2020_ACH_FORM.pdf
PDF 54 KB Posted
- Attached to
- GENERATOR SERVICE AND MAINTENANCE
- Solicitation number
- 25-S-039
- 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 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 for payment purposes. The agreement remains in full force and effect until WCSA receives written termination notification from the authorized party, providing the company and depository reasonable time to process the cancellation.
The form requires the contractor to provide their company name, EIN or tax ID, depository information including the bank name, branch location, ABA transit number, and account number. The authorized signatory must include their name, title, email address for ACH notification, phone number, and signature, with a voided check attached to verify account information. This document is a standard financial authorization used to facilitate vendor payments related to the Generator Service and Maintenance contract solicitation.
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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 .