2020_ACH_FORM_(2).pdf
PDF 54 KB Posted
- Attached to
- RFP- INTERNATIONAL AND NATIONAL SPORTS & ENTERTAINMENT BUSINESS DEVELOPMENT SUPPORT SERVICES
- Solicitation number
- 25-S-025
- Issued by
- District of Columbia
About this file
This is an Authorization Agreement for Automatic Deposits (ACH Credits) form issued by the Washington Convention and Sports Authority (WCSA), operating as Events DC, a District of Columbia government agency. The form authorizes WCSA to initiate credit entries and, if necessary, debit entries and adjustments to a designated checking or savings account held at a specified depository institution. The form requires the contractor to provide company name, Employer Identification Number (EIN) or Tax ID, depository information including bank name, branch location, transit/ABA number, and account number. The authorization remains in effect until WCSA receives written termination notice providing the company and depository reasonable opportunity to act on the request. The contractor must provide contact information including name, title, email address, phone number, and signature, with a voided check attached as supporting documentation. This ACH authorization form is a standard administrative requirement for contract payment processing and does not establish contract terms, pricing, scope of work, or performance obligations.
The form serves as a prerequisite administrative document for contractors awarded contracts with WCSA and does not contain pricing terms, set-asides, incumbency information, funding sources, or other salient contract details. Rather, it functions solely as a banking authorization mechanism to facilitate electronic fund transfers for contract payments. Completion and submission of this form would typically occur after contract award and prior to the initiation of services or invoicing.
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Text version
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS (ACH CREDITS)
COMPANY NAME: _____________________________________
EIN or Tax ID of the Business: ________________________________________
I (we) hereby authorize Washington Convention and Sports Authority (WCSA), hereinafter called COMPANY, to initiate credit entries and to initiate, if necessary, debit entries and adjustments for any credit entries in error to my (our) Checking Savings account (select one) indicated below and the depository named below, hereinafter called DEPOSITORY, to credit and/or debit the same to such account.
DEPOSITORY
NAME BRANCH
CITY STATE ZIP
TRANSIT/ABA NO. ACCOUNT NO.
This authority is to remain in full force and effect until COMPANY has received written notification from me (or either of us) of its termination in such time and in such manner as to afford COMPANY and DEPOSITORY a reasonable opportunity to act on it.
NAME: __ TITLE: _______________________
Email for ACH Notification: ______________________ cc: ___________________________
PHONE #: __________________________________ DATE: ________________________
SIGNATURE:
*** ATTACH A VOIDED CHECK ***
File details come from the government source that posted it. Updated .