Compliance Review Questionnaire - Illinois

This printable "Compliance Review Questionnaire" is a document issued by the Illinois Department of Human Rights specifically for Illinois residents.

Download a PDF of the latest edition of the form down below or find it through the department's forms library.

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IDHR Public Contracts Number:
Compliance Review Number:
ILLINOIS DEPARTMENT OF HUMAN RIGHTS
PUBLIC CONTRACTS UNIT
COMPLIANCE REVIEW QUESTIONNAIRE
General Instructions
According to Title 44, Subpart D, Section 750.230 of the Department Rules, the Department may periodically
request information from any facilities or operations of a public contractor/eligible bidder to determine compliance
with the Act and this Part.
Answer all questions.
·
If company, through computer printout or other format, maintains information that addresses all or part of
a question, such documentation may be attached in lieu of filling out the applicable section of the
questionnaire. These support documents may be either sent by mail or e-mail.
Please contact the Program Administrator of the Public Contracts Unit for assistance at
florence.griffin@illinois.gov
Please include the 7 digit compliance review number on all correspondence.
For response by mail
Please type or print in ink. If space is inadequate, attach additional sheet. Give the number of the question
being answered.
Send to: Illinois Department of Human Rights, 100 W. Randolph Street, Suite 10-100, Chicago, Illinois
60601 Attn: Florence Griffin, Public Contracts Unit.
Please include the 7 digit compliance review number on all correspondence.
For Response by e-mail
This form is available to be filled out online and e-mailed to
florence.griffin@illinois.gov
Please type in the live fields.
Please include the seven (7) digit compliance review number on all correspondence.
IDHR Public Contracts Number:
Compliance Review Number:
ILLINOIS DEPARTMENT OF HUMAN RIGHTS
PUBLIC CONTRACTS UNIT
COMPLIANCE REVIEW QUESTIONNAIRE
General Instructions
According to Title 44, Subpart D, Section 750.230 of the Department Rules, the Department may periodically
request information from any facilities or operations of a public contractor/eligible bidder to determine compliance
with the Act and this Part.
Answer all questions.
·
If company, through computer printout or other format, maintains information that addresses all or part of
a question, such documentation may be attached in lieu of filling out the applicable section of the
questionnaire. These support documents may be either sent by mail or e-mail.
Please contact the Program Administrator of the Public Contracts Unit for assistance at
florence.griffin@illinois.gov
Please include the 7 digit compliance review number on all correspondence.
For response by mail
Please type or print in ink. If space is inadequate, attach additional sheet. Give the number of the question
being answered.
Send to: Illinois Department of Human Rights, 100 W. Randolph Street, Suite 10-100, Chicago, Illinois
60601 Attn: Florence Griffin, Public Contracts Unit.
Please include the 7 digit compliance review number on all correspondence.
For Response by e-mail
This form is available to be filled out online and e-mailed to
florence.griffin@illinois.gov
Please type in the live fields.
Please include the seven (7) digit compliance review number on all correspondence.
PART ONE - ALL PUBLIC CONTRACTORS AND ELIGIBLE BIDDERS MUST COMPLETE
SECTION A - GENERAL INFORMATION
1. Legal name of company, mailing address
1a.
Company's County
1b.
Describe briefly the type of work the public contractor/eligible bidder provides
2.
List the following for the person completing this form:
2a.
Full Name
2b.
Job Title
2c.
Mailing Address
2d.
Telephone and Fax Number
2e.
E-Mail Address
3. Is the company a parent, subsidiary, or an affiliate of another company?
Yes
No
If yes, please describe
3a.
Describe the type of products/services the company provides
4. Does the company operate from more than one Illinois location?
Yes
No
If yes, provide city (cities) and number of employees at each location.
5. Is the company or any of the locations in the company a federal contractor subject to
Executive Order No.
11246
as amended?
Yes
No
If no, continue to question 6.
If yes, has the company or any of the locations within the company undergone a desk audit by the Office
of Federal Contract Compliance Programs ("OFCCP")?
Yes
No
If yes, provide the date of the audit and attach a copy of OFCCP's letter of findings.
6. Does the company have a written affirmative action plan?
Yes
No
If yes, attach a copy.
SECTION B - COMPLAINTS OF UNLAWFUL DISCRIMINATION
7. During the last three years, has an employee filed a complaint of unlawful discrimination with the United
States Equal Employment Opportunity Commission ("EEOC"), the Illinois Department of Human Rights, or
other governmental entity against any locations within the company?
Yes
No
If yes, list the following for each complainant:
7a.
The complaint number and governmental agency with whom the complaint was filed
7b.
A summary of the complaint
7c.
The status of the complaint
8. During the last three years, has an employee filed an internal complaint of unlawful discrimination with the
company?
Yes
No
If yes, list the following for each complaint:
8a.
A summary of the complaint
8b.
The status of the complaint
SECTION C - PERSONNEL POLICIES, PRACTICES AND PROCEDURES
9. Has the company developed a written equal employment opportunity policy statement?
If yes, attach a copy.
Yes
No
10. Has the company developed a
sexual harassment policy
statement?
Yes
No
If yes, attach a copy.
11. Does the company have a policy manual or employee handbook containing all of the employer's policies?
Yes
No
If yes, please provide a copy of the manual or handbook.
SECTION D - PUBLIC CONTRACT
12. Has the company entered into a public contract or been given an award or grant by the State of Illinois using
their Public Contract Number for the current and previous calendar year?
Yes
No
If no, skip Part Two (questions 13 through 19) and proceed to Part Three (question 20).
PART TWO - PUBLIC CONTRACTORS
13. List the following for each public contract entered into using your Public Contract Number for the current and
previous calendar year.
13a. The name of the contracting governmental agency
13b. The date of the contract
13c. The amount of the contract
13d. Has the company hired employees to perform the contract?
Yes
No
If yes, please attach a copy of the company's underutilization analysis for the newly hired
employees.
14. Did the company use subcontractors to complete the public contract?
Yes
No
If yes, did the company include the Equal Employment Opportunity Clause set forth in Appendix A of 44 Ill.
Admin. Code, Ch. X, Section 750 of the Department's Rules and Regulations?
Yes
No
If yes, please attach a copy of the subcontract which contains this provision.
15. Does the company utilize employment applications?
If yes, please attach a copy of the application.
Yes
No
16. Has the company advertised vacancies within the last 12 months?
If yes, please attach a copy of the advertisement(s).
Yes
No
17. Describe briefly the method used by the company to recruit new employees.
Are recruitment organization(s) used?
Yes
No
18. Is the company bound by a collective bargaining or other agreement to use a labor organization or other
representative of workers?
If yes, please attach a copy of the following:
Yes
No
18a. The collective bargaining agreement
18b. The underutilization analysis that was provided to the labor organization
18c. The manner of notification to the labor organization or representative of the company's obligations for
equal employment opportunity and affirmative action.
19. How are employees made aware of company's equal employment opportunity/non-discrimination program?

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