Interview and Selection for IT Consultants  
Agency Name*: Agency Number*:
Vendor Name*: Project Name*:
Position Title*: Pricing*:  
Consultant's Name*: Consultant Job Classification*:
Start Date*: Calendar End Date*: Calendar
Interviewer's Name (s)*: No. of Days*:
Daily Rate*: Total Cost*:
No. of OT Hours/Week*: Per Hour Rate*:
Total Hours*: Total OT Cost*:
Grand Total*:
New Consultant/Position or Renewal of existing Consultant/Position*:
Qualified DOIT Personnel Available*:
Check Appropriate SDM Project Option*:
Small Business Set-Aside Program Vendor*:
References Checked*:
OPM Hiring Freeze Guideline Compliance as of 4/29/11*:
Has been determined that there are no qualified SEBAC/Re-Employment
Candidates for this position (through agency's personnel)?*:
Has the candidate for this position been made aware of the State Code of Ethics as it applies to vendors conducting business with the State of
Connecticut? *:
Is the vendor selection most cost-effective?*:
Does the candidate have other contracts with the state?*:
Does the candidate have any immediate family member employed by the state?*:
I attest, under penalty of perjury, that the information provided is accurate and current, and I am (Check one of the following)*:
A citizen or national of the United States   (Attach I-9)
A Lawful Permanent Resident (Alien # A )   (Attach I-9)
An Alien authorized to work until Calendar , Alien # or Admission #     (Attach I-9)
Signature of Consultant*: Certified by Agency*: Date*: Calendar
Prior version DOIT-2 Interview Sheet