nist.gov/programs-projects/usgv6-program”

Invoice Processing Platform (IPP) The Indian Health Service (IHS) is in the process of implementing an electronic invoicing system.

http://www.acquisition.gov/ mailto:wenda.wright@ihs.gov http://www.sam.gov/ http://exclusions.org.hhs.gov/ http://www.sam.gov/ https://www.nist.gov/programs-projects/usgv6-program

In compliance with the Office of Management and Budget (OMB) M-15-19 memorandum “Improving Government Efficiency and Saving Taxpayer Dollars Through Electronic Invoicing” directing Federal agencies to adopt electronic invoicing as the primary means to disburse payment to vendors. Invoices submitted under any award will be required to utilize the Invoice Processing Platform (IPP) in accordance with HHSAR 352.232-71, Electronic Submission and Processing of Payment Requests”

IPP is a secure, web-based electronic invoicing system provided by the U.S. Department of the Treasury’s Bureau of the Fiscal Service, in partnership with the Federal Reserve Bank of St. Louis (FRSTL). Respondents to this solicitation are encouraged to register an account with IPP if they have not already done so. If your organization is already registered to use IPP, you will not be required to re-register- however, we encourage you make sure your organization and designated IPP user accounts are valid and up to date.

The IPP website address is: https://www.ipp.gov

If you require assistance registering or IPP account access, please contact the IPP Helpdesk at (866) 973-3131 (M-F 8AM to 6PM ET), or IPPCustomerSupport@fiscal.treasury.gov

Should the contractor feel that use of the IPP would be unduly burdensome, their response to this solicitation should include an explanation of this position for a determination by the contracting officer.

https://obamawhitehouse.archives.gov/sites/default/files/omb/memoranda/2015/m-15-19.pdf https://www.ipp.gov/ mailto:IPPCustomerSupport@fiscal.treasury.gov

Specifications Part 1

Phones, Printers & Copiers June 2022

Vendor shall supply and deliver Phones, Printers & Copiers as detailed in the specifications below or approved equal, to the delivery address listed in Part 2.

SPECIFICATIONS:

HP M856X printer

• Office Machine:

▪ monthly duty cycle = 100,000+ pages – (max) 250,000 pages

▪ 50,000 recommended monthly volume

▪ 5-20 Users

▪ Laser Technology

▪ Color Output Type

• Dimension & Weights: Dimension & Weights (Shipping):

Width – 21.9 inch Width – 33.7 inch Depth – 25.9 inch Depth – 29.9 inch Height – 38.2 inch Height – 53.6 inch Weight – 188.27 lbs Weight – 205.38 lbs

• Environmental Parameters:

▪ Operating Temperature – (Min) 50 degree Fahrenheit - (Max) 90.5 degree Fahrenheit

▪ Humidity Range Operating – 10-80%

▪ Idle Sound Emission – 33 dBA

▪ Operating Sound Emission – 52 dBA

• Physical Characteristics:

▪ Color: White TAA Compliant No Scanner

• Other Characteristics:

▪ Chassis - 4.3” Preview Screen Size

▪ Processor Clock Speed – 1.2 GHZ

▪ Ram Technology – DDR3 SDRAM with Installed size 1.5 GB and Max size 2 GB

▪ One toner cartridge (black) included up to 16,000 pages

• Printing:

▪ Max Resolution B/W and Color – 1200 x 1200 dpi

▪ Max Printing Speed B/W and Color – 55 pages per minute

▪ Automatic Duplexing - Yes

• Connectivity Printing:

▪ Interface - Gigabit Lan, USB 2.0, USB 2.0 host, Wi-Fi (n)

▪ Connections – (1) Gigabit LAN – RJ-45, (1) USB 2.0, (4) pin USB Type B & A, (3) USB 2.0 host

▪ AirPrint Enabled – Yes

▪ Wireless Ready – Yes

▪ Mobile Printing Capability – Google Cloud Print, HP ePrint, HP Roam, Mopria Print Service

Specifications - Continued:

HP M856X printer - Continued

• Printer:

▪ Type Workgroup printer

▪ Connectivity Technology – Wired, Wireless

▪ Image Enchancement – HP Image Ret 4800

▪ Min H-Document Size – 2.5 In Max H-Document Size – 12.6 In

▪ Min V-Document Size – 5 In Max V-Document Size – 18 In

▪ Min Media Weight – 16 lbs (60 gram) Max Media Weight – 80 lbs (300 gram)

