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), operating 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 bank. The form requires the contractor to provide company name, EIN or Tax ID, depository bank details including transit/ABA number and account number, along with contact information including name, title, email, and phone number. A voided check must be attached to complete the submission. This document serves as the payment mechanism for contractors awarded contracts with WCSA and establishes the banking details through which contract payments will be processed electronically.

The form is a standard administrative requirement typically submitted by contractors upon contract award or before commencing work. It contains no pricing information, set-asides, or contract-specific terms, as it functions solely as a banking authorization document. Contractors must complete this form accurately to ensure proper receipt of payments throughout the contract performance period. The authorization remains in effect until WCSA receives written notice of termination, providing both the company and depository reasonable opportunity to act on such notification.

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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 .