(3) Three Non-Personal Healthcare Services for Diagnostic Radiologic Technologists at Northern Navajo Medical Center

Form / Attachment / Pricing Sheet

This document is the "Indian Health Service Buy Indian Act Indian Economic Enterprise Representation Form." It serves as a self-certification for offerors to declare their status as an "Indian Economic Enterprise" (IEE) in accordance with the Buy Indian Act. This form is required in response to Sources Sought Notices, Requests for Information (RFIs), or Solicitations.

• Solicitation/Sources Sought/RFI #: Field to enter the relevant solicitation number.
• Project Title: Field to enter the project title.
• Date: Field to enter the date.
• Representation: Offerors must check a box to indicate whether they represent that their offer does or does not meet the definition of an "Indian Economic Enterprise" with "Indian Ownership" under the Buy Indian Act.
• Name of Federally Recognized Tribal Entity: Field for the name of the tribal entity, if applicable.
• Name of the 51% owner of IEE Firm: Field for the name of the 51% owner.
• Business Name: Field for the business name.
• DUNS Number: Field for the Data Universal Numbering System (DUNS) number.
• Certifying Signature: Field for the signature of the certifying individual.
• Print Name: Field for the printed name of the certifying individual.

Bidders must complete and submit this form to self-certify their eligibility as an Indian Economic Enterprise. Failure to meet the definition of an IEE throughout the solicitation, award, and contract performance periods can lead to penalties. The contracting officer may require documentation of eligibility, and successful offerors must be registered with the System of Award Management (SAM). False information submitted on this form is a violation of law.

Solicitation / RFP / RFQ

This solicitation is for non-personal healthcare services for Diagnostic Radiologic Technologists (CT) for the Radiology Department at Northern Navajo Medical Center. The acquisition is set aside 100% for Indian Small Business Economic Enterprises (ISBEE).

• Provision of non-personal healthcare services for Diagnostic Radiologic Technologists (CT).

• Services are to be provided in accordance with Attachment A - Performance Work Statement.

• The contract type is Labor-Hour CLIN.

• Base Period: Performance from 05/01/2026 to 04/30/2028.

• Option Period 1: Performance from 05/01/2026 to 10/31/2026.

• Option Period 2: Performance from 11/01/2026 to 04/30/2027.

• Option Period 3: Performance from 05/01/2027 to 10/31/2027.

• Option Period 4: Performance from 11/01/2027 to 04/30/2028.

• Offer Due Date: March 26, 2026, at 12:00 PM MST.

• Proposals must be submitted electronically via www.ipp.gov for payment requests.

• The solicitation incorporates FAR clauses 52.212-1, 52.212-4, and 52.212-5 by reference, with addenda.

• This acquisition is a 100% ISBEE (Indian Small Business Economic Enterprise) set-aside.

• The North American Industry Classification Standard (NAICS) code is 561320, with a size standard of $34 million.

• The government will keep the solicitation posted and open for quotes until the offer due date.

• Payment will be made via electronic payment process through the Department of Treasury.

Statement of Work (SOW) / Performance Work Statement (PWS)

This Performance Work Statement (PWS) outlines the requirements for non-personal Diagnostic Radiologic Technologist CT services to support the Indian Health Service (IHS) mission, specifically within the Navajo Area Indian Health Service (NAIHS) at the Northern Navajo Medical Center in Shiprock, New Mexico.

• Provide Diagnostic Radiologic Technologist CT and X-ray care for patients.

• Services include general patient care, operating room procedures, surgical cases, and emergency situations.

• Consult with surgical and CT staff on patient care matters.

• Ensure patients receive proper CT and X-ray care.

• Review clinical records and adhere to documentation procedures.

• Work under the administrative supervision of the Chief of Diagnostic Radiologic Technologist CT.

• Performance will be evaluated based on a Performance-based Matrix (Section 10.0).

• Key indicators include Competency, Compliance, Patient Outcomes, Professionalism, Credentialing, and Documentation.

• Standards include performing 100% of required tasks, 100% compliance with IHS policies and procedures, no reports of breached patient safety or infection control, 100% adherence to the Code of Ethics, uninterrupted credentialing, and 100% of medical records meeting established standards for timeliness, legibility, accuracy, content, date, time, signature, and designated profession.

• Service Quality will be assessed based on customer inputs.

• Place of Performance: Northern Navajo Medical Center, Shiprock, New Mexico.

• Period of Performance: Flexible, allowing for short-term (13 weeks), long-term (1-year), and intermittent support to meet unplanned needs.

• Contractor must possess a minimum of 5 years of experience as a Diagnostic Radiologic Technologist CT.

• Must hold a current, valid, unrestricted ARRT Radiology and CT license and National registry.

• Basic Life Support (BLS) certification is mandatory.

• Must provide a fitness for duty certificate.

• No history of specific adverse actions or criminal convictions related to professional conduct or violent crimes.

• Required immunizations include Rubella, Mumps, Measles, Hepatitis B series, Tetanus Diphtheria (Td), and a TB test within the past 12 months.

• Flu vaccination is REQUIRED.

• Must read, understand, speak, and write English and be respectful of local cultures.

• Must possess basic IT skills.

• Must attend mandatory orientations and training.

• Must undergo Level I and Level II background checks.

• Contract is for non-personal services, with the contractor acting as an independent contractor.

• Contractor shall maintain liability insurance.

• Order of precedence for conflicts: Supervisor's directions, Position Description, PWS Exhibits, PWS Narrative.

Solicitation / RFP / RFQ

This is a combined synopsis/solicitation for non-personal healthcare services for Diagnostic Radiologic Technologist CT in the Radiology Department at Northern Navajo Medical Center. The acquisition is set aside for an Indian Small Business Economic Enterprise (ISBEE).

• Provision of three (3) NPSC Diagnostic Radiologic Technologist CT Techs.

• Services include a Base Period of 6 continuous months, followed by three (3) Option Periods of 6 months each.

• Performance Work Statement (PWS) is included as an attachment.

• Contract type: Request for Quotation (RFQ).

• NAICS Code: 561320 - Temporary Help Services.

• Period of Performance: Base Period (6 months) + 3 Option Periods (6 months each).

• Quotes are requested and a separate written solicitation will not be issued.

• Submission requirements are divided into three volumes:

  • Volume 1: Administrative Documents (SF-1449, amendments, representations, and certifications).
  • Volume 2: Technical Capability and Approach (demonstrating ability to meet PWS requirements, including key personnel qualifications and resumes).
  • Volume 3: Price (detailed pricing aligned with the technical approach, including all CLINs and option periods).

• Quotations must address all three volumes to be considered responsive.

• Evaluation factors include: Technical capability and approach, Key Personnel qualifications, Capability to meet the Period of Performance Schedule, and Price.

• Quotes are due: March 26, 2026, by 12:00 pm MST.

• This acquisition is an Indian Small Business Economic Enterprise (ISBEE) set-aside.

• The solicitation incorporates provisions and clauses by reference, accessible electronically at www.acquisition.gov and www.acquisition.gov/hhsar.

• The provision at 52.212-1, Instructions to Offerors – Commercial Products and Commercial Services (NOV 2025)(DEVIATION), applies with addenda.

• The provision at 52.212-2, Evaluation – Commercial Products and Commercial Services (NOV 2025)(DEVIATION), applies.

• Contact for questions: Felecia Chavez, Contract Specialist, at felecia.chavez@ihs.gov.