Tab 12 - Sol_75H71026Q00292.pdf
PDF 1 MB Posted
- Solicitation number
- IHS1523699
About this file
This is a Solicitation/Contract/Order for Commercial Items (Standard Form 1449) issued by the Gallup Indian Medical Center, an Indian Health Service facility located in Gallup, New Mexico.
The solicitation seeks fifteen (15) new 12-lead Electrocardiogram (EKG) machines to support inpatient and outpatient clinical services at the facility. Solicitation Number 75H71026Q00292 was issued on September 9, 2026, with an offer due date of September 14, 2026 at 1000 MD. The requirement is set aside as a 100% Indian Small Business Economic Enterprise (ISEBEE) set-aside, restricted to Indian Economic Enterprises under the Buy Indian Act. The NAICS code is 339112 with a size standard of 1,000 employees. Delivery must be completed within thirty (30) calendar days of contract award to 1808 W. Aztec Avenue, Gallup, NM 87301. Technical requirements specify FDA-approved equipment with 12-lead capability, digital display and print/electronic output, hospital-compatible power standards, all leads, cables, stands, and accessories, manufacturer warranty, and new equipment only—no refurbished items. Deliverables include the fifteen machines, all required accessories, user manuals, warranty documentation, and confirmation of successful training and testing to biomedical and subject matter experts. Evaluation criteria include technical capability to meet Statement of Work specifications, delivery time, and price. All invoices must be submitted electronically through the Department of Treasury Invoice Processing Platform (www.ipp.gov). The acquisition incorporates multiple Federal Acquisition Regulation clauses and Department of Health and Human Services Acquisition Regulation provisions addressing small business protections, Buy American requirements, sustainable products, payment procedures, and security provisions.
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Other files
| File | Type | Posted |
|---|---|---|
| Tab 3 - Statement of Work.docx | DOCX document | |
| IHS IEE Representation Form_Jan 2022_508 Compliant.pdf |
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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
51CODE 16. ADMINISTERED BYCODE
X
X
339112
SIZE STANDARD:
100.00 % FOR:SET ASIDE:UNRESTRICTED OR51
REQUEST FOR
PROPOSAL
(RFP)
INVITATION
FOR BID (IFB)
10. THIS ACQUISITION ISCODE
REQUEST FOR
QUOTE (RFQ)
14. METHOD OF SOLICITATION
13b. RATING
NORTH AMERICAN INDUSTRY
CLASSIFICATION STANDARD
(NAICS):
SMALL BUSINESS
09/14/2026 1000 MD
09/09/2026
5057268876Kimberly Livingston (No collect calls)
INFORMATION CALL:
FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBER a. NAME
4. ORDER NUMBER3. AWARD/ 6. SOLICITATION
75H71026Q00292
5. SOLICITATION NUMBER
SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF
1 27 OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30
TELEPHONE NO.
17a. CONTRACTOR/
15. DELIVER TO
Gallup NM 87301
1808 W. Aztec Avenue
Acquisition Department
9. ISSUED BY
7.
2. CONTRACT NO.
EFFECTIVE DATE
1,000
18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW
ISSUE DATE
DELIVERY FOR FREE ON BOARD
(FOB) DESTINATION UNLESS
BLOCK IS MARKED
11.
SEE SCHEDULEX
12. DISCOUNT TERMS THIS CONTRACT IS A RATED
ORDER UNDER THE DEFENSE
PRIORITIES AND ALLOCATIONS
SYSTEM - DPAS (15 CFR 700)
13a.
SERVICE-DISABLED
VETERAN-OWNED
SMALL BUSINESS
(SDVOSB)
HUBZONE SMALL
BUSINESS
8(A)
Gallup Indian Medical Center WOMEN-OWNED SMALL
BUSINESS (WOSB)
ECONOMICALLY DISADVANTAGED
WOMEN-OWNED SMALL
BUSINESS (EDWOSB)
Gallup New Mexico 87301
1808 W. Aztec Ave
Gallup Indian Medical Center
Gallup NM 87301
1808 W. Aztec Avenue
Acquisition Department
Gallup Indian Medical Center
24.
