State of Connecticut Comptroller's Requests for Proposals CONNECTICUT STATE EMPLOYEES RETIREMENT COMMISSION REQUEST FOR PROPOSAL ACTUARIAL VALUATION AND CONSULTING SERVICES STATE EMPLOYEES RETIREMENT SYSTEM JUDGES, FAMILY SUPPORT MAGISTRATES, AND COMPENSATION COMMISSIONERS RETIREMENT SYSTEM PROBATE JUDGES AND EMPLOYEES RETIREMENT SYSTEMAttachment I

State of Connecticut

This page was last updated on: June 22, 2015

CONNECTICUT STATE EMPLOYEES
RETIREMENT COMMISSION

ACTUARIAL VALUATION AND CONSULTING SERVICES
STATE EMPLOYEES RETIREMENT SYSTEM
JUDGES, FAMILY SUPPORT MAGISTRATES, AND COMPENSATION COMMISSIONERS RETIREMENT SYSTEM
PROBATE JUDGES AND EMPLOYEES RETIREMENT SYSTEM

Attachment I

STATE OF CONNECTICUT
EMPLOYMENT INFORMATION FORM COMMISSION ON HUMAN RIGHTS & OPPORTUNITIES
WORKFORCE ANALYSIS AFFIRMATIVE ACTION REPORT

BIDDER/CONTRACTOR
 CONTACT PERSON
 DATE
ADDRESS
 PHONE NUMBER
 CONTRACT AWARD NUMBER

Report all permanent full-time or part-time employees, including apprentice and on-the-job trainees. Enter the numbers on all lines and in all columns.

JOB CATEGORIES OVERALL TOTALS
(Sum of all Columns,
A thru E
Male and Female)		 A
WHITE (NOT OF
HISPANIC ORIGIN) 		B 
BLACK (NOT OF HISPANIC ORIGIN) 		C 
HISPANIC 		D 
ASIAN OR PACIFIC ISLANDER 		E 
AMER. INDIAN OR ALASKAN NATIVE
MALE FEMALE MALE FEMALE MALE FEMALE MALE FEMALE MALE FEMALE
Officials and Managers                      
Professionals                      
Technicians                      
Sale Workers                      
Office and Clerical                      
Craft Workers
(Skilled) 		                     
Operatives
(Semi-skilled)
                   
Laborers
(Unskilled) 		                     
Service
Workers 		                     
TOTALS
ABOVE 		                     
Do you use minority businesses as subcontractors or suppliers?  YES check box NOcheck box Explain:
If Ct. based, do you post all employment openings with the State of Connecticut Employment Service? YES check boxNOcheck box Explain:
Do you implement a written Affirmative Action Plan? YES check box NOcheck box Explain:
DESCRIBE YOUR RECRUITMENT, HIRING, TRAINING AND PROMOTION ANTIDISCRIMINATION PRACTICES

RMF/emv:042500 Bid Employ Chart

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