SPECIAL CONSULTANT AGREEMENT FORM

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SPECIAL CONSULTANT AGREEMENT FORM
Number:
Consultant:
CSU, Chico Emp ID:
(TYPE OR PRINT NAME AS IT APPEARS ON THE SOCIAL SECURITY CARD)
Complete Address:
Check all that apply:
Phone:
Has another position on campus
Primary CSU/CSUC Position:
Full Time
Has position at other campus:
Part Time time base:
Hourly
Will this special consultant appointment result in more than 125% employment within the CSU system?
Yes
No
Is this special consultant appointment outside normal CSU work hours?
Yes
No
If "No," complete the following:
Appointee is taking vacation to complete this assignment (attach form 634)
Adjusted work schedule attached.
This contract must be signed by the appropriate dean or department head and approved by the Office of Human Resources or
Faculty Affairs, before any work begins. (For current CSU, Chico faculty, form must be sent to Faculty Affairs).
FOR HUMAN RESOURCES USE ONLY
Classification:
Dept:
Timebase:
s
Description of Duties (must be detailed and specific):
IF CURRENT CSU, CHICO FACULTY: Please explain in detail how/why this appointment is outside the responsibility of employee's primary faculty
position:
CONDITIONS OF APPOINTMENT
Special Consultant appointments are approved only for the dates, daily rate, and total number of days specified in this agreement.
Any changes in the period of employment, the daily rate, the total number of days authorized, or assignments must be submitted on
a new agreement form and approved by the Office of Human Resources.
Special Consultant appointments automatically expire at the end of the period stated and do not establish consideration for
subsequent appointments.
If the assignment, as described in this agreement, is not completed or is not completed in a satisfactory manner, the University
reserves the right to cancel this contract or to reduce the total number of days for which payment will be made.
Current CSU system employees who accept additional employment as Special Consultants are subject to the Additional Employment
Policy of the California State University (HR 2002-05 and Public Contract Code 2003-21) or the applicable collective bargaining
agreement, all of which limit total employment within the CSU to a maximum of 125% of full time.
OATH OF ALLEGIENCE AND IRCA VERIFICATION
NEW HIRED CONSULTANTS: All consultants are required to sign an Oath of Allegiance. Under the Immigration Reform and Control
Act 1986 (IRCA), all new consultants are required to complete a Form I-9 and present original documents that establish identity and
employment authorization to the Human Resources Office. The documents must be presented on or before the first day of
employment and must be originals. A list of acceptable I-9 documents can be found at this link: http://www.uscis.gov/files/form/I-9.pdf,
or you may contact Staff Human Resources at 530-898-6771.
SHRM-Special Consultant Agreement.pdf
Page 1 of 2
rev. 11/10/2010
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REHIRED CONSULTANTS: Rehired consultants are required to complete a new Oath of Allegiance if their original Oath of Allegiance
was signed more than one year ago. Rehired consultants who have previously completed a Form I-9, may re-verify their information
without presenting original documents if the consultant is rehired within three years of initial date of hire; and other eligibility
requirements are met.
Completion of these forms, approval of this appointment, and an approved time sheet are necessary before payment can be made.
BENEFITS
Special consultants may be eligible for Worker's Compensation Insurance and Unemployment Insurance.
PAYMENT PROCESS
Special Consultants are paid on a daily rate basis. An approved Special Consultant Timesheet must be submitted to the project
supervisor, in accordance with their instruction, before the campus Payroll Office can request payment from the State Controller's
Office. If paid on a monthly basis, a separate timesheet is required for each pay period (NOTE: pay periods do not always match the
calendar months - the faculty and staff calendar can be found at www.csuchico.edu/faaf. Official campus pay period dates are 10
working days. Consultants on the State's Direct Deposit Program will have their checks deposited; Consultants who which to have
their checks mailed must submit a self-address stamped envelope (with their SSN number printed on the inside flap) to their
supervisor with their timesheet.
TAXES
Special Consultant pay may be subject to retirement/social security/medical tax deductions which, for current CSU employees will be
aggregated with regular pay for tax purposes.
Start Date
Daily Rate:
End Date
Cannot exceed daily rate in Section E99 of Salary Schedule. Minimum rate $91/day.)
Estimated number of work days:
Position number:
Unit
Maximum payment authorized:
CMS Position Number:
4660
Class
Funding Source:
Department ID:
Dept/Division:
Campus Zip:
Consultant's Supervisor (print name):
Phone:
Form completed by (print name):
Phone:
Email:
***Must attach Independent Contractor vs. Employee Worksheet for processing
I have reviewed the above and agree to the conditions of this consulting appointment as stated on the reverse of this form.
in accordance with the immigration Reform and Control Act of of 1986, I understand I will be required to provide identity
documents and complete a I-9 to verify my right to work in the United States.
Consultant Signature
Date
I have reviewed the special consultant policy and procedures. This appointment will be consistent with the appropriate CSU
guidelines and collective bargaining agreement. (Supervisor & Dean/Dept Head must be different signees)
Supervisor
Date
Human Resources Office
Date
Dean/Dept Head
Date
DISTRIBUTION: Submit original to Staff Human Resources, Zip 010.
SHRM-Special Consultant Agreement.pdf
Page 2 of 2
rev. 11/10/2010