AMOUNT
23.
UNIT PRICE
22.
UNIT
21.
QUANTITY
20.
SCHEDULE OF SUPPLIES/SERVICES
19.
ITEM NO.
***THIS IS A 100% INDIAN SMALL BUSINESS ECONOMIC
ENTERPRISE (ISEBEE) 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 (APR
2026)(DEVIATION).
(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 (FEDERAL ACQUISITION REGULATION) FAR 52.212-1, 52.212-4. FAR 52.212-3
AND 52.212-5 ARE ATTACHED. ADDENDA
26. TOTAL AWARD AMOUNT (For Government Use Only)
OFFER
STANDARD FORM 1449 (REV. 11/2021)
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: REFERENCE
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. 11/2021) BACK
24.
AMOUNT
23.
UNIT PRICE
22.
UNIT
21.
QUANTITY
20.
SCHEDULE OF SUPPLIES/SERVICES
19.
ITEM NO.
1 The Contractor shall provide Fifteen (15) New 12 lead Electrocardiogram (EKG) machines in accordance with the Statement of Work (Attachment
A) specifications for the Nursing Department of the Gallup Indian Medical Center in Gallup, New
Mexico.
32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE
32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE
27 2 of
Rev. 04/29/2026
SECTION B – CONTINUATION OF SF-1449
This page 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
(DEVIATION)
☐ 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)
☐ 52.219-33 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
☐ 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)
☒ 52.222-90 ADDRESSING DEI DISCIMINATION BY FEDERAL CONTRACTORS APR 2026
(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, WITH 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
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)
☐ 52.226-7 DRUG-FREE WORKPLACE MAY 2024
☒ 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
52.219-14 LIMITATIONS ON SUBCONTRACTING NOV 2025
(a) This clause does not apply to the unrestricted portion of a partial set-aside.
(b) Definition. Similarly situated entity, as used in this clause, means a first-tier subcontractor, including an independent contractor, that—
(1) Has the same small business program status as that which qualified the prime contractor for the award (e.g., for a small business set-aside contract, any small business concern, without regard to its socioeconomic status); and
(2) Is considered small for the size standard under the North American Industry Classification System (NAICS) code the prime contractor assigned to the subcontract.
(c) Applicability. This clause applies only to—
(1) Contracts that have been set aside for any of the small business concerns identified in 19.000(a)(3);
(2) Part or parts of a multiple-award contract that have been set aside for any of the small business concerns identified in 19.000(a)(3);
(3) Contracts that have been awarded on a sole-source basis in accordance with subparts 19.105, 19.106, 19.107, and 19.108;
(4) Orders expected to exceed the simplified acquisition threshold and that are set aside for small business concerns under multiple-award contracts, as described in 8.4 and 16.5;
(5) Orders, regardless of dollar value, that are set aside in accordance with section 19.105, 19.106, 19.107, and 19.108 under multiple-award contracts, as described in 8.4 and 16.5; and
(6) Contracts using the HUBZone price evaluation preference to award to a HUBZone small business concern unless the concern waived the evaluation preference.
(d) Independent contractors. An independent contractor shall be considered a subcontractor.
