2020_ACH_FORM.pdf

PDF 54 KB Posted

Attached to
COOLING TOWER REPLACEMENT SERVICES
Solicitation number
25-S-030
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, for the District of Columbia. The form authorizes WCSA to initiate electronic credit and debit entries to a contractor's designated checking or savings account for payment processing purposes. The authorization remains in effect until the contractor provides written termination notice to both WCSA and the designated depository. The form requires the contractor to provide company name, Employer Identification Number or Tax ID, depository information including bank name, branch location, transit/ABA number, and account number. Additionally, the contractor must include contact information consisting of an authorized representative's name, title, email address, phone number, and signature, along with a voided check attached as verification of account validity. The form serves as a standard requirement for electronic fund transfers related to the Cooling Tower Replacement Services contract at the Walter E. Washington Convention Center, with proposals due April 6, 2026.

This ACH authorization form is a mandatory submission document for the cooling tower replacement procurement and does not contain pricing information, set-asides, or funding details. Rather, it functions as an administrative requirement to facilitate electronic payment processing between Events DC and the selected contractor upon contract award. The form emphasizes the contractor's responsibility to maintain accurate banking information and promptly notify WCSA of any changes to ensure uninterrupted payment processing throughout the contract term extending through September 30, 2027, with optional renewal periods available.

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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 .