Sol_75H71026Q00021.pdf

SEE ADDENDUMIS CHECKED

CODE 18a. PAYMENT WILL BE MADE BY

CODE

FACILITYCODE

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

OFFEROR

Highway 160, Mile Post 394.3 PO Box 368 Acquisition Department Kayenta Health Center

IHSINSCRIPTONHOUSE CODE 16. ADMINISTERED BYCODE

X

X

339113

SIZE STANDARD:

% FOR:SET ASIDE:UNRESTRICTED OR25

RFPIFB

10. THIS ACQUISITION ISCODE

RFQ

14. METHOD OF SOLICITATION

13b. RATING

NAICS:

SMALL BUSINESS

01/06/2026 1200 MT

12/22/2025

FLORA WASHINGTON

(No collect calls)

INFORMATION CALL:

FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBER a. NAME

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

75H71026Q00021

5. SOLICITATION NUMBER

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF

1 24 IHS1519270OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

Kayenta AZ 86033

TELEPHONE NO.

17a. CONTRACTOR/

Tonalea AZ 86044 PO Box 7397

INSCRIPTION HOUSE

15. DELIVER TO

Kayenta AZ 86033 Highway 160, Mile Post 394.3 PO Box 368 Acquisition Department

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW

ISSUE DATE

DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

11.

SEE SCHEDULEX

12. DISCOUNT TERMS

THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

8(A)

Kayenta Health Center

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

**This is an Indian-Owned, Small Business Economic Enterprise (ISBEE) Set-Aside**

This contract is subject to the electronic payment process by the Department of Treasury.

All invoices complying to the requirements at 52.212-4(g) must be submitted through www.ipp.gov. For additional information, refer to the incorporated clause at 352.232-71 Electronic Submission of Payment Requests (FEB 2022).

(Use Reverse and/or Attach Additional Sheets as Necessary)

HEREIN, IS ACCEPTED AS TO ITEMS:

XX

DATED

JERLYN R. BEGAY

. YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ARE

ARE

31c. DATE SIGNED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print)

ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

26. TOTAL AWARD AMOUNT (For Govt. Use Only)

OFFER

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED.

ARE NOT ATTACHED.

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

30b. NAME AND TITLE OF SIGNER (Type or print)

30a. SIGNATURE OF OFFEROR/CONTRACTOR

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

25. ACCOUNTING AND APPROPRIATION DATA

29. AWARD OF CONTRACT:

REF.

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

40. PAID BY39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER

37. CHECK NUMBER

FINALPARTIAL

36. PAYMENT

FINALPARTIAL

35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER33. SHIP NUMBER

COMPLETE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)

42b. RECEIVED AT (Location)

42a. RECEIVED BY (Print)

41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

STANDARD FORM 1449 (REV. 2/2012) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

Period of Performance: 02/01/2026 to 05/31/2026

1 The Contractor shall provide and install new medical cabinets per the Statement of Work

(Attachment A) for the Urgent Care Department, Inscription House Health Center in Shonto, Arizona 86044.

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

24 2 of

Rev. 11/30/2025

SECTION B – CONTINUATION OF SF-1449

THIS PAGE IS INTENTIONALLY LEFT BLANK

SECTION C – CONTRACT CLAUSES

52.212-4 CONTRACT TERMS AND CONDITIONS –

COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES

NOV 2025

(DEVIATION)

The following Federal Acquisition Regulation clauses also apply:

52.203-3 GRATUITIES APR 1984

52.203-6 RESTRICTIONS ON SUBCONTRACTOR SALES TO THE GOVERNMENT Alt I

NOV 2021

52.203-12 LIMITATION OF PAYMENTS TO INFLUENCE CERTAIN FEDERAL

TRANSACTIONS

JUN 2020

52.203-13 CONTRACTOR CODE OF BUSINESS ETHICS AND CONDUCT NOV 2021

52.203-16 PREVENTING PERSONAL CONFLICTS OF INTEREST JUN 2020

52.203-17 CONTRACTOR EMPLOYEE WHISTLEBLOWER RIGHTS NOV 2023

52.203-19 PROHIBITION ON REQUIRING CERTAIN INTERNAL CONFIDENTIALITY

AGREEMENTS OR STATEMENTS

JAN 2017

52.204-9 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR PERSONNEL JAN 2011

52.204-13 SYSTEM FOR AWARD MANAGEMENT MAINTENANCE NOV 2025

(DEVIATION)

52.204-14 SERVICE CONTRACT REPORTING REQUIREMENTS NOV 2025

(DEVIATION)

52.204-15 SERVICE CONTRACT REPORTING REQUIREMENTS FOR INDEFINITE-

DELIVERY CONTRACTS

NOV 2025

(DEVIATION)

52.204-91 CONTRACTOR IDENTIFICATION NOV 2025

(DEVIATION)