▪ Language Simulation – PCL5, PCL6, PDF 1.4 and PostScript 3

▪ Media Handling – (1) 100 sheets multipurpose tray, (4) automatic trays 550-sheet input trays

▪ Media Type – Card Stock, Envelopes, Extra heavy-weight paper, labels, Light-weight paper, plain paper and Transparencies

▪ Output Tray Capacity – 500 sheets

• Power Device:

▪ Type – Power Supply

▪ Form Factor – Internal

▪ Nominal Voltage – AC 120 V

▪ Frequency Required – 50/60 hertz

▪ Power Consumption Operational 870 watt

▪ Power Consumption Stand by 77 watt

▪ Power Consumption Sleep by 0.7 watt

• System Requirements:

▪ Android Microsoft Windows 7 / 8 / 8.1 / 10 (32/64 bits)

▪ Apple iOS Microsoft Windows Server 2008 R2 (64 bits)

▪ Apple macOS 10.12 Microsoft Windows Server 2008 R2 SP1 (64-bits)

▪ Apple macOS 10.13 Microsoft Windows Server 2008 R2 x64 Edition

▪ Apple macOS 10.14 Microsoft Windows Server 2012 (64-bit)

▪ Microsoft Windows Server 2012 R2 (64-bit) Microsoft Windows Server 2012 R2 x64 Edition

▪ Microsoft Windows Server 2012 x64 Edition Microsoft Windows Server 2016 (64-bit)

Cisco 8832 with License

• Cisco IP Conference Phone 8832 in Charcoal for North America; CLIN:

• (1 Year) Cisco SmartNet-8X5XNBD Cisco IP Conference Phone 8832 in Char; CLIN: 000002

• Cisco 8832 Ethernet deployment accessories for N America; CLIN: 000002

• Top Level SKU For 9.x/10.x User License – eDelivery

• (5 Years) Cisco SmartNet SWSS UPGRADES Top Level SKU For 9.

• CUCM Software Version 10.X

• UC Manager-10.x Enhanced Single User License; CLIN: 000002

• (5 Years) Cisco SmartNet SWSS UPGRADES UC Manager-10.x Enhanced Single User-Und; CLIN: 00002

Cisco 8832 with License - Continued

• Enable TURN Relay Option

• Expressway Series, Expressway-E PAK

• UC Encryption License

• UCMPAK

• Cisco Expressway-C Server, Virtual Edition

• Enable Expressway-E Feature Set

• Enable GW Feature (H323-SIP)

• Prime Collaboration Standard 10.x

• Software Image for Expressway with Encryption, Version X8

• Enable Advanced Networking Option

• Cisco Expressway-E Server, Virtual Edition

• UC Manager Enhanced 10.x License

• Expressway Desktop Endpoint License

• License Key Software Encrypted

• Enable Expressway Series Feature Set

Cisco 8841 with License

• Cisco IP Phone 8841; CLIN: 000002

• (1 Year) Cisco SmartNet-8X5XNBD Cisco UC Phone 8841; CLIN: 000002

• Top Level SKU For 9.x/10.x User License – eDelivery

• (5 Years) Cisco SmartNet SWSS UPGRADES Top Level SKU For 9.

• CUCM Software Version 10.X

• UC Manager-10.x Enhanced Single User License; CLIN: 000002

• (5 Years) Cisco SmartNet SWSS UPGRADES UC Manager-10.x Enhanced Single User-Und; CLIN:

000002

• Enable TURN Relay Option

• Expressway Series, Expressway-E PAK

• UC Encryption License

• UCMPAK

• Cisco Expressway-C Server, Virtual Edition

• Enable Expressway-E Feature Set

• Enable GW Feature (H323-SIP)

• Prime Collaboration Standard 10.x

• Software Image for Expressway with Encryption, Version X8

• Enable Advanced Networking Option

• Cisco Expressway-E Server, Virtual Edition

Cisco 8841 with License - Continued

• UC Manager Enhanced 10.x License

• Expressway Desktop Endpoint License

• License Key Software Encrypted

• Enable Expressway Series Feature Set

Lexmark CX920 Series

Paper capacity:

Configured for high volume, a maximum input capacity of 6,650 sheets handles the largest workloads, while output scales to a massive 3,500.

Toner for the long run:

Replacement cartridges print up to 34,000 monochrome or color pages*.

Long-life service intervals:

Fusers and developer units produce up to 720,000 and 600,000 pages**, respectively, for impressive uptime.