(e) By submission of an offer and execution of a contract, the Contractor agrees that in performance of a contract assigned a North American Industry Classification System (NAICS) code for—
(1) Services (except construction), it will not pay more than 50 percent of the amount paid by the Government for contract performance to subcontractors that are not similarly situated entities. Any work that a similarly situated entity further subcontracts will count towards the prime contractor's 50 percent subcontract amount that cannot be exceeded. When a contract includes both services and supplies, the 50 percent limitation shall apply only to the service portion of the contract;
(2) Supplies (other than procurement from a nonmanufacturer of such supplies), it will not pay more than 50 percent of the amount paid by the Government for contract performance, excluding the cost of materials, to subcontractors that are not similarly situated entities. Any work that a similarly situated entity further subcontracts will count towards the prime contractor's 50 percent subcontract amount that cannot be exceeded. When a contract includes both supplies and services, the 50 percent limitation shall apply only to the supply portion of the contract;
(3) General construction, it will not pay more than 85 percent of the amount paid by the Government for contract performance, excluding the cost of materials, to subcontractors that are not similarly situated entities. Any work that a similarly situated entity further subcontracts will count towards the prime contractor's 85 percent subcontract amount that cannot be exceeded; or
(4) Construction by special trade contractors, it will not pay more than 75 percent of the amount paid by the Government for contract performance, excluding the cost of materials, to subcontractors that are not similarly situated entities. Any work that a similarly situated entity further subcontracts will count towards the prime contractor's 75 percent subcontract amount that cannot be exceeded.
(f) The Contractor shall comply with the limitations on subcontracting as follows:
(1) For contracts, in accordance with paragraphs (c)(1), (2), (3) and (6) of this clause—
☐ By the end of the base term of the contract and then by the end of each subsequent option period; or
☒ By the end of the performance period for each order issued under the contract.
(2) For orders, in accordance with paragraphs (c)(4) and (5) of this clause, by the end of the performance period for the order.
(g) A joint venture agrees that, in the performance of the contract, the applicable percentage specified in paragraph (e) of this clause will be performed by the aggregate of the joint venture participants.
(1) In a joint venture comprised of a small business protégé and its mentor approved by the Small Business Administration, the small business protégé shall perform at least 40 percent of the work performed by the joint venture. Work performed by the small business protégé in the joint venture must be more than administrative functions.
(2) In an 8(a) joint venture, the 8(a) participant(s) shall perform at least 40 percent of the work performed by the joint venture. Work performed by the 8(a) participants in the joint venture must be more than administrative functions.
(End of Clause)
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
APR 2026
(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 in FAR 32.905(b) and the applicable payment clause included in this contract.
(b) Submission instructions. Except as provided in paragraph (c) of this clause, the Contractor must 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) Alternate submission procedures. The Contractor may submit payment requests using other than IPP only when the Contracting Officer authorizes alternate procedures in writing.
(d) Submission of alternate payment procedures authorization. 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-04 PROTECTION AGAINST THE DISTRIBUTION
OF COUNTERFEIT RESPIRATORS AND
MEDICAL DEVICES
FEB 2021
Prospective Contractors submitting a quote represents and certifies that its proposed respirators and medical devices are compliant with the following Food and Drug Administration’s and Center for Disease Control’s strict guidance against counterfeit products. A Contractor proposed and/or delivering a counterfeit product shall be subject to adverse actions including, but not limited to, termination for cause in accordance with the clause at 52.212-4(m);
negative performance evaluation entered into the Contractor Performance Assessment Reporting System; and reporting to other government agencies responsible for investigating and prosecuting fraudulent contract actions.
