2020_ACH_FORM.pdf
PDF 54 KB Posted
- Solicitation number
- 25-S-005
- Issued by
- District of Columbia
About this file
This document is an Authorization Agreement for Automatic Deposits (ACH Credits) issued by Events DC (Washington Convention and Sports Authority or WCSA), designed to facilitate electronic financial transactions. The form allows a business to authorize WCSA to initiate direct credit and debit entries to a specified bank account, with provisions for the account holder to terminate the authorization by providing written notice.
The form is part of a broader procurement process for Guided Tours, Bus Wrapping, and Transportation (Fleet) Services in the District of Columbia, as indicated by the related Request for Quotes (RFQ). While the ACH form itself does not provide detailed pricing or service specifications, it is a standard financial authorization document that enables efficient payment processing for vendors participating in the contract opportunity. The form requires completion of banking details, including depository information, account type, and a voided check attachment, and must be signed by an authorized representative of the business.
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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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