Intelligent and accessible

Power for performance:

It starts with a 1.2 GHz Quad Core processor and 2 GB of memory (expandable to 4 GB) for both a responsive user interface and exceptional imaging speed.

Bright and easy:

A bright, next generation 10-inch class color touch screen with Lexmark’s own e-Task interface creates an icon- and text driven experience that’s always intuitive to navigate and can walk you through each step. A convenient USB port is right up front for easy document printing and file transfer.

Solutions and more:

Enhance your user experience and productivity with the included solution apps, and customize your device via optional apps tailored to your specific need or industry. With available software development kits, you can even create apps of your own.

Hard disk enhancement:

The CX920 series’ standard hard disk enables efficiency-boosting features like job buffering while enhancing functions like collating and overall system responsiveness.

Accessibility:

There’s integrated voice guidance, a standard headphone jack, tiltable control panel, and the ability to use both standard accessibility “swipe” gestures and an optional USB keyboard. It’s all part of making Lexmark’s best SRA3/12x18-in MFPs ever not just accessible to those with varying levels of abilities, but a better user experience for everyone.

Lexmark CX920 Series – Continued:

Equipped for professional output

Pro color:

Match your most critical colors and present your boldest ideas with a well-stocked color toolbox that includes PANTONE® calibration, embedded color sample pages and Lexmark Color Replacement for easy matching of spot and RGB colors.

Advanced finishing:

Boost your inhouse production capabilities and reach new customers with optional finishing like multi-position stapling, hole punch, booklet, saddle stitch and tri-fold.

Connected to your world:

Gigabit Ethernet ports ensure connectivity to all modern networks, while dual USB 2.0 high-speed rear ports can interface to individual devices.

Optional wireless and fiber optic cards further expand your circle of authorized users.

The Lexmark advantage

Security:

Lexmark’s comprehensive full-spectrum security is built into all our products to create not just a safer but a more productive environment. Our portfolio of security covers secure access, document and network security, secure remote management, hard disk security and optional features like secure print release. Together, they reflect our experience working in some of the most highly regulated, mission critical settings on earth.

Mobility:

Make mobile printing as easy as PC printing with the free Lexmark Mobile Print app, or get output via AirPrint®, Google Cloud Print™, Mopria® or Windows® Mobile on networks with wireless access. Adding the CX920 series’ optional wireless card enables direct printing, so you can bypass the network. More mobile printing options means more choices for you and your users.

Manageability:

CX920 series MFPs become an integrated part of an existing managed Lexmark fleet as soon as you plug them in, thanks to full compatibility with free, downloadable Markvision Enterprise software. With MVE, you can track, troubleshoot and update devices throughout their lifecycle—from the moment they join the network until the day you retire them.

Lexmark services integration:

Every CX920 series device is fully compatible with optional Lexmark services. Managed Print Services optimizes and manages your organization’s entire print and document output infrastructure, while the Lexmark Print Management solution reduces unnecessary printing, protects confidential information and puts you in complete control of mobile policies, options and defaults.

Security and more

Device management:

A combination of administrative access and passwords, HTTPS, SMNPv3, IPsec and 802.1x support lets you remotely monitor, manage, authorize and authenticate who and what gets access to the network.

Device hardening:

Built-in tools include port filtering and TCP connection filtering which restrict what connections are active from which sources. Encrypting and wiping the hard disk protects sensitive print job data. Digitally signed firmware updates prevent hackers from uploading compromised software to the MFP.

Device operation:

You get user authentication via PIN, passwords or badge reader, address book lookup via LDAP over SSL (Secure Socket Layer) to provide a secure connection between the MFP and the network, and device operator panel lockouts to protect the device settings.

Hard disk protection:

The hard disk is protected with 256-bit AES encryption and encryption keys stored in the MFP’s memory, not the hard disk. The data is protected even if the hard drive is removed. This level of protection is automatic at power up—users and administrators don’t have to do anything.

Built for planet earth

Power saving modes:

Sleep mode sips less than 3 watts to save money and energy between print jobs. When the device is not in use, it goes to sleep and quickly wakes for incoming print jobs. In addition, it can be manually powered on or off from its control panel or automatically via a user-defined schedule. And low power-mode sensors wake the MFP when paper is placed in the ADF or the scanner lid is opened.

