2020_ACH_FORM_(2).pdf
PDF 54 KB Posted
- Solicitation number
- 25-S-008
- Issued by
- District of Columbia
About this file
This document is an Authorization Agreement for Automatic Deposits (ACH Credits) form from Events DC (Washington Convention and Sports Authority), specifically related to a Request for Quote (RFQ) for the supply, delivery, installation, and maintenance of industrial washers and dryers in the District of Columbia. The form is designed to facilitate electronic financial transactions, allowing the organization to initiate credit and debit entries to a vendor's bank account for payment processing.
The form requires a business to provide its name, tax identification number, banking details, and authorized representative information, with space to attach a voided check for verification. While the form itself does not contain specific contract details, it is part of the procurement process for the RFQ, which invites qualified firms to bid on providing industrial laundry equipment and related services. Interested parties can access the full Request for Quote through Events DC's e-procurement website, indicating a competitive bidding process for this equipment procurement and maintenance opportunity.
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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 ***
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