52.209-6 PROTECTING THE GOVERNMENT’S INTEREST WHEN

SUBCONTRACTING WITH CONTRACTORS DEBARRED, SUSPENDED, OR

PROPOSED FOR DEBARMENT

NOV 2025

(DEVIATION)

52.209-9 UPDATES OF PUBLICLY AVAILABLE INFORMATION REGARDING

RESPONSIBILITY MATTERS

NOV 2025

(DEVIATION)

52.209-10 PROHIBITION ON CONTRACTING WITH INVERTED DOMESTIC

CORPORATIONS

NOV 2025

(DEVIATION)

52.213-1 RESERVED

52.219-3 NOTICE OF HUBZONE SET-ASIDE OR SOLE-SOURCE AWARD NOV 2025

(DEVIATION)

52.219-6 NOTICE OF TOTAL SMALL BUSINESS SET-ASIDE NOV 2025

(DEVIATION)

52.219-6 Alt I

NOTICE OF TOTAL SMALL BUSINESS SET-ASIDE, WITH ALTERNATE I NOV 2025

52.219-7 NOTICE OF PARTIAL SMALL BUSINESS SET-ASIDE NOV 2020

52.219-7 Alt I

NOTICE OF PARTIAL SMALL BUSINESS SET-ASIDE, WITH ALTERNATE I MAR 2020

52.219-8 UTILIZATION OF SMALL BUSINESS CONCERNS NOV 2025

(DEVIATION)

52.219-9 SMALL BUSINESS SUBCONTRACTING PLAN NOV 2025

(DEVIATION)

52.219-9 Alt I

SMALL BUSINESS SUBCONTRACTING PLAN, WITH ALTERNATE I NOV 2025

(DEVIATION)

52.219-9 Alt II

SMALL BUSINESS SUBCONTRACTING PLAN, WITH ALTERNATE II NOV 2025

(DEVIATION)

52.219-9 Alt III

SMALL BUSINESS SUBCONTRACTING PLAN, WITH ALTERNATE III NOV 2025

(DEVIATION)

52.219-9 Alt IV

SMALL BUSINESS SUBCONTRACTING PLAN, WITH ALTERNATE IV NOV 2025

(DEVIATION)

52.219-13 NOTICE OF SET-ASIDE OF ORDERS MAR 2020

52.219-13 Alt I

RESERVED

52.219-16 LIQUIDATED DAMAGES—SUBCONTRACTING PLAN NOV 2025

(DEVIATION)

52.219-27 NOTICE OF SET-ASIDE FOR, OR SOLE-SOURCE AWARD TO, SERVICE-

DISABLED VETERAN-OWNED SMALL BUSINESS (SDVOSB) CONCERNS

ELIGIBLE UNDER THE SDVOSB PROGRAM

NOV 2025

(DEVIATION)

52.219-28 POSTAWARD SMALL BUSINESS PROGRAM REREPRESENTATION NOV 2025

(DEVIATION)

52.219-28 Alt I

POSTAWARD SMALL BUSINESS PROGRAM REREPRESENTATION, WITH

ALTERNATE I

NOV 2025

(DEVIATION)

52.219-29 NOTICE OF SET-ASIDE FOR, OR SOLE-SOURCE AWARD TO,

ECONOMICALLY DISADVANTAGED WOMEN-OWNED SMALL BUSINESS

CONCERNS

NOV 2025

(DEVIATION)

52.219-30 NOTICE OF SET-ASIDE FOR, OR SOLE-SOURCE AWARD TO, WOMEN-

OWNED SMALL BUSINESS CONCERNS ELIGIBLE UNDER THE WOMEN-

OWNED SMALL BUSINESS PROGRAM

NOV 2025

(DEVIATION)

52.219-32 ORDERS ISSUED DIRECTLY UNDER SMALL BUSINESS RESERVES MAR 2020

52.219-33 NONMANUFACTURER RULE NOV 2025

(DEVIATION)

52.222-3 CONVICT LABOR NOV 2025

(DEVIATION)

52.222-19 CHILD LABOR—COOPERATION WITH AUTHORITIES AND REMEDIES NOV 2025

(DEVIATION)

52.222-35 EQUAL OPPORTUNITY FOR VETERANS NOV 2025

(DEVIATION)

52.222-36 EQUAL OPPORTUNITY FOR WORKERS WITH DISABILITIES NOV 2025

(DEVIATION)

52.222-36

ALT I

EQUAL OPPORTUNITY FOR WORKERS WITH DISABILITIES, WITH

ALTERNATE I

JUL 2014

52.222-37 EMPLOYMENT REPORTS ON VETERANS NOV 2025

(DEVIATION)

52.222-40 NOTIFICATION OF EMPLOYEE RIGHTS UNDER THE NATIONAL LABOR

RELATIONS ACT

NOV 2025

(DEVIATION)

52.222-41 SERVICE CONTRACT LABOR STANDARDS NOV 2025

(DEVIATION)