Paper and toner savings:

Standard duplex mode prints on both sides of each sheet by default, without slowing down, for complete duplex efficiency at the device’s rated print speed. Plus, the unique ColorSaver feature prints images at a lighter shade by default, while leaving text dark and readable, saving toner and money.

Lexmark Managed Print Services (MPS)

Lexmark Managed Print Services (MPS) takes a holistic approach to improving the enterprise print architecture. Lexmark aligns devices with your business mission and takes care of their day-today management with proactive and predictive services to ensure maximum uptime. Once in place, the managed environment becomes a conduit to unify print and digital information for streamlined processes. Customers benefit with fewer devices, fewer pages, lower cost and improved productivity.

Recycled paper compatibility:

To ensure that you can minimize the impact of paper you use, the Lexmark CX920 Series has been fully tested with a range of recycled papers, up to 100% recycled.

Environmental certifications:

These Lexmark products meet globally recognized environmental standards*:

}} ENERGY STAR® }} Blue Angel }} EPEAT® Silver }} RoHS Compliant

Lexmark CX920 Series features

1. Intuitive color touch screen with next-generation e-Task interface

The large 10-in. class color touch screen features an ultra-smooth surface and can be activated by almost anything, including pens, fingertips or nails—without pressure or direct skin contact. The modern interface is familiar to users, minimizing the need for training.

2. Speedy scanner

Duplex automatic document feeder (ADF) holds 100 sheets and supports scanning at up to 160 sides per minute for outstanding capture velocity. Support for mixed originals, page-level jam recovery, standard OCR and a “classify and route” option fulfill the highest-speed automated scanning requirements.

3. Expandable input

Print on multiple paper types and sizes, with input capacity up to 6,650 sheets.

4. Finishing options

Expand your capabilities with finishing options that include multi-position stapling, hole punch, booklet, saddle stitch and tri-fold.

The finisher raises output capacity to 3,500 sheets.

5. High-capacity production yields

Genuine Lexmark toner cartridges print up to 34,000 monochrome or color pages*, while fusers and developer units produce up to 720,000 and 600,000** pages, respectively, for impressive uptime.

6. Software solutions

Enhance your user experience and productivity with the included solution apps, and customize your device via optional apps tailored to your specific need or industry. With available software development kits, you could even create apps of your own. Lexmark smart MFP adaptability helps future-proof your investment.

7. Direct printing

Print Microsoft Office files, PDFs and other document and image types from flash drives, or select and print documents from Network servers or online drives.

Part 1

Phones, Printers & Copiers June 2022

Specifications - Continued:

HP Color Laser Jet Enterprise MFP M776 series

1. Hardware Integration Pocket

2. 200-sheet inner finisher output bin

3. 500-sheet output bin

4. Convenience stapler

5. Stapler/stacker inner finisher

6. Pull-out keyboard (Flow models only)

7. Front door (access to JetIntelligence toner cartridges and imaging drums)

8. 550-sheet tray 2 supports media sizes up to 11.7 x 17 inches (297 x 432 mm)

9. Dual-band Wi-Fi® and Wi-Fi Direct with Bluetooth® Low Energy

10. 200-sheet ADF with single-pass, two-sided scanning handles media sizes up to 11.7 x 34 inches (297 x 864 mm)

11. 9.0-inch (22.8 cm) functional touchscreen with 8.0-inch (20.3 cm) Color Graphics

Display

12. Easy-access USB port

13. Upper-right door (access to print path)

14. Right door (access to the fuser)

15. Automatic two-sided printing

16. 100-sheet multipurpose tray 1 supports media sizes up to 12 x 18 inches (305 x 457

mm) and SRA3

17. 2x550-sheet tray with stand supports media sizes up to 12 x 18 inches (305 x 457

mm) and SRA3

18. 2 Hi-Speed USB 2.0 Host ports

19. Gigabit/Fast Ethernet 10/100/1000Base-TX network port

20. Hi-Speed USB 2.0 device port

21. Fax port

DELIVERY:

Deliveries shall be no later than 60 days from date of purchase order.

Delivery Location:

For questions, please contact:

Mark LeBrun, IT Specialist. Phone 605-226-7608

Vendor shall supply and deliver the equipment to the delivery site locations as listed below with address on next page.

Item Description

1.

Aberdeen

(Qty)

2.

Pierre (Qty)

3.

Sioux City (Qty)

4.

