2020_ACH_FORM_(3).pdf

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Attached to
DESIGN/BUILD EXTERIOR EXPANSION JOINT REPLACEMENT AND FAÇADE RESTORATION SERVICES
Solicitation number
25-S-040
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), also known as Events DC, located in the District of Columbia. The form authorizes WCSA to initiate credit entries and, if necessary, debit entries and adjustments to a designated checking or savings account at a specified depository. The agreement remains in full force and effect until WCSA receives written termination notice from the authorized party, providing the company and depository reasonable opportunity to process the request.

The form requires the contractor or vendor to provide company name, EIN or Tax ID, depository information including branch location, transit/ABA number, and account number. The authorized signatory must provide their name, title, email address for ACH notifications, phone number, and signature, with the submission date required. A voided check must be attached to the form to verify banking information. This document is typically used in conjunction with contract awards to establish the payment mechanism for contract invoices and reimbursements related to services such as the Design/Build Exterior Expansion Joint Replacement and Façade Restoration Services project at the Walter E. Washington Convention Center.

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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 .