52.222-43 FAIR LABOR STANDARDS ACT AND SERVICE CONTRACT LABOR

STANDARDS-PRICE ADJUSTMENT (MULTIPLE YEAR AND OPTION

CONTRACTS)

NOV 2025

(DEVIATION)

52.222-44 FAIR LABOR STANDARDS ACT AND SERVICE CONTRACT LABOR

STANDARDS-PRICE ADJUSTMENT

NOV 2025

(DEVIATION)

52.222-50 COMBATING TRAFFICKING IN PERSONS NOV 2025

(DEVIATION)

52.222-50 Alt I

COMBATING TRAFFICKING IN PERSONS NOV 2025

(DEVIATION)

52.222-51 EXEMPTION FROM APPLICATION OF THE SERVICE CONTRACT LABOR

STANDARDS TO CONTRACTS FOR MAINTENANCE, CALIBRATION, OR

REPAIR OF CERTAIN EQUIPMENT—REQUIREMENTS

NOV 2025

(DEVIATION)

52.222-53 EXEMPTION FROM APPLICATION OF THE SERVICE CONTRACT LABOR

STANDARDS TO CONTRACTS FOR CERTAIN SERVICES—

REQUIREMENTS

NOV 2025

(DEVIATION)

52.222-54 EMPLOYMENT ELIGIBILITY VERIFICATION NOV 2025

(DEVIATION)

52.222-55 MINIMUM WAGES FOR CONTRACTOR WORKERS UNDER EXECUTIVE

ORDER 14026

NOV 2025

(DEVIATION)

52.222-62 PAID SICK LEAVE UNDER EXECUTIVE ORDER 13706 NOV 2025

(DEVIATION)

52.223-2 REPORTING OF BIOBASED PRODUCTS UNDER SERVICE AND

CONSTRUCTION CONTRACTS

NOV 2025

(DEVIATION)

52.223-5 POLLUTION PREVENTION AND RIGHT-TO-KNOW INFORMATION MAY 2024

52.223-11 OZONE-DEPLETING SUBSTANCES NOV 2025

(DEVIATION)

52.223-12 MAINTENANCE, SERVICE, REPAIR, OR DISPOSAL OF REFRIGERATION

EQUIPMENT AND AIR CONDITIONERS

NOV 2025

(DEVIATION)

52.223-23 SUSTAINABLE PRODUCTS NOV 2025

(DEVIATION)

52.224-1 PRIVACY ACT NOTIFICATION APR 1984

52.224-2 PRIVACY ACT APR 1984

52.224-3 PRIVACY TRAINING JAN 2017

52.224-3

ALT I

PRIVACY TRAINING, ITH ALTERNATE I JAN 2017

52.225-1 BUY AMERICAN-SUPPLIES NOV 2025

(DEVIATION)

52.225-1 Alt I

BUY AMERICAN-SUPPLIES, WITH ALTERNATE I OCT 2022

52.225-3 BUY AMERICAN-FREE TRADE AGREEMENTS-ISRAELI TRADE ACT NOV 2025

(DEVIATION)

52.225-3

ALT I

RESERVED

52.225-3 Alt II

BUY AMERICAN-FREE TRADE AGREEMENTS-ISRAELI TRADE ACT,

WITH ALTERNATE II

NOV 2025

(DEVIATION)

52.225-3 Alt III

BUY AMERICAN-FREE TRADE AGREEMENTS-ISRAELI TRADE ACT,

WITH ALTERNATE III

NOV 2025

(DEVIATION)

52.225-3 Alt IV

BUY AMERICAN-FREE TRADE AGREEMENTS-ISRAELI TRADE ACT,

WITH ALTERNATE IV

NOV 2025

(DEVIATION)

52.225-5 TRADE AGREEMENTS NOV 2023

52.225-14 INCONSISTENCY BETWEEN ENGLISH VERSION AND TRANSLATION OF

CONTRACT

FEB 2000

52.225-19 CONTRACTOR PERSONNEL IN A DESIGNATED OPERATIONAL AREA OR

SUPPORTING A DIPLOMATIC OR CONSULAR MISSION OUTSIDE THE

UNITED STATES

MAY 2020

52.225-26 CONTRACTORS PERFORMING PRIVATE SECURITY FUNCTIONS

OUTSIDE THE UNITED STATES

OCT 2016

52.226-1 UTILIZATION OF INDIAN ORGANIZATIONS AND INDIAN-OWNED

ECONOMIC ENTERPRISES

NOV 2025

(DEVIATION)

52.226-5 RESTRICTIONS ON SUBCONTRACTING OUTSIDE DISASTER OR

EMERGENCY AREA

NOV 2025

(DEVIATION)

52.226-6 PROMOTING EXCESS FOOD DONATION TO NONPROFIT

ORGANIZATIONS

NOV 2025

(DEVIATION)

52.226-8 ENCOURAGING CONTRACTOR POLICIES TO BAN TEXT MESSAGING

WHILE DRIVING

MAY 2024

52.229-12 TAX ON CERTAIN FOREIGN PROCUREMENTS AUG 2025

(DEVIATION)