Dunseith

(Qty)

1 HP M856X printer 1

2 Cisco 8832 with License 2

3 Cisco 8841 with License 24

4 LEXMARK CX921DE -

MULTIFUNCTION PRINTER

5 HP Color Laser Jet Enterprise MFP

M776DN series

Deliver to Locations:

1. Great Plains Area Indian Health Service -

OEHE

115 4th Ave. SE Room 309

Aberdeen, SD 57401

2. Indian Health Service - OEHE 420 S. Garfield Ave., Suite 200 Pierre, SD 57501 (no delivery dock)

3. Indian Health Service

OEHE

320 6th St., Room 212 Sioux City, IA 51101-1214 (yes-loading dock at the back of the Federal Building)

4. Indian Health Service

OEHE

211 Main St North Dunseith, ND 58329

Delivery Locations Part 2

Phones, Printers & Copiers

Price Schedule

Description Price Qty. Subtotal 1 HP M856X printer $ 1 $ 2 Cisco 8832 with License $ 2 $ 3 Cisco 8841 with License $ 24 $

4 LEXMARK CX921DE -

MULTIFUNCTION PRINTER $ 1 $

5 HP Color Laser Jet Enterprise MFP

M776DN series $ 1 $

Total $ .

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

CLAUSES INCORPORATED BY REFERENCE

(Firm Fixed-Price, Commercial)

FAR CITATION: 52.252-2: Clauses Incorporated by Reference. (FEB 1998) I. Federal Acquisition Regulations (FAR) (48 CFR Chapter 1) Clauses

No. FAR Citation Clause Title Clause Date ____

1. 52.204-7 System for Award Management October 2018

2. 52.204-13 System for Award Management Maintenance October 2016

3. 52.204-16 Commercial and Government Entity Code August 2020 Reporting

4. 52.204-17 Ownership or Control of Offeror August 2020

5. 52.204-18 Commercial and Government Entity Code August 2020 Maintenance

6. 52.204-19 Incorporation by Reference of December 2014 Representations and Certifications

7. 52.212-1 Instructions to Offerors – Commercial Items November 2021

8. 52.212-4 Contract Terms and Conditions November 2021

- Commercial Items

9. 52.225-25 Prohibition on Contracting with Entities June 2020 Engaging in Certain Activities or Transactions Relating to Iran – Representation and Certifications

10. 52.232-39 Unenforceability of Unauthorized Obligations June 2013

11. 52.232-40 Providing Accelerated Payments to Small November 2021 Business Subcontractors

12. 52.253-1 Computer Generated Forms January 1991

CLAUSES INCORPORATED IN FULL TEXT

II. Federal Acquisition Regulations (FAR) (48 CFR Chapter 1) Clauses

No. FAR Citation Clause Title Clause Date ____

1. 52.204-24 Representation Regarding Certain November 2021 Telecommunications and Video Surveillance Services or Equipment

2. 52.212-3 Offeror Representations and Certifications May 2022 (See attached)

3. 52.212-5 Contract Terms and Conditions Required To May 2022 Implement Statues or Executive Orders – Commercial Items (See attached)

4. 52.217-8 Option to Extend the Services November 1999

5. 52.223-99 Ensuring Adequate COVID-19 Safety Protocols October 2021 For Federal Contractors

6. 52.252-1 Solicitation Provisions Incorporated by February 1998 Reference

7. 52.252-2 Clauses Incorporated by Reference February 1998

52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment.

As prescribed in 4.2105(a), insert the following provision:

REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS AND VIDEO SURVEILLANCE SERVICES OR

EQUIPMENT (NOV 2021)

The Offeror shall not complete the representation at paragraph (d)(1) of this provision if the Offeror has represented that it "does not provide covered telecommunications equipment or services as a part of its offered products or services to the Government in the performance of any contract, subcontract, or other contractual instrument" in paragraph (c)(1) in the provision at 52.204-26, Covered Telecommunications Equipment or Services—Representation, or in paragraph (v)(2)(i) of the provision at 52.212-3, Offeror Representations and Certifications-Commercial Products or Commercial Services. The Offeror shall not complete the representation in paragraph (d)(2) of this provision if the Offeror has represented that it "does not use covered telecommunications equipment or services, or any equipment, system, or service that uses covered telecommunications equipment or services" in paragraph (c)(2) of the provision at 52.204-26, or in paragraph (v)(2)(ii) of the provision at 52.212-3.

(a) Definitions. As used in this provision—

Backhaul, covered telecommunications equipment or services, critical technology, interconnection arrangements, reasonable inquiry, roaming, and substantial or essential component have the meanings provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

(b) Prohibition.

