Independent Contractor Questionnaire

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Contractor Information
1. First / Last name:
 
First
 
Last
2. Business name:
3. Business address:
 
Street 1:
 
Street 2:
 
City:
 
State:
 
Zip code:
 – 
4. Job title:
5. Personal address:
 
Street 1:
 
Street 2:
 
City:
 
State:
 
Zip code:
 – 
6. Phone:
7. Email:
8. Does the individual have a business Tax ID number that is not a Social Security Number?
 


  If Yes, please enter it.
  A individual with a business Tax ID will be asked for a W-9.
A individual without a business Tax ID will be asked for a Social Security Number.
9. Is the individual eligible to work in the United States?
 


A individual eligible to work in the US will be asked for a I-9.
10. Does the individual provide these services to other clients?


If so, list at leasr two (2)—preferably three (3)—references with phone numbers
 
Reference 1 name:
 
Reference 1 phone number:
 
Reference 2 name:
 
Reference 2 phone number:
 
Reference 3 name:
 
Reference 3 phone number:
Project Information
11. Who is the Otis Reprsentative/Lead in accomplishing this project?
 
Indicate Name/Role/Department
12. What is the scope and deliverables of the project?
13. What is the timeline for the project?
 
Please include due dates for deliverables AND start and end dates of overall prject/work:
14. How will the Otis Representative hiring for services oversee the project/work?
 


If Other, specify:
15. Do you require the contractor to work schedule times and days?
 

If Yes, indicate the schedule
16. Where will the work be performed?
 


If Other (Off Site), specify location
17. Are resources provided by the College?
 

If yes, please check all that apply:
18. What is the Payment Plan for Services?
 


 
Payment amount (Flat Fee) or description (Periodic Basis or Other)
19. Budget to be charged:
20. The payment to the individual will be based on
 



 
If Other, describe the pay basis
College/Departmental Information
21. How did you find out about the individual?
 



 
 
  If Alumni, year graduated:    
 
22. Has the individual provided services to the College before?
 



If Paid on payroll, give approximate start and end dates:
Approx. start date:
  , 
Approx. end date:
  , 




Thank you for completing this form. Please allow at least three (3) business days for review. You will then be contacted with further instructions by either Human Resources & Development or the Business Office depending on the classification (Employee or Independent Contractor).