2020_ACH_FORM_(2).pdf
PDF 54 KB Posted
- Attached to
- TWENTY-FOUR (24) HOUR CAMPUS SECURITY SERVICES
- Solicitation number
- 25-S-043
- 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) related to a District of Columbia contract opportunity for twenty-four (24) hour campus security services at the Robert F. Kennedy Stadium Campus. The form authorizes WCSA to initiate credit entries and, if necessary, debit entries and adjustments for any credit entries in error to a contractor's designated checking or savings account. The agreement remains in full force and effect until WCSA receives written notification of termination in sufficient time to allow the company and depository to act upon the request.
The form requires the contractor to provide company name, EIN or Tax ID, depository information including bank name, branch location, state, ZIP code, transit/ABA number, and account number. The contractor must also furnish contact information including name, title, email address for ACH notification, phone number, and signature, along with an attached voided check to verify account validity. The authorization enables WCSA to process electronic payments to the contractor for security services provided at the RFK Campus, which encompass the fields, festival grounds, parking lots, skate park, batting cages, and the non-military portion of the DC Armory.
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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 .