(1) Section 889(a)(1)(A) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Pub. L. 115-232) prohibits the head of an executive agency on or after August 13, 2019, from procuring or https://www.acquisition.gov/far/part-4#FAR_4_2105 https://www.acquisition.gov/far/part-52#FAR_52_204_26 https://www.acquisition.gov/far/part-52#FAR_52_212_3 https://www.acquisition.gov/far/part-52#FAR_52_204_26 https://www.acquisition.gov/far/part-52#FAR_52_212_3 https://www.acquisition.gov/far/part-52#FAR_52_204_25 obtaining, or extending or renewing a contract to procure or obtain, any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. Nothing in the prohibition shall be construed to—

(i) Prohibit the head of an executive agency from procuring with an entity to provide a service that connects to the facilities of a third-party, such as backhaul, roaming, or interconnection arrangements; or

(ii) Cover telecommunications equipment that cannot route or redirect user data traffic or cannot permit visibility into any user data or packets that such equipment transmits or otherwise handles.

(2) Section 889(a)(1)(B) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Pub. L. 115-232) prohibits the head of an executive agency on or after August 13, 2020, from entering into a contract or extending or renewing a contract with an entity that uses any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. This prohibition applies to the use of covered telecommunications equipment or services, regardless of whether that use is in performance of work under a Federal contract. Nothing in the prohibition shall be construed to—

(i) Prohibit the head of an executive agency from procuring with an entity to provide a service that connects to the facilities of a third-party, such as backhaul, roaming, or interconnection arrangements; or

(ii) Cover telecommunications equipment that cannot route or redirect user data traffic or cannot permit visibility into any user data or packets that such equipment transmits or otherwise handles.

(c) Procedures. The Offeror shall review the list of excluded parties in the System for Award Management (SAM) ( https://www.sam.gov) for entities excluded from receiving federal awards for "covered telecommunications equipment or services".

(d) Representation. The Offeror represents that—

(1) It □ will, □ will not provide covered telecommunications equipment or services to the Government in the performance of any contract, subcontract or other contractual instrument resulting from this solicitation.

The Offeror shall provide the additional disclosure information required at paragraph (e)(1) of this section if the Offeror responds "will" in paragraph (d)(1) of this section; and

(2) After conducting a reasonable inquiry, for purposes of this representation, the Offeror represents that—

It □ does, □ does not use covered telecommunications equipment or services, or use any equipment, system, or service that uses covered telecommunications equipment or services. The Offeror shall provide the additional disclosure information required at paragraph (e)(2) of this section if the Offeror responds "does" in paragraph (d)(2) of this section.

(e) Disclosures.

(1) Disclosure for the representation in paragraph (d)(1) of this provision. If the Offeror has responded "will" in the representation in paragraph (d)(1) of this provision, the Offeror shall provide the following information as part of the offer:

(i) For covered equipment— https://www.sam.gov/

(A) The entity that produced the covered telecommunications equipment (include entity name, unique entity identifier, CAGE code, and whether the entity was the original equipment manufacturer (OEM) or a distributor, if known);

(B) A description of all covered telecommunications equipment offered (include brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); and

(C) Explanation of the proposed use of covered telecommunications equipment and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(1) of this provision.

(ii) For covered services—

(A) If the service is related to item maintenance: A description of all covered telecommunications services offered (include on the item being maintained: Brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); or

(B) If not associated with maintenance, the Product Service Code (PSC) of the service being provided; and explanation of the proposed use of covered telecommunications services and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(1) of this provision.

(2) Disclosure for the representation in paragraph (d)(2) of this provision. If the Offeror has responded "does" in the representation in paragraph (d)(2) of this provision, the Offeror shall provide the following information as part of the offer:

(i) For covered equipment—

(A) The entity that produced the covered telecommunications equipment (include entity name, unique entity identifier, CAGE code, and whether the entity was the OEM or a distributor, if known);

(B) A description of all covered telecommunications equipment offered (include brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); and

(C) Explanation of the proposed use of covered telecommunications equipment and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(2) of this provision.

(ii) For covered services—

(A) If the service is related to item maintenance: A description of all covered telecommunications services offered (include on the item being maintained: Brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); or

(B) If not associated with maintenance, the PSC of the service being provided; and explanation of the proposed use of covered telecommunications services and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(2) of this provision.

(End of provision)

52.217-8 Option to Extend Services.

