Sources Sought for 1 Alcor ISED Elite ESR analyzer and supplies

Form / Attachment / Pricing Sheet

This document is the Indian Health Service (IHS) Buy Indian Act Indian Economic Enterprise (IEE) Representation Form. It serves as a self-certification for offerors to confirm they meet the definition of an "Indian Economic Enterprise" as defined by the Buy Indian Act and HHSAR 326.601. This form is required in response to Sources Sought Notices, Requests for Information (RFI), or Solicitations.

• Eligibility Requirements: The enterprise must meet the IEE definition at the time of offer, contract award, and throughout the contract performance period. Any change in eligibility requires immediate notification to the Contracting Officer.
• Documentation: Contracting Officers may request documentation of eligibility before awarding contracts under the Buy Indian Act.
• Registration: Successful Offerors must be registered with the System of Award Management (SAM).
• Penalties: False or misleading information is a violation of law, punishable under 18 U.S.C. 1001, and false claims are subject to penalties under 31 U.S.C. 3729-3731 and 18 U.S.C. 287.
• Representation Section: Bidders must indicate whether they represent that their offer meets the definition of an "Indian Economic Enterprise" with "Indian Ownership."
• Required Fields: Name of Federally Recognized Tribal Entity, Name of the 51% owner of IEE Firm, Business Name, DUNS Number, Certifying Signature, and Print Name.

This form is critical for any bidder seeking to qualify for contracts or set-asides under the Buy Indian Act. Bidders must accurately complete this self-certification to demonstrate their eligibility. Failure to meet the IEE definition or provide accurate information can lead to disqualification or penalties.

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

This Statement of Work (SOW) outlines the requirements for providing an ISED Elite ESR analyzer and associated services to the Chinle Laboratory on an instrument placement agreement.

• Instrument: Provide one (1) ISED Elite ESR analyzer (product # 112-00222).

• Consumables & Supplies: The Chinle Laboratory will purchase consumables, Quality Control, and any necessary testing supplies required to operate the analyzer from the contractor.

• Service Agreement: The instrument service agreement will be purchased separately.

• Current Status: The analyzer is currently installed and operational.

• Nature of Request: This is an annual renewal request.

• Location: Chinle Comprehensive Health Care Facility.

• Period of Performance: April 1, 2026, to March 31, 2027, with two (2) 12-month option periods.

• Supplies: Contractor will ship/deliver supplies on an "as needed basis."

• Service: Required service requests will be acted upon by the contractor according to their service agreement terms.

• Invoicing: Contractor will provide proper invoices for billing in IPP (Invoicing, Receipt, Acceptance, and Property Management).

• Maintenance: Instrumentation will be replaced/repaired at the manufacturer’s discretion, following their internal protocols.

• Name: Colleen Ben

• Title: Laboratory Supervisor

• Phone: (928)-674-7101

• Email: colleen.ben@ihs.gov

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

This Statement of Work outlines the requirements for an instrument placement agreement for an ISED Elite ESR analyzer at the Chinle Laboratory.

• The contractor shall provide one ISED Elite ESR analyzer (product # 112-00222).

• Chinle Laboratory will purchase consumables, Quality Control, and testing supplies required to operate the analyzer from the contractor.

• The instrument service agreement will be purchased separately by Chinle Laboratory.

• The analyzer is currently installed and operational; this request is for an annual renewal.

• Period of Performance: April 1, 2026 - March 31, 2027, with two (2) 12-month option periods.

• Location of Work: Chinle Comprehensive Health Care Facility.

• Supplies will be shipped/delivered on an "as needed basis."

• Service requests will be acted upon by the contractor according to their service agreement terms.

• The contractor will provide proper invoices for billing in IPP.

• Instrumentation will be replaced/repaired at the manufacturer’s discretion, following their internal protocols.

• Colleen Ben, Laboratory Supervisor

• Phone: (928)-674-7101

• Email: colleen.ben@ihs.gov