CDC National Personal Protective Technology Laboratory (NPPTL) respirator resources https://www.cdc.gov/niosh/npptl/topics/respirators/disp_part/default.html - NIOSH approved list https://www.cdc.gov/niosh/npptl/usernotices/counterfeitResp.html - Counterfeit Respirators https://www.cdc.gov/niosh/npptl/usernotices/AdditionalTips.html - Additional Tips for Spotting Counterfeit Respirators
FDA Emergency Use Authorizations (EUA) for respirators NIOSH-Approved Air Purifying Respirators for Use in Health Care Settings During Response to the COVID-19 Public Health Emergency (Reissued 06/06/20)
Imported, Non-NIOSH-Approved Disposable Filtering Facepiece Respirators (Reissued 06/06/20)
List of authorized respirators under EUA above: Exhibit 1: Authorized Respirators Non-NIOSH-Approved Disposable Filtering Facepiece Respirators Manufactured in China (Reissued 06/06/2020)
List of authorized respirators under EUA above: Appendix A List of no longer authorized respirators for the EUA above: Respirator Models No Longer Authorized-
COVID19
General FDA medical device EUA webpage for all medical devices during this PHE https://www.fda.gov/medical-devices/emergency-situations-medical-devices/emergency-use-authorizations#covid19ppe
Below is the link to CDC’s webpage strategies for optimizing the supply of N95 respirators https://www.cdc.gov/coronavirus/2019-ncov/hcp/respirators-strategy/index.html
Below is CDC’s link to its testing results for international respirators that are not NIOSH-approved https://www.cdc.gov/niosh/npptl/respirators/testing/NonNIOSHresults.html
Below is CDC’s link to its testing results for expired NIOSH-approved respirators https://www.cdc.gov/niosh/npptl/respirators/testing/ExpiredN95results.html
FDA also recently conducted a webinar – Respirators for Health Care Personnel Use during COVID-19 Pandemic. The Webinar material slides are provided in the link below https://www.fda.gov/media/138740/download – Webinar Slides
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.
NAIHS-ACQ-20 PROTECTING FEDERAL EMPLOYEES AND
THE PUBLIC FROM EXPOSURE TO TOBACCO
SMOKE IN THE FEDERAL WORKPLACE
APR 2026
In accordance with Executive Order 13058 “Protecting Federal Employees and the Public from Exposure to Tobacco Smoke in the Federal Workplace,” and the Assistant Secretary for Health memorandum “Prohibition of Tobacco Use in HHS Occupied Facilities,” the use of tobacco products, in any form, is strictly prohibited at IHS-operated properties including, but not limited to:
1. All interior and exterior spaces of IHS-operated properties.
2. All HIS-operated spaces in multi-tenant buildings.
3. All Government vehicles regardless of their location.
4. Private vehicles while on IHS property.
The IHS continues to recognize the value and efficacy of patients’ traditional beliefs and ceremonial practices. The use of tobacco products for ceremonial purposes is allowed in the designated traditional healing room, including any space designated for a ceremony, or in a patient’s hospital room.
To the maximum extent practicable, Contractor must notify the Contracting Officer’s Representative in advance of using tobacco products in a ceremony.
SECTION D – DOCUMENTS, EXHIBITS, ATTACHMENTS, ETC.
Attachment A – Statement of Work
Attachment B – Indian Health Service Buy Indian Act Indian Economic Enterprise Representation Form
STATEMENT OF WORK (SOW)
Procurement of Electrocardiogram (EKG) Machine Gallup Indian Medical Center (GIMC) Indian Health Service (IHS)
1. Purpose The purpose of this Statement of Work (SOW) is to procure fifteen (15) new 12 lead Electrocardiogram (EKG) machine to support inpatient and outpatient clinical services at Gallup Indian Medical Center (GIMC). Currently, inpatients units and ambulatory care units share a single EKG machine, resulting in operational inefficiencies and delays in patient care.
2. Background GIMC is an Indian Health Service (IHS) hospital providing comprehensive inpatient and outpatient medical services. Timely access to cardiac diagnostic equipment is critical to patient safety and quality of care. An additional EKG machine is required to meet inpatient demand.
3. Scope of Work The contractor shall provide fifteen (15) new, unused EKG machine suitable for all patient care areas for hospital use. Services include delivery, training of equipment, operational testing, and provision of all required accessories and documentation.
