2020_ACH_FORM.pdf
PDF 54 KB Posted
- Attached to
- LENEL ACCESS CONTROL MODERNIZATION AND INFASTRUCTURE UPGRADE SERVICES State and local contract opportunity
- Solicitation number
- 25-S-026
- 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, 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 notification, provided with reasonable advance notice to both WCSA and the depository. The form requires completion of company identification information, including the company name and EIN or Tax ID, depository details including transit/ABA number and account number, and the signatory's name, title, phone number, email, and date. A voided check must be attached to the form to verify banking information.
This ACH authorization form is a standard financial processing document used in conjunction with contract payments and vendor disbursements. The form is associated with the Lenel Access Control Modernization and Infrastructure Upgrade Services solicitation issued by the Washington Convention and Sports Authority for work at the Walter E. Washington Convention Center. The RFP includes a thirty-five percent (35%) set-aside for Certified Business Enterprises (CBEs) as mandated under the Small and Certified Business Enterprise Development and Assistance Amendment Act of 2014. Contractors selected for this project would be required to complete and submit this ACH authorization form to facilitate electronic payment of contract invoices and 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 .