2020_ACH_FORM_(4)_(1).pdf

PDF 54 KB Posted

Attached to
Design and Permit Ready Sprinkler Systems Services
Solicitation number
25-S-051
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 establishes the framework for automatic electronic fund transfers to a contractor's designated banking account. The agreement authorizes WCSA to initiate credit entries and, if necessary, debit entries and adjustments for erroneous credits to the contractor's checking or savings account at a specified depository institution. The authorization remains in full force and effect until WCSA receives written termination notification that provides the company and depository with reasonable time to process the request.

The form requires contractors to provide essential banking information including the depository name, branch location, state, ZIP code, transit/ABA number, and account number. Contractors must complete and sign the form, providing their company name, EIN or Tax ID, contact person name and title, email address for ACH notifications, phone number, and signature date. A voided check must be attached to the form to verify account ownership and accuracy of banking details. This document is a standard administrative requirement for contractors awarded contracts by WCSA to facilitate timely and efficient payment processing for services rendered.

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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 .