4. Technical Requirements The EKG machine shall:
- Provide 12-lead EKG capability
- Be FDA-approved for clinical use
- Include digital display and print or electronic output
- Be compatible with hospital power standards
- Include all leads, cables, stand, and accessories
- Include manufacturer warranty
- Be new equipment (no refurbished items)
5. Deliverables
1. Fifteen (15) new EKG machine
2. All required accessories
3. User manuals and warranty documentation
4. Confirmation of successful training and testing to Bio-Medical and Subject Matter Experts (SMEs).
Attachment A - Statement of Work
6. Place of Performance Gallup Indian Medical Center (GIMC) 516 E. Nizhoni blve Gallup, New Mexico 87301
7. Period of Performance Delivery and training shall be completed within thirty (30) calendar days of contract award.
8. Acceptance Criteria The Government will accept the equipment upon verification that all requirements in this SOW are met and the equipment is fully operational.
9. Government-Furnished Property None.
10. Contractor Responsibilities The Contractor is responsible for providing compliant equipment, coordinating delivery, correcting deficiencies, and honoring warranty obligations.
11. Government Responsibilities The Government shall provide facility access, designate a point of contact, and perform inspection and acceptance.
12. Justification Fifteen (15) EKG machine is currently available for inpatient units at GIMC. This procurement is necessary to reduce delays, improve workflow, and ensure timely cardiac diagnostics.
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
Attachment B - Indian Health Service Buy Indian Act Indian Economic Enterprise Representation Form
SECTION E – SOLICITATION PROVISIONS
52.212-1 INSTRUCTIONS TO OFFERORS – COMMERCIAL
PRODUCTS AND COMMERCIAL SERVICES
To facilitate evaluation of your quotation, please provide the following information:
1. Price Quotation
• Submit a detailed quotation that clearly demonstrates compliance with all requirements and specifications outlined in the Statement of Work (Attachment A).
• Include manufacturer, model number, product literature, and any other supporting documentation necessary to verify conformance with the stated requirements.
2. Capability Statement
• Provide a brief capability statement describing your firm's experience, qualifications, and ability to provide (15) Fifteen EKG machines in accordance with the specifications.
3. IHS Buy Indian Act IEE Representation Form
• Complete and submit the required IHS Buy Indian Act Indian Economic Enterprise (IEE)
Representation Form (Attachment B) with your quotation package.
4. Delivery Information
• Provide the anticipated lead time and delivery schedule for the Fifteen Electrocardiogram (EKG) machines.
• Include estimated delivery dates after receipt of award/order and identify any factors that may affect delivery timelines.
Please ensure your quotation addresses all requirements contained in the Statement of Work. Failure to provide the requested documentation above may affect the Government's ability to evaluate your quotation.
Please email your quotation package to Ms. Kimberly Livingston, Purchasing Agent, at
Kimberly.livingston2@ihs.gov. Please include “RFQ 75H71026Q00292” in the subject line of your email.
52.212-2 EVALUATION – COMMERCIAL PRODUCTS AND
COMMERCIAL SERVICES
(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:
• Technical capability to provide the requested Fifteen Electrocardiogram (EKG) machines per the Statement of Work Specifications
• Delivery time
• Price
(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
NOV 2025
(DEVIATION)
☐ 52.204-7 Alt I
SYSTEM FOR AWARD MANAGEMENT—REGISTRATION, WITH
ALTERNATE I
NOV 2025
(DEVIATION)
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
52.204-90 OFFEROR IDENTIFICATION NOV 2025
If the Offeror will not have an active Federal Government contracts registration in the System for Award Management (https://www.sam.gov) when submitting its offer, it shall complete paragraphs (c) and (d) of this provision and include its responses with its offer.
(a) Definitions. As used in this provision— Commercial and Government Entity (CAGE) code has the meaning provided in the clause at FAR 52.204-91, Contractor Identification, of this solicitation.
Common parent means that corporate entity that owns or controls an affiliated group of corporations that files its Federal income tax returns on a consolidated basis, and of which the offeror is a member.
Electronic Funds Transfer (EFT) indicator means a bank account identifier to establish additional System for Award Management records for identifying alternative EFT accounts (see part 32) for the same entity.
