State of Connecticut

This page was last updated on: April 15, 2011

CONNECTICUT STATE EMPLOYEES
RETIREMENT COMMISSION

REQUEST FOR PROPOSAL
ACTUARIAL VALUATION AND CONSULTING SERVICES
MUNICIPAL EMPLOYEES RETIREMENT SYSTEM
POLICEMEN AND FIREMEN SURVIVORS' BENEFIT FUND

Attachment II

comptroller's Seal
STATE OF CONNECTICUT
NANCY WYMAN
COMPTROLLER
OFFICE OF THE STATE COMPTROLLER
55 ELM STREET
HARTFORD, CONNECTICUT 06106-1775
MARK OJAKIAN
DEPUTY COMPTROLLER

TO: All Potential Contractors
FROM: Jeffrey Holyst, Fiscal Administrative Manager II (702-3330)
Re: CONTRACT COMPLIANCE REQUIREMENTS

All contracts to be awarded are subject to contract compliance requirements mandated by Section 4-114a of the Connecticut General Statutes and, when the awarding agency is the State, Section 46a-71 (d) of the Connecticut General Statutes. The awarding agency must consider the following factors when reviewing the bidder's qualifications under the following factors when reviewing the bidder's qualifications under the contract compliance requirements; therefore, we are asking that the following information be provided:

1. Contractor

Name: __________________________________________________________________________

Address: ________________________________________________________________________

Telephone: ______________________________________________________________________

Principal Place of Business: _________________________________________________________

2. Subcontractor(s)

Name: __________________________________________________________________________

Address: ________________________________________________________________________

Telephone: ______________________________________________________________________

Principal Place of Business: _________________________________________________________

Contact Person: __________________________________________________________________

3. Section 4-114a 3 (10) Criteria

>Does the contractor have an Affirmative Action Plan? Yes____ No ____

>If no, does the contractor plan to develop an Affirmative Action Plan? Yes___ No___

>Total Number of employees? _______

>What percentage of total employees are women? _______

>What percentage of total employees are minorities? _______

>Does the contractor promise to set aside a portion of the Contract for minority business enterprises?

Yes ___ No ___

______________________________________ _______________________________
Signature and Title of Principal Officer Date