2020_ACH_FORM_(2).pdf
PDF 54 KB Posted
- Solicitation number
- 25-S-063
- Issued by
- District of Columbia
About this file
This is an Authorization Agreement for Automatic Deposits (ACH Credits) form for the Washington Convention and Sports Authority (WCSA), related to a District of Columbia Request for Quotation for Arbitrage Rebate Computation and Municipal Continuing Disclosure Report Services. The form is a standard banking authorization document that authorizes WCSA to initiate credit entries and, if necessary, debit entries and adjustments to a contractor's designated checking or savings account at a specified depository. The agreement remains in full force and effect until written termination notification is received by WCSA and the depository, allowing reasonable time for processing.
The form requires the contractor to provide company name, EIN or Tax ID, depository information including branch location, transit/ABA number, and account number, along with the authorized signatory's name, title, phone number, email address, and signature. A voided check must be attached to complete the authorization. This document serves as the mechanism through which WCSA would remit payments to successful bidders for services rendered under the solicitation for arbitrage rebate computation and municipal continuing disclosure report services.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Attachment_A.pdf | ||
| STANDARD_CONTRACT_PROVISIONS_(2)_(1).pdf | ||
| tax_certification_affidavit_.pdf | ||
| OCPS_Disclosure_Statement.pdf | ||
| Form_W-9_.pdf | ||
| RFQ_25-S-_063_Arbitrage_Services.pdf |
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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 .