52.232-18 AVAILABILITY OF FUNDS APR 1984

52.232-29 TERMS FOR FINANCING OF COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES

NOV 2021

52.232-30 INSTALLMENT PAYMENTS OF COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES

NOV 2021

52.232-33 PAYMENT BY ELECTRONIC FUNDS TRANSFER—SYSTEM FOR AWARD

MANAGEMENT

OCT 2018

52.232-34 PAYMENT BY ELECTRONIC FUNDS TRANSFER—OTHER THAN SYSTEM

FOR AWARD MANAGEMENT

JUL 2013

52.232-36 PAYMENT BY THIRD PARTY NOV 2025

(DEVIATION)

52.232-40 PROVIDING ACCELERATED PAYMENTS TO SMALL BUSINESS

SUBCONTRACTORS

MAR 2023

52.232-90 FAST PAYMENT PROCEDURE NOV 2025

(DEVIATION)

52.233-3 PROTEST AFTER AWARD NOV 2025

(DEVIATION)

52.233-4 APPLICABLE LAW FOR BREACH OF CONTRACT CLAIM NOV 2025

52.237-2 PROTECTION OF GOVERNMENT BUILDING, EQUIPMENT, AND

VEGETATION

APR 1984

52.237-3 CONTINUITY OF SERVICES JAN 1991

52.240-91 SECURITY PROHIBITIONS AND EXCLUSIONS NOV 2025

(DEVIATION)

52.240-91 Alt I

SECURITY PROHIBITIONS AND EXCLUSIONS, WITH ALTERNATE I NOV 2025

(DEVIATION)

52.240-92 SECURITY REQUIREMENTS NOV 2025

(DEVIATION)

52.240-92 Alt II

SECURITY REQUIREMENTS WITH ALTERNATE II NOV 2025

(DEVIATION)

52.240-93 BASIC SAFEGUARDING OF COVERED CONTRACTOR INFORMATION

SYSTEMS

NOV 2025

(DEVIATION)

52.242-5 PAYMENTS TO SMAL BUSINESS SUBCONTRACTORS JAN 2017

52.242-13 BANKRUPTCY JUL 1995

52.244-2 SUBCONTRACTS JUN 2020

52.244-6 SUBCONTRACTS FOR COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES

NOV 2025

(DEVIATION)

52.245-1 GOVERNMENT PROPERTY SEP 2021

52.245-2 GOVERNMENT PROPERTY INSTALLATION OPERATION SERVICES APR 2012

52.245-9 USE AND CHARGES APR 2012

52.247-64 PREFERENCE FOR PRIVATELY OWNED U.S.-FLAG COMMERCIAL

VESSELS

NOV 2025

(DEVIATION)

52.247-64 Alt I

PREFERENCE FOR PRIVATELY OWNED U.S.-FLAG COMMERCIAL

VESSELS, WITH ALTERNATE I

APR 2003

52.247-64 Alt II

PREFERENCE FOR PRIVATELY OWNED U.S.-FLAG COMMERCIAL

VESSELS, WITH ALTERNATE II

NOV 2021

52.222-36 EQUAL OPPORTUNITY FOR WORKERS WITH

DISABILITIES, ALT I

JUL 2014

52.252-2 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):

Revolutionary FAR Overhaul - FAR Overhaul - FAR Part Deviation Guidance | Acquisition.GOV

Federal Acquisition Regulation - https://www.acquisition.gov/browse/index/far

Department of Health and Human Services Acquisition Regulation – https://www.acquisition.gov/hhsar

(End of clause)

52.252-6 AUTHORIZED DEVIATIONS IN CLAUSES NOV 2020

(a)The use in this solicitation or contract of any Federal Acquisition Regulation (48 CFR Chapter 1) clause with an authorized deviation is indicated by the addition of "(DEVIATION)" after the date of the clause.

(b)The use in this solicitation or contract of any Department of Health and Human Services (48 CFR Chapter 3) clause with an authorized deviation is indicated by the addition of "(DEVIATION)" after the name of the regulation.

(End of clause)

The following Department of Health and Human Services Acquisition Regulation clauses also apply:

352.203-70 ANTI-LOBBYING DEC 2015

352.208-70 PRINTING AND DUPLICATION DEC 2015

352.211-3 PAPERWORK REDUCTION ACT DEC 2015

352.219-71 MENTOR-PROTÉGÉ PROGRAM REPORTING REQUIREMENTS JAN 2010

352.223-70 SAFETY AND HEALTH DEC 2015

352.224-70 PRIVACY ACT DEC 2015

352.226-6 INDIAN ECONOMIC ENTERPRISE SUBCONTRACTING

LIMITATIONS

MAR 2022

352.227-70 PUBLICATIONS AND PUBLICITY DEC 2015

352.231-70 SALARY RATE LIMITATION DEC 2015

352.237-70 PRO-CHILDREN ACT DEC 2015

352.237-71 CRIME CONTROL ACT – REPORTING OF CHILD ABUSE DEC 2015

352.237-72 CRIME CONTROL ACT – REQUIREMENTS FOR BACKGROUND

CHECKS

DEC 2015

352.237-73 INDIAN CHILD PROTECTION AND FAMILY VIOLENCE ACT DEC 2015

352.232-71 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.

