Independent Contractor Request Form

This form is designed to streamline the request to hire process for independent contractors at Cal Poly Pomona.


By submitting this form, you are providing the necessary details to determine whether the individual qualifies as an independent contractor based on CSU and CPP guidelines.


  • If the total payment amount is under $50,000, the request will be reviewed by EODA/HR Operations.
  • If the total payment amount is $50,000 or more, and the agreement has not gone through an informal/formal bidding process, DO NOT COMPLETE THIS FORM at this time and email procurement@cpp.edu with your request.


Please ensure all required information is accurate and complete to avoid delays in processing. If you have any questions, email eoda@cpp.edu.

Department Request Details

Select or enter value
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Contractor Information

Phone
Contractor's Business Structure*
Is the contractor licensed?*

Description of Services

Provide upload a Scope of Work to provide a detailed description of the services the independent contractor will provide, outlining specific tasks, deliverables, or project outcomes.

Drag and drop files here or

If the total payment amount is $50,000 or more, and the agreement has not gone through an informal/formal bidding process, DO NOT COMPLETE THIS FORM at this time and email procurement@cpp.edu with your request.

Conflict of Interest

1. Will the Independent Contractor make a CSU decision on behalf of the institution?*
2. Will the Independent Contractor influence a CSU decision, whose input is not independently reviewed?*
3. Will the Independent Contractor provide investment advice?*
4. Will the Independent Contractor work on an ongoing basis for a year or more?*

Questionnaire

1. Will the worker be required to comply with university provided instructions about when, where, and how to work?*
2. Will the worker be provided with instructions/training by the university regarding the particular method or manner by which the work will be performed?*
3. Is the work to be performed a regular part of university business/work?*
4. Does your department or another department on campus have employees performing the same, or similar, functions?*
5. Will the worker be required to perform the work himself or herself?*
6. Will the worker be hiring or supervising university employees?*
7. Will the worker and the university have a continuing relationship, meaning that the period of service will not be performed in a finite time frame?*
8. Can the worker terminate his/her relationship without incurring a liability for failure to complete the job?*
9. Will the worker be able to hire and pay his/her own assistants?*
10. Does the worker offer similar services to others as part of his/her own business?*
11. Will the worker be allowed to work concurrently for other organizations/clients while working for the university?*
12. Will the worker be able to determine his/her own hours and priorities?*
13. Will the worker be hired and paid to complete one specific job/project for the university?*
14. Will the worker realize a profit or loss as a result of his/her services?*
15. Will the worker provide his/her own tools or materials?*
16. Did the worker retire/separate from the CSU fewer than 2 (two) years ago?*
17. Was an employee in a policy making position or an MPP?*
18. Will the worker participate in the process of planning, negotiations, transaction, or any part of the decision making process?*
19. Will the worker’s position be funded by a CSU contract?*
20. Will the worker be responsible for supervision of CSU contracted employees?*
21. Is the worker free from control and direction of the public agency in the performance of work?*
22. Does the worker perform work that is outside the usual course of public agencies business?*
23. Is the worker customarily engaged in independently establish trade, occupation or business of the same nature as the work performed for the public agency?*
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