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 owner means an entity, other than the offeror, that has direct control of the offeror. Indicators of control include, but are not limited to, one or more of the following: ownership or interlocking management, identity of interests among family members, shared facilities and equipment, and the common use of employees. There may be more than one immediate owner (e.g., joint ventures).
Predecessor means an entity whose assets were acquired by the offeror or another entity (most often through merger or acquisition) and whose affairs are now carried out by the offeror or the other entity under a new name.
Taxpayer Identification Number means the number required by the Internal Revenue Service (IRS) to be used by the offeror to report income tax and other returns. It may be either a Social Security Number or an Employer Identification Number.
Unique entity identifier (UEI) has the meaning provided in the clause at FAR 52.204-91, Contractor Identification, of this solicitation.
(b) Unique entity identifier (UEI).
(1) The Offeror shall enter, in the block with its name and address on the cover page of its offer, the annotation “Unique Entity Identifier” followed by the UEI that identifies the Offeror's name and address exactly as stated in the offer. The Offeror shall also enter its EFT indicator, if applicable.
(2) If the Offeror does not have a UEI, it shall go to https://www.sam.gov to obtain one. The Government will independently validate the existence and uniqueness of the Offeror before assigning a UEI.
(c) Taxpayer identification. The Offeror shall provide with its offer the following information that is necessary to comply with debt collection requirements of 31 U.S.C. 7701(c) and 3325(d); reporting requirements of 26 U.S.C.
6041, 6041A, and 6050M; and the implementing IRS regulations:
(1) Taxpayer identification number (TIN)
□ TIN: ______________;
□ TIN has been applied for; or
□ TIN is not required because:
□ Offeror is a nonresident alien, foreign corporation, or foreign partnership that does not have income effectively connected with the conduct of a trade or business in the United States and does not have an office or place of business or a fiscal paying agent in the United States;
□ Offeror is an agency or instrumentality of a foreign government; or
□ Offeror is an agency or instrumentality of the Federal Government.
(2) Type of organization.
□ Sole proprietorship;
□ Partnership;
□ Corporate entity (not tax-exempt);
□ Corporate entity (tax-exempt);
□ Government entity (Federal, State, or local);
□ Foreign government;
□ International organization per 26 CFR 1.6049-4; or
□ Other.
(3) Common parent.
□ Offeror is not owned or controlled by a common parent as defined in paragraph (a) of this provision; or
□ Name and TIN of common parent:
Name: ______________
TIN: ______________
(4) The TIN provided in paragraph (c)(1) of this provision may be matched with IRS records to verify the accuracy of the Offeror's TIN. The Government may use the TIN to collect and report on any delinquent amounts arising out of the Offeror's relationship with the Government (31 U.S.C. 7701(c)(3)).
(d) Commercial and Government Entity (CAGE) code.
(1) The Offeror shall provide its CAGE code with its offer with its name and location address or otherwise include it prominently in its offer. The CAGE code shall be for that name and location address. Insert the word “CAGE” before the code. The Offeror may obtain a CAGE code as indicated in the following table.
If the Offeror is… Then… Located in the United States or its outlying areas
Submit a request to the DLA CAGE Branch via https://cage.dla.mil
Located outside the United States and its outlying areas and its country is a member of the North Atlantic Treaty
Contact the appropriate National Codification Bureau (https://www.nato.int/structur/ac/135/about/contacts
Organization (NATO) or a sponsored nation Located outside the United States and its outlying areas and its country is not a member of NATO or a sponsored nation
Contact the NATO Support and Procurement Agency (NSPA)(https://eportal.nspa.nato.int/AC135Public/scage/CageList.aspx)
(2) The Offeror shall provide the CAGE code and legal business name (Do not use a “doing business as” name) for—
(i) Its immediate owner(s), if any;
(ii) Its highest-level owner, if any; and
(iii) Any predecessor(s), or predecessor of an Offeror’s predecessor, that held a Federal contract or grant within the last three years.