(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)

The following local Indian Health Service, Navajo Area terms also apply:

NAIHS-ACQ-08 CONTRACTING OFFICER’S REPRESENTATIVE NOV 2025

(a) Definition. “Contracting Officer’s Representative (COR)” means an individual, including a contracting officer’s technical representative (COTR), designated and authorized in writing by the contracting officer to perform specific technical or administrative functions.

(b) Per FAR Subpart 1.404(a): The Contracting Officer (CO) determines that this contract requires a Contracting Officer Representative (COR). The Contracting Officer Representative (COR) is:

Rosita Franklyn, COR I

(c) Upon award, the COR will receive a copy of the written designation, specifying the extent of the COR’s authority on behalf of the CO.

(d) Limitations.

(1) The COR has no authority to make any commitments or changes that affect price, quality, quantity, delivery, or other terms and conditions of the contract.

(2) The COR must not direct the contractor or its subcontractors to operate in conflict with the contract terms and conditions.

NAIHS-ACQ-09 UNAUTHORIZED COMMITMENTS NOV 2025

(a) Definitions.

Contracting Officer means a person with the authority to enter into, administer, and/or terminate contracts and make related determination and findings.

Ratification means the act of approving an unauthorized commitment by an official who has the authority to do so.

Unauthorized Commitment (UAC) means an agreement that is not binding solely because the Government representative who made it lacked the authority to enter into that agreement on behalf of the Government.

(b) Policy.

The Government is not bound by agreements with, or contractual commitments made to, prospective contractors by individuals who do not have delegated contracting authority. Unauthorized commitments do not follow the appropriate process for the expenditure of Government funds. Consequently, the Government may not be able to ratify certain actions, putting a contractor at risk for taking direction from a Federal official other than the contracting officer (see FAR 1.403-2) Government employees responsible for unauthorized commitments are subject to disciplinary action. Contractors perform at their own risk when accepting direction from unauthorized officials. Failure to follow statutory and regulatory processes for the expenditure of Government funds is a very serious matter.

(c) Procedure.

Any agreement, modification, or change to a contractual agreement made by a government personnel who lack authority will be deemed an unauthorized commitment. The Government is not liable to the Contractor or under the terms of the contract, financially or otherwise – unless the unauthorized commitment successfully passes the ratification process.

The ratification process does not have any lead time, nor does the Government make any promise that an unauthorized commitment will be ratified and, therefore, the Contractor would be paid. The Contractor proceeds at its own risk if any of the terms of the contract are altered, changed, or modified without the written concurrence by a Contracting Officer.

SECTION D – DOCUMENTS, EXHIBITS, ATTACHMENTS, ETC.

Attachment A – Statement of Work

Attachment B – Indian Health Service Buy Indian Act Indian Economic Enterprise

Representation Form

Attachment C – Pricing Schedule

STATEMENT OF WORK

FOR

URGENT CARE CABINETRY SYSTEM UPGRADE

AT

INSCRIPTION HOUSE HEALTH CARE CENTER

TONALEA, ARIZONA

OCT 8, 2025

KAYENTA SERVICE UNIT

Attachment A – Statement of Work

1. Introduction:

1.1. Inscription House Health Center is located one mile north of Junction Highway 98 and Navajo

Route 16 Tonalea, AZ 86044. The Inscription House Health Center provides 40 hour per week ambulatory care for approximately 7,000 nearby residents. The facility is closed after 5 p.m. on weekdays and is closed on weekend morning 8:00 am to 12:00 pm. The Urgent Care Dept.

requires an upgrade of new cabinetry system that are easy to clean, disinfect and to improve workflow for both patient and staff. Due to wear and tear the existing cabinetry system need replacement to help prevent the spread of infections, and keep supplies organized.

2. PROJECT BACKGROUND

2.1. The Inscription House Health Center (IHHC) requires a professional construction services and expertise to perform the following:

1. Upgrade the current cabinetry system with material that is non-porous, smooth surface and durable, suitable for healthcare setting.

2. Remove all old cabinetry system that are unsafe. Includes all base and wall cabinets, the countertops and all plumbing items; sinks and drain piping.

3. Discard the old cabinetry system, plumbing and debris.

4. Installation of new cabinetry system; base, wall cabinets, countertops, hardware and all plumbing fixtures with sinks and drain piping.

3. PROJECT DESCRIPTION:

3.1. For the project, the contractor shall prepare a proposal, and upon award, shall perform the engineering/install/construction work (turnkey project).

3.2. Have a per-construction meeting. During the meeting an ICRA/PCRA will be filled out with the IHS staff of Kayenta Service Unit and the vendor personnel.