As prescribed in 17.208(f), insert a clause substantially the same as the following:

OPTION TO EXTEND SERVICES (NOV 1999)

The Government may require continued performance of any services within the limits and at the rates specified in the contract. These rates may be adjusted only as a result of revisions to prevailing labor rates provided by the Secretary of Labor. The option provision may be exercised more than once, but the total extension of performance hereunder shall not exceed 6 months. The Contracting Officer may exercise the option by written notice to the Contractor within 30 days.

(End of clause)

52.223-99 Ensuring Adequate COVID-19 Safety Protocols for Federal Contractors.

ENSURING ADEQUATE COVID-19 SAFETY PROTOCOLS FOR FEDERAL CONTRACTORS (OCT 2021) (DEVIATION)

(a) Definition. As used in this clause - United States or its outlying areas means—

(1) The fifty States;

(2) The District of Columbia;

(3) The commonwealths of Puerto Rico and the Northern Mariana Islands;

(4) The territories of American Samoa, Guam, and the United States Virgin Islands; and

(5) The minor outlying islands of Baker Island, Howland Island, Jarvis Island, Johnston Atoll, Kingman Reef, Midway Islands, Navassa Island, Palmyra Atoll, and Wake Atoll.

(b) Authority. This clause implements Executive Order 14042, Ensuring Adequate COVID Safety Protocols for Federal Contractors, dated September 9, 2021 (published in the Federal Register on September 14, 2021, 86 FR 50985).

(c) Compliance. The Contractor shall comply with all guidance, including guidance conveyed through Frequently Asked Questions, as amended during the performance of this contract, for contractor or subcontractor workplace locations published by the Safer Federal Workforce Task Force (Task Force Guidance) at https:/www.saferfederalworkforce.gov/contractors/.

(d) Subcontracts. The Contractor shall include the substance of this clause, including this paragraph (d), in subcontracts at any tier that exceed the simplified acquisition threshold, as defined in Federal Acquisition Regulation 2.101 on the date of subcontract award, and are for services, including construction, performed in whole or in part within the United States or its outlying areas.

(End of clause)]

52.252-1 Solicitation Provisions Incorporated by Reference.

As prescribed in 52.107(a), insert the following provision:

SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998)

This solicitation incorporates one or more solicitation provisions by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available.

The offeror is cautioned that the listed provisions may include blocks that must be completed by the offeror https://www.acquisition.gov/sites/default/files/current/far/html/Subpart%2017_2.html#wp1078175 https://www.acquisition.gov/sites/default/files/current/far/html/52_000_107.html#wp1114174 and submitted with its quotation or offer. In lieu of submitting the full text of those provisions, the offeror may identify the provision by paragraph identifier and provide the appropriate information with its quotation or offer. Also, the full text of a solicitation provision may be accessed electronically at this/these address(es):

https://www.acquisition.gov

(End of provision)

52.252-2 Clauses Incorporated by Reference.

As prescribed in 52.107(b), insert the following clause:

CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es): https://www.acquisition.gov

III. Department of HHS Acquisition Regulations (HHSAR) (49 Chapter 3) Clauses

No. HHSAR Citation Clause Title Clause Date______

1. HHSAR 352.226-1 Indian Preference December 2015

2. HHSAR 352.232-71 Electronic Submission of Payment Requests February 2022

352.226-1 Indian Preference.

As prescribed in HHSAR 326.505(a), the Contracting Officer shall insert the following clause:

Indian Preference (December 18, 2015)

(a) The Contractor agrees to give preference in employment opportunities under this contract to Indians who can perform required work, regardless of age (subject to existing laws and regulations), sex, religion, or tribal affiliation. To the extent feasible and consistent with the efficient performance of this contract, the Contractor further agrees to give preference in employment and training opportunities under this contract to Indians who are not fully qualified to perform regardless of age (subject to existing laws and regulations), sex, religion, or tribal affiliation. The Contractor also agrees to give preference to Indian organizations and Indian-owned economic enterprises in the awarding of any subcontracts to the extent feasible and consistent with the efficient performance of this contract. The Contractor shall maintain the necessary statistical records to demonstrate compliance with this paragraph.

(b) In connection with the Indian employment preference requirements of this clause, the Contractor shall provide reasonable opportunities for training, incident to such employment. Such training shall include on-the—job, classroom, or apprenticeship training designed to increase the vocational effectiveness of an Indian employee.

