Sources Sought-Bulk Oxygen Tank System Replacement for Zuni Comprehensive Community Health Center (ZCCHC)

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

To replace the existing bulk liquid oxygen (LOX) storage tank and install a new 1,500-gallon LOX bulk tank system at the Zuni Comprehensive Community Health Center (ZCCHC).

• Furnish and install a new 1,500-gallon LOX bulk tank system, including a manifold control center, alarm panel, vaporizer, reserve assembly piping, and associated fittings and controls.
• Remove the existing concrete pad and fencing, and construct a new concrete pad and fencing with an access gate.
• Install two 1-inch underground PVC conduits for signal and line-voltage wiring, complying with NFPA 70 and local requirements.
• Install new electrical and alarm systems, including voltage junction boxes and signal wiring for low liquid oxygen level, oxygen reserve in use, and oxygen reserve low alarms.
• Troubleshoot and repair existing non-functioning signal wiring and test all oxygen alarm signals.
• Provide as-built documentation for underground conduit installations.

Not explicitly stated, but the work is to be performed at the Zuni Comprehensive Community Health Center in southwestern New Mexico.

• Contractor personnel performing medical gas work must be certified in accordance with NFPA 99 and ASSE 6010/6020.
• Maintain required insurance coverage (general liability, automobile liability, workers' compensation).
• All electrical work must be performed by a licensed electrician.
• Crane operators must be licensed and certified in accordance with OSHA 29 CFR 1926 Subpart CC, and crane safety planning is required.
• The Facilities Department will coordinate system shutdown, provide emergency backup systems, and address site-specific requirements.

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.

• Eligibility Criteria: Offerors must certify that their enterprise meets the definition of an "Indian Economic Enterprise" throughout the offer period, at the time of contract award, and during the full contract performance period.
• Notification Requirement: Contractors must immediately notify the Contracting Officer in writing if they no longer meet the eligibility requirements.
• 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: Requires the offeror to check a box indicating whether they do or do not meet 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 participate in opportunities designated under the Buy Indian Act. Bidders must accurately complete and submit this form to self-certify their eligibility. Failure to meet the criteria or provide accurate information can lead to disqualification or penalties. It also highlights the need for SAM registration.