Water service line and Septic Tank Lagoon for D. Rupnicki SR#574 in Mayetta, KS (Jackson Co.)

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 tool for offerors to declare their status as an "Indian Economic Enterprise" in accordance with 25 U.S.C. 47 and HHSAR 326.601.

• Self-Certification: Offerors must sign to certify they meet the definition of an "Indian Economic Enterprise" with "Indian Ownership."
• Eligibility Period: The enterprise must meet the definition at the time of offer, contract award, and throughout the contract performance period. Notification is required if eligibility is lost.
• Documentation: Contracting Officers may require documentation of eligibility before awarding Buy Indian Act set-aside or sole source contracts.
• Required Information: The form requires the Offeror to indicate "yes" or "no" regarding meeting the definition, and to provide the Name of Federally Recognized Tribal Entity, Name of the 51% owner of IEE Firm, Business Name, DUNS Number, Certifying Signature, and Printed Name.
• Penalties: False or misleading information is a violation of law, subject to penalties under 18 U.S.C. 1001, 31 U.S.C. 3729-3731, and 18 U.S.C. 287.

This form is critical for any bidder intending to claim status as an Indian Economic Enterprise for an opportunity set aside or awarded under the Buy Indian Act. Bidders must accurately complete and submit this form as part of their offer to self-certify their eligibility. Failure to meet the definition or provide accurate information can lead to disqualification or penalties. Registration in the System for Award Management (SAM) is also required.

Solicitation / RFP / RFQ

This solicitation is for the furnishing and installation of a water service line and septic tank lagoon for D. Rupnicki SR #574 in Mayetta, KS (Jackson Co.). The project is a 100% Indian Small Business Economic Enterprise set aside.

• Furnish and install approximately 940 LF of 2" HDPE DR 11 water service line by trenching/open cut excavation.

• Furnish and install approximately 165 LF of 4" PVC Schedule 40 building sewer service pipe.

• Construct a 40'x 40' sewage lagoon (inside top of berm 52'x 52').

• Furnish and install 280 LF of wire fencing, gate, chain, and keyed padlock.

• Directional bore 160 LF of 2" HDPE DR 11 water service line.

• Install 10 LF of 4" PVC Schedule 40 PVC building sewer between the home and septic tank.

• Include two (2) cleanouts on the sewer service line.

• All work must be performed in accordance with contract specifications and drawings.

• Materials must meet NSF/ANSI-61 and NSF/ANSI-14 requirements.

• A minimum one-year warranty for all materials and labor is required.

• Contract Type: Not explicitly stated, but implied to be firm-fixed-price based on evaluation factors.

• Period of Performance: 60 days after receipt of award.

• Estimated Value: Not stated, but the NAICS code associated side standard is $45.0 million.

• Quote Due Date: April 1, 2026, at 5:00 PM CST.

• Submission Method: Electronically in PDF format via email to Noleen.Powell@ihs.gov.

• Evaluation Criteria: Lowest Price Technically Acceptable (LPTA). Proposals will be evaluated for technical acceptability first, then by price.

• Key Deadlines: Inquiries must be received no later than 5 calendar days prior to the quote receipt date.

• This procurement is a 100% Indian Small Business Economic Enterprise set aside.

• NAICS Code: 237110, Water and Sewer Line and Related Structures Construction.

• A site visit is recommended but not scheduled; contact the Contracting Officer for scheduling.

• Wage Determination is included (WD KS20260152 Dated 01.02.2026).