(c) If the Contractor is unable to fill its employment and training opportunities after giving full consideration to Indians as required by this clause, the Contractor may satisfy those needs by selecting non-Indian persons in accordance with the clause of this contract entitled "Equal Opportunity."

https://www.acquisition.gov/sites/default/files/current/far/html/52_000_107.html#wp1114174 http://www.hhs.gov/grants/contracts/contract-policies-regulations/hhsar/part-326-other-socioeconomic-programs/index.html#326.505

(d) If no Indian organizations or Indian-owned economic enterprises are available under reasonable terms and conditions, including price, for awarding of subcontracts in connection with the work performed under this contract, the Contractor agrees to comply with the provisions of this contract involving utilization of small businesses; HUBZone small businesses; service-disabled, veteran-owned small businesses; 8(a) small businesses; veteran-owned small businesses; women-owned small businesses; or small disadvantaged businesses.

(e) As used in this clause,

(1) Indian means a person who is a member of an Indian tribe. If the Contractor has reason to doubt that a person seeking employment preference is an Indian, the Contractor shall grant the preference but shall require the individual provide evidence within 30 days from the tribe concerned that the person is a member of the tribe.

(2) Indian tribe means an Indian tribe, pueblo, band, nation, or other organized group or community, including Alaska Native village or regional or village corporation as defined in or established pursuant to the Alaska Native Claims Settlement Act (85 Stat. 688; 43 U.S.C. 1601) which the United States recognizes as eligible for the special programs and services provided to Indians because of its status as Indians.

(3) Indian organization means the governing body of any Indian Tribe or entity established or recognized by such governing body in accordance with the Indian Financing Act of 1974 (88 Stat. 77; 25 U.S.C. 1451).

(4) Indian-owned economic enterprise means any Indian-owned commercial, industrial, or business activity established or organized for the purpose of profit, provided that such Indian ownership shall constitute not less than 51 percent of the enterprise, and that ownership shall encompass active operation and control of the enterprise.

(f) The Contractor agrees to include the provisions of this clause, including this paragraph (f) of this clause, in each subcontract awarded at any tier under this contract.

(g) In the event of noncompliance with this clause, the Contracting Officer may terminate the contract in whole or in part or may pursue any other remedies authorized by law or by other provisions of the contract.

(End of clause)

332.232-71 Electronic Submission of Payment Requests.

In accordance with HHSAR 332.7003, the Contracting Officer shall insert the following clause:

Electronic Submission of Payment Requests (Feb 2022)

(a) Definitions. As used in this clause –

Payment request means a bill, voucher, invoice, or request for contract financing payment with associated supporting documentation. The payment request must comply with the requirements identified in FAR 32.905(b), “Content of Invoices” and the applicable Payment clause included in this contract.

(b) Except as provided in paragraph (c) of this clause, the Contractor shall submit payment requests electronically using the Department of Treasury Invoice Processing Platform (IPP) or successor system.

Information regarding IPP, including IPP Customer Support contact information, is available at www.ipp.gov or any successor site.

http://www.ipp.gov/

(c) The Contractor may submit payment requests using other than IPP only when the Contracting Officer authorizes alternate procedures in writing in accordance with HHS procedures.

(d) If alternate payment procedures are authorized, the Contractor shall include a copy of the Contracting Officer's written authorization with each payment request.

(End of Clause)

52.212-3 Offeror Representations and Certifications—Commercial Products and Commercial Services.

As prescribed in 12.301(b)(2), insert the following provision:

OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES (MAY 2022)

The Offeror shall complete only paragraph (b) of this provision if the Offeror has completed the annual representations and certification electronically in the System for Award Management (SAM) accessed through https://www.sam.gov. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (v)) of this provision.

(a) Definitions. As used in this provision—

"Covered telecommunications equipment or services" has the meaning provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

Economically disadvantaged women-owned small business (EDWOSB) concern means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States and who are economically disadvantaged in accordance with 13 CFR part 127. It automatically qualifies as a women-owned small business eligible under the WOSB Program.

Forced or indentured child labor means all work or service—

(1) Exacted from any person under the age of 18 under the menace of any penalty for its nonperformance and for which the worker does not offer himself voluntarily; or

(2) Performed by any person under the age of 18 pursuant to a contract the enforcement of which can be accomplished by process or penalties.

Highest-level owner means the entity that owns or controls an immediate owner of the offeror, or that owns or controls one or more entities that control an immediate owner of the offeror. No entity owns or exercises control of the highest level owner.

Immediate…