3.3. There are 5 locations where cabinetry system need replacement; Cast Room 165, OB Room 176, Isolation Room 172, Bay 1 room 177 and Bay 2 room 177.

3.4. Contractor to take actual measurements and supplies and materials needed to complete the project. Develop drawings and listings of the cabinetry system. Includes all base, wall cabinets, countertops, hardware, and all plumbing fixtures with sinks and drain piping.

3.5. Contractor to provide all tools, supplies, materials, equipment and PPE necessary to complete the project.

3.6. Contractor to replace the cabinetry system to include cabinets, countertops and plumbing. The material must be non-porous, smooth surface and durable, suitable for healthcare setting.

3.7. Contractor to patch and paint walls before and after installation. Color will match existing color of the wall.

3.8. Contractor to remove sink and plumbing and install new sinks and replace drainage up to the wall using new plumbing materials. Also, test for leaks to ensure that the sinks are functioning as should.

3.9. Contractor to dispose of all debris that are removed in a safe manner as to not to interrupt patient care and other areas of the building using safe protocols.

4. CRITERIA:

4.1. Codes and Standards: The Contractor shall perform in accordance with best common practices and standards;

Safety and Hazard Awareness (PPE, working under a load, jobs specific hazards).

Materials used to be safe.

Proper preparation of wall surfaces and platforms where support object or structures will be positioned.

Leveling and securing of the new cabinetry system.

Compliance of NFPA Codes, Plumbing Certifications, Electrician Certifications, and OSHA.

5. GENERAL REQUIREMENTS:

5.1. Contractor shall develop a set plan and accurate timeline to present to IHHC project representative prior to the project start date.

5.2. A report and walk through of the cabinetry system placement completion will be necessary after completion of project.

5.3. Work area should be well kept and free of trash and debris after each work day. Housekeeping throughout the project is best practice to mitigate safety issues.

5.4. The contractor shall perform work between the hours of 8:00am and 5:00pm Monday through

Friday excluding Federal Holidays, weekends are open to schedule the project which will benefit both the contractor and Inscription House Health Center. Alternate hours discussed and agreed upon with facility. The contractor shall furnish a schedule of the dates agreed upon to the project officer and the facility manager at least two weeks in advance.

5.5. Any foreseen or unplanned costs, workhours or changes that will affect or incur extra costs to Inscription House Health Center/IHS, needs to be brought to the attention of the Inscription House Health Center project representative and Kayenta Service Unit Contract Representative before proceeding with this matter.

5.6. Have a per-construction meeting. During the meeting an ICRA/PCRA will be filled out with the IHS staff and the vendor personnel.

5.7. Post-construction meeting with Facilities Manager or Maintenance Mechanic Supervisor and IHHC Staff.

6. SPECIAL REQUIREMENTS

6.1. Proper procedure/practices for installation of the cabinetry system and plumbing.

6.2. Contractor encouraged site visit to know more about project.

6.3. Post-construction meeting with Facilities Manager or Maintenance Mechanic Supervisor and

KSU Staff

7. ATTACHEMENTS

7.1. Site plot plan- drawings with marked locations of cabinetry system and plumbing removal and installation.

8. Period of Performance

8.1. Upon award contractor to complete project within 120 days or less.

9. Contact information:

9.1. Darwin James at (928)672-3076

9.2. Billy Elliott at (928)672-3000

9.3. Desmond D. Jones at (928)697-4375

9.4. Rosita Franklyn ay (928)672-3075

10. Warranty

10.1 Workmanship warranty one year

7.1 IHHC Plot Plan:

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.

Attachment B – Indian Health Service Buy Indian Act Indian Economic Enterprise Representation Form

Attachment C – Pricing Schedule

SECTION E – SOLICITATION PROVISIONS

52.212-1 INSTRUCTIONS TO OFFERORS – COMMERCIAL

PRODUCTS AND COMMERCIAL SERVICES

(1) Volume 1 – Label “Administrative Documents.” Signed and dated SF-1449 and all associated SF-30 amendments, if any. Submit one (1) copy.

(2) Volume 2 – Label “Statement of Work and Delivery/Schedule.” A technical description and delivery schedule of the services being offered in sufficient detail to evaluate compliance with the requirements in the solicitation. This shall include product literature, and other documentation that demonstrates how the supplies and services offered meets – at a minimum – Attachment A, Statement of Work. This volume must also include information about delivery. NO PRICING INFORMATION SHALL BE INCLUDED IN THIS VOLUME. Submit one (1) copy.

(3) Volume 3 – Label “Past Performance.” Provide past performance experience that it has successfully performed at least three similar contracts within the past 3 years.

(4) Volume 4 – Label “Price.” Include a narrative that supports the total quote or budget for the project. Please fill out Attachment C – Pricing Schedule. Submit one (1) copy of official Quote and (1) copy of the Pricing Schedule.

Failure to follow instructions and/or to provide required information may render your quote unacceptable.

