Instruments and Supplies for Central Supply Department, SFIHC

Form / Attachment / Pricing Sheet

This document is a blank Past Performance Survey form used by the Department of Health and Human Services, Indian Health Service. It is designed to collect feedback on a contractor's performance for a specific project.

• Contractor Information: Fields for contractor name, client name and address, project name, contract number(s), performance period, and teaming partners.
• Government/Commercial Project Manager Contact: Fields for contact name, title, phone, fax, and email.
• Specific Performance Questions: Open-ended questions asking about contract type, end goal/product, patient background, planning and staffing, and timeline adherence.
• Past Performance Ratings: A rating scale (Excellent, Good, Acceptable, Marginal, Unacceptable, N/A) applied to various aspects of performance, including:
  • Quality of Service (e.g., compliance, report accuracy, personnel effectiveness, technical excellence)
  • Cost Control (e.g., forecasting, billings, relationship of costs to actual, cost efficiencies)
  • Timeliness of Performance (e.g., milestones, reliability, responsiveness, completion time, delivery schedules, liquidated damages)
  • Business Relations (e.g., management, behavior, responsiveness, problem notification, flexibility, pro-activity, subcontracting program, staff turnover)
  • Customer Satisfaction (e.g., commitment, recommendation, overall rating)
• Additional Comments: A section for qualitative feedback.

This form is used by the government to evaluate a contractor's past performance. Bidders may encounter this form as part of a solicitation where past performance is an evaluation factor. Understanding the criteria and rating system will help bidders prepare to provide relevant information about their own past performance or to understand how their past performance will be assessed.

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 confirm they meet the definition of an "Indian Economic Enterprise" as required by the Buy Indian Act. This form is to be submitted in response to a Sources Sought Notice, Request for Information (RFI), or Solicitation.

• Self-Certification: Offerors must attest whether they meet the definition of an "Indian Economic Enterprise" with "Indian Ownership."
• Eligibility Period: The enterprise must meet the definition throughout the offer period, at contract award, and during the contract performance period. Immediate notification is required if eligibility is lost.
• Required Information: Fields include:
  • Solicitation/Sources Sought/RFI #
  • Project Title
  • Date
  • Name of Federally Recognized Tribal Entity
  • Name of the 51% owner of IEE Firm
  • Business Name
  • DUNS Number
  • Certifying Signature
  • Print Name
• Compliance: False or misleading information is a violation of law and subject to penalties. Offerors must also be registered with the System of Award Management (SAM).

This form is critical for bidders responding to opportunities that are set aside or sole-sourced under the Buy Indian Act. Bidders must accurately complete this form to demonstrate their eligibility. Failure to meet the definition or provide accurate information can lead to disqualification or penalties.

Solicitation / RFP / RFQ

This solicitation (75H70726Q00068) is for the procurement of Central Sterile Surgical and Clinical Instruments and Supplies for the Santa Fe Indian Health Center (SFIHC) in Santa Fe, New Mexico. The Indian Health Service (IHS), Albuquerque Area Office (AAO) has a requirement for these items.

• The contractor will provide surgical and clinical instruments as listed in the attached instrument list, or equivalent instruments meeting or exceeding specifications.

• Associated services include scheduled replacements, repair services, instrument sharpening, warranty coverage, preventive servicing, and sterilization tray compatibility support.

• Instruments must be new, unused, free from defects, manufactured from surgical-grade stainless steel, and meet applicable FDA regulations, ISO manufacturing standards, and ASTM surgical instrument standards.

• Instruments must be autoclavable, corrosion-resistant, and suitable for repeated sterilization cycles.

• A detailed list of specific instrument categories and quantities is provided.

• This will result in a Firm-Fixed-Price (FFP) Purchase Order.

• The contract includes a Base Period (TBD, 2026 to TBD, 2027) and four Option Periods (TBD, 2027-2028, TBD, 2028-2029, TBD, 2029-2030, TBD, 2030-2031).

• The total contract award will not exceed five years.

• The estimated contract value is TBD.

• Offerors must be registered in the System for Award Management (SAM).

• Quotes must include a Technical Approach (Volume I), Past Performance (Volume II), and Price Quote (Volume III).

• Pricing should be valid for at least 90 days.

• The quote must be signed by an authorized official and submitted no later than 6/30/2026, 12:30 pm MDT via email to patricia.trujillo@ihs.gov.

• Questions must be submitted in writing by 6/25/2026.

• Award will be made on a best-value basis, considering technical approach, past performance, and price. Technical and past performance are more important than price.

• This acquisition is set aside for Small Business.

• The North American Industry Classification Standard (NAICS) code is 339112.

• The contract will be administered by the Albuquerque Indian Health Service.

• Invoices must be submitted electronically via the Invoice Processing Platform (IPP).