SELF CERT BUY INDIAN ACT.pdf
PDF 46 KB Posted
- Attached to
- PRE-ACCREDITATION SURVEY
- Solicitation number
- 75H71324Q00025
About this file
This document contains an Indian Health Service Buy Indian Act Indian Firm Representation Form and details of a related federal contract opportunity. The Representation Form is a self-certification template for offerors to indicate whether they meet the definition of an "Indian Firm" with "Indian Ownership" under the Buy Indian Act. It requires certification at the time of offer, award, and during contract performance.
The related federal contract opportunity is a solicitation from the Department of Health and Human Services Indian Health Service seeking assessment and evaluation services of Accreditation Association for Ambulatory Health Care accreditation readiness through on-site mock surveys. The solicitation number is 75H71324Q00025 for the PRE-ACCREDITATION SURVEY opportunity with responses due as indicated on the Representation Form date field. Set aside provisions and registration requirements in SAM and D&B apply.
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Other files
| File | Type | Posted |
|---|---|---|
| 75H71324Q00025 PRE-ACCREDITATION SOLICITATION RD 01112024.docx | DOCX document |
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Text version
DEPARTMENT OF HEALTH & HUMAN SERVICES
Indian Health Service
Division of Acquisition Policy (DAP) 5600 Fishers Lane
Rockville, MD 20857
INDIAN HEALTH SERVICE
BUY INDIAN ACT
INDIAN FIRM REPRESENTATION FORM
SOLICIATION NUMBER: _________________________________________________
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 Firm” (HHSAR 326.602) with “Indian Ownership” (HHSAR 326.603), in response to this solicitation and resultant contract.
The enterprise must meet the definition of “Indian Firm” 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 DUN and Bradstreet (D&B) and 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 Firm” with “Indian Ownership” under the authority of the Buy Indian Act.
Business Name Certifying Signature
DUNS Number Print Name
| SOLICITATION NUMBER: |
| PROJECT TITLE: |
| DATE: |
| Business Name: |
| DUNS Number: |
| Print Name: |
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