SSN-Large Capacity Autoclaves for Kayenta Health Center Dental Department

The Indian Health Service (IHS) Buy Indian Act Indian Economic Enterprise Representation Form is a mandatory self-certification document for offerors responding to solicitations, sources sought notices, or RFIs under the Buy Indian Act (25 U.S.C. 47). This form requires offerors to affirm that they meet the definition of an “Indian Economic Enterprise” (HHSAR 326.601) at the time of offer, contract award, and throughout the contract performance period. Contractors must immediately notify the Contracting Officer if they no longer meet eligibility requirements. Individual Contracting Officers may request documentation of eligibility, and awards are subject to protest if eligibility is questioned. Successful offerors must also be registered with the System for Award Management (SAM). The form warns against submitting false or misleading information, citing potential penalties under 18 U.S.C. 1001 for false information and 31 U.S.C. 3729-3731 and 18 U.S.C. 287 for false claims during contract performance. The representation section requires the offeror to indicate whether they meet the definition of an “Indian Economic Enterprise” with “Indian Ownership” and provides fields for the 51% owner's name, certifying signature, print name, federally recognized tribal entity name, business name, and DUNS number.