Submit documents in PDF format. Limit pages to 15.

52.212-2 EVALUATION – COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES

NOV 2025

(DEVIATION)

(a)Evaluation factors. The Government will award a contract resulting from this solicitation to the responsible Offeror whose offer conforming to the solicitation will be most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate offers:

Evaluation factors other than price when combined are approximately equal to price.

i. Technical Capability. The offeror must demonstrate that the product offered complies with the mandatory technical requirements described in Attachment A – Statement of Work.

ii. Experience of similar projects. The offeror must demonstrate that it has successfully performed at least three similar contracts within the past 3 years.

iii. Delivery; and

iv. Price

For submission requirements, refer to the provision at 52.212-1 and any associated addenda. Failure to follow instructions and/or to provide required information may render your quote unacceptable.

(b) Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the Government to exercise the option(s).

(c) Notice of award. A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer’s specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

(End of provision)

The following Federal Acquisition Regulations provisions incorporated by reference also apply:

52.203-11 CERTIFICATION AND DISCLOSURE REGARDING PAYMENTS TO

INFLUENCE CERTAIN FEDERAL TRANSACTIONS

SEP 2024

52.203-18 PROHIBITION ON CONTRACTING WITH ENTITIES THAT REQUIRE

CERTAIN INTERNAL CONFIDENTIALITY AGREEMENTS OR

STATEMENTS-REPRESENTATION

JAN 2017

52.204-7 SYSTEM FOR AWARD MANAGEMENT – REGISTRATION

52.204-7 Alt I

SYSTEM FOR AWARD MANAGEMENT—REGISTRATION, WITH

ALTERNATE I

52.207-6 SOLICITATION OF OFFERS FROM SMALL BUSINESS CONCERNS AND

SMALL BUSINESS TEAMING ARRANGEMENTS OR JOINT VENTURES

(MULTIPLE-AWARD CONTRACTS)

AUG 2024

52.209-12 CERTIFICATION REGARDING TAX MATTERS OCT 2025

52.216-31 TIME-AND-MATERIALS/LABOR-HOUR PROPOSAL REQUIREMENTS –

COMMERCIAL ACQUISITION

NOV 2021

52.219-4 NOTICE OF PRICE EVALUATION PREFERENCE FOR HUBZONE SMALL

BUSINESS CONCERNS

NOV 2025

(DEVIATION)

52.219-31 NOTICE OF SMALL BUSINESS RESERVE MAR 2020

52.222-18 CERTIFICATION REGARDING KNOWLEDGE OF CHILD LABOR FOR

LISTED END PRODUCTS

FEB 2021

52.222-48 EXEMPTION FROM APPLICATION OF THE SERVICE CONTRACT LABOR

STANDARDS FOR MAINTENANCE, CALIBRATION, OR REPAIR OF

CERTAIN EQUIPMENT–CERTIFICATION

MAY 2014

52.222-52 EXEMPTION FROM APPLICATION OF THE SERVICE CONTRACT LABOR

STANDARDS FOR CERTAIN SERVICES-CERTIFICATION

MAY 2014

52.222-56 CERTIFICATION REGARDING TRAFFICKING IN PERSONS COMPLIANCE

PLAN

OCT 2020

52.223-1

BIOBASED PRODUCT CERTIFICATION

MAY 2024

52.223-4

RECOVERED MATERIAL CERTIFICATION

MAY 2008

52.229-11 TAX ON CERTAIN FOREIGN PROCUREMENTS—NOTICE AND

REPRESENTATION

AUG 2025

(DEVIATION)

52.237-1

SITE VISIT

APR 1984

52.240-90 SECURITY PROHIBITIONS AND EXCLUSIONS REPRESENTATIONS AND

CERTIFICATIONS

52.209-2 PROHIBITION ON CONTRACTING WITH

INVERTED DOMESTIC CORPORATIONS –

REPRESENTATION

(a) Definitions. As used in this clause—

Inverted domestic corporation means a foreign incorporated entity that meets the definition of an inverted domestic corporation under 6 U.S.C. 395(b), applied in accordance with the rules and definitions of 6 U.S.C. 395(c).

Subsidiary means an entity in which more than 50 percent of the entity is owned—

(1) Directly by a parent corporation; or

(2) Through another subsidiary of a parent corporation.

(b) Government agencies are not permitted to use appropriated (or otherwise made available) funds for contracts with either an inverted domestic corporation, or a subsidiary of an inverted domestic corporation, unless the exception at 9.108-3(b) applies or the requirement is waived in accordance with the procedures at 9.108-5.

(c) Representation. The Offeror represents that-

(1) It is, is not an inverted domestic corporation; and

(2) It is, is not a subsidiary of an inverted domestic corporation.