Owner Type CAGE Code Legal Business Name Immediate owner Highest-level owner Predecessor*
* Predecessor CAGE code may be marked “Unknown.”
(3) If the Offeror has more than one immediate owner (such as a joint venture), give the information for each owner (or joint venture participant). If the Offeror has more than one predecessor, provide information for each predecessor in reverse chronological order.
(End of provision)
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.
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.
52.219-2 EQUAL OR LOW BIDS OCT 1995
(a) This provision applies to small business concerns only.
(b) The bidder’s status as a labor surplus area (LSA) concern may affect entitlement to award in case of tie bids.
If the bidder wishes to be considered for this priority, the bidder must identify, in the following space, the LSA in which the costs to be incurred on account of manufacturing or production (by the bidder or the first-tier subcontractors) amount to more than 50 percent of the contract price.
(c) Failure to identify the labor surplus areas as specified in paragraph (b) of this provision will preclude the bidder from receiving priority consideration. If the bidder is awarded a contract as a result of receiving priority consideration under this provision and would not have otherwise received award, the bidder shall perform the contract or cause the contract to be performed in accordance with the obligations of an LSA concern.
52.225-2 BUY AMERICAN CERTIFICATE OCT 2022
(a) (1) The Offeror certifies that each end product, except those listed in paragraph (b) of this provision, is a domestic end product and that each domestic end product listed in paragraph (c) of this provision contains a critical component.
(2) The Offeror shall list as 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”.
(3) The Offeror shall separately list the line item numbers of domestic end products that contain a critical component (see FAR 25.105).
(4) The terms “commercially available off-the-shelf (COTS) item,” “critical component,” "domestic end product," "end product," and "foreign end product" are defined in the clause of this solicitation entitled "Buy American-Supplies."
(b)Foreign End Products:
Line Item No. Country of Origin Exceeds 55% domestic content (yes/no)
(b)[List as necessary]
(c) Domestic end products containing a critical component:
Line Item No. ___
[List as necessary]
(d) The Government will evaluate offers in accordance with the policies and procedures of part 25 of the Federal Acquisition Regulation.
(End of provision)
52.229-11 TAX ON CERTAIN FOREIGN PROCUREMENTS –
NOTICE AND REPRESENTATION
AUG 2025
(a) Definitions. As used in this provision—
Foreign person means any person other than a United States person.
Specified Federal procurement payment means any payment made pursuant to a contract with a foreign contracting party that is for goods, manufactured or produced, or services provided in a foreign country that is not a party to an international procurement agreement with the United States. For purposes of the prior sentence, a foreign country does not include an outlying area of the United States.
United States person as defined in 26 U.S.C. 7701(a)(30) means
(1) A citizen or resident of the United States;
(2) A domestic partnership;
(3) A domestic corporation;
(4) Any estate (other than a foreign estate, within the meaning of 26 U.S.C. 701(a)(31)); and
(5) Any trust if–
(i) A court within the United States is able to exercise primary supervision over the administration of the trust; and
(ii) One or more United States persons have the authority to control all substantial decisions of the trust.
(b) Unless exempted, there is a 2 percent tax of the amount of a specified Federal procurement payment on any foreign person receiving such payment. See 26 U.S.C. 5000C and its implementing regulations at 26 CFR 1.5000C- 1 through 1.5000C-7.
(c) Exemptions from withholding under this provision are described at 26 CFR 1.5000C-1(d)(5) through (7). The Offeror may claim an exemption from the withholding by using the Department of the Treasury Internal Revenue Service (IRS) Form W-14, Certificate of Foreign Contracting Party Receiving Federal Procurement Payments, available at www.irs.gov/w14. Any exemption claimed and self-certified on the IRS Form W-14 is subject to audit by the IRS. Any disputes regarding the imposition and collection of the 26 U.S.C. 5000C tax are adjudicated by the IRS as the 26 U.S.C. 5000C tax is a tax matter, not a contract issue.
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