(End of provision)

52.209-11 REPRESENTATION BY CORPORATIONS

REGARDING DELINQUENT TAX LIABILITY OR A

FELONY CONVICTION UNDER ANY FEDERAL

LAW

(a) The Government will not enter into a contract with any corporation that—

(1) Has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability, where the awarding agency is aware of the unpaid tax liability, unless an agency has considered suspension or debarment of the corporation and made a determination that suspension or debarment is not necessary to protect the interests of the Government; or

(2) Was convicted of a felony criminal violation under any Federal law within the preceding 24 months, where the awarding agency is aware of the conviction, unless an agency has considered suspension or debarment of the corporation and made a determination that this action is not necessary to protect the interests of the Government.

(b) The Offeror represents that–

(1) It is is not a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability; and

(2) It is is not a corporation that was convicted of a felony criminal violation under a Federal law within the preceding 24 months.

(End of provision)

52.225-4 BUY AMERICAN – FREE TRADE AGREEMENTS –

ISRAELI TRADE ACT CERTIFICATE

(a) (1) The Offeror certifies that each end product, except those listed in paragraph (b) or (c)(1) of this provision, is a domestic end product and that each domestic end product listed in paragraph (c)(2) of this provision contains a critical component.

(2) The terms "Bahraini, Moroccan, Omani, Panamanian, or Peruvian end product," "commercially available off-the-shelf (COTS) item," "critical component," "domestic end product," "end product," "foreign end product," "Free Trade Agreement country," "Free Trade Agreement country end product," "Israeli end product," and "United States" are defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements-Israeli Trade Act."

(b) The Offeror certifies that the following supplies are Free Trade Agreement country end products (other than Bahraini, Moroccan, Omani, Panamanian, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements-Israeli Trade Act":

Free Trade Agreement Country End Products (Other than Bahraini, Moroccan, Omani, Panamanian, or Peruvian End Products) or Israeli End Products:

Line Item No. Country of Origin

[List as necessary]

(c) (1) The Offeror shall list those supplies that are foreign end products (other than those listed in paragraph (b) of this provision) as defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements- Israeli Trade Act." The Offeror shall list as other foreign end products those end products manufactured in the United States that do not qualify as domestic end products. For those foreign end products that do not consist wholly or predominantly of iron or steel or a combination of both, the Offeror shall also indicate whether these foreign end products exceed 55 percent domestic content, except for those that are COTS items. If the percentage of the domestic content is unknown, select “no”.

Other Foreign End Products:

(2) The Offeror shall list the line item numbers of domestic end products that contain a critical component (see FAR 25.105).

Line Item No. ___

(d) The Government will evaluate offers in accordance with the policies and procedures of part 25 of the Federal Acquisition Regulation.

(End of provision)

Alternate I [Reserved]

Alternate II (JAN 2025). As prescribed in 25.601(b)(2)(ii), substitute the following paragraph (b) for paragraph

(b) of the basic provision:

(b) The offeror certifies that the following supplies are Israeli end products as defined in the clause of this solicitation entitled “Buy American—Free Trade Agreements—Israeli Trade Act”.

ISRAELI END PRODUCTS:

Alternate III (JAN 2025). As prescribed in 25.601(b)(2)(iii), substitute the following paragraph (b) for paragraph (b) of the basic provision:

(b) The Offeror certifies that the following supplies are Korean end products or Israeli end products as defined in the clause of this solicitation entitled “Buy American—Free Trade Agreements—Israeli Trade Act”.

Korean End Products or Israeli End Products:

52.252-1 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 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):

Revolutionary FAR Overhaul - FAR Overhaul - FAR Part Deviation Guidance | Acquisition.GOV

Federal Acquisition Regulation - https://www.acquisition.gov/browse/index/far

Department of Health and Human Services Acquisition Regulation – https://www.acquisition.gov/hhsar

(End of Provision)

52.252-5 AUTHORIZED DEVIATIONS IN PROVISIONS NOV 2020

(a)The use in this solicitation of any Federal Acquisition Regulation (48 CFR Chapter 1) provision with an authorized deviation is indicated by the addition of "(DEVIATION)" after the date of the clause.

(b)The use in this solicitation of any Department of Health and Human Services (48 CFR Chapter 3) provision with an authorized deviation is indicated by the addition of "(DEVIATION)" after the name of the regulation.

(End of Provision)

The following Department of Health and Human Services Acquisition Regulation provisions also apply:

352.219-70 MENTOR-PROTÉGÉ PROGRAM DEC 2015

352.223-71 INSTRUCTIONS TO OFFERORS – SUSTAINABLE ACQUISITION DEC 2015

352.226-5 NOTICE OF INDIAN ECONOMIC ENTERPRISE SET ASIDE MAR 2022

352.226-4 NOTICE OF INDIAN SMALL BUSINESS ECONOMIC ENTERPRISE SET

ASIDE

MAR 2022

352.226-7 INDIAN ECONOMIC ENTERPRISE REPRESENTATION MAR 2022

352.239-73 ELECTRONIC AND INFORMATION TECHNOLOGY ACCESSIBILITY

NOTICE

DEC 2015