2020_ACH_FORM_.pdf

PDF 54 KB Posted

Attached to
IFB- Replacement of Meeting room Special Lite Doors
Solicitation number
25-S-029
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, a District of Columbia government agency. The form authorizes WCSA to initiate credit entries and, if necessary, debit entries and adjustments to a contractor's designated checking or savings account at a specified depository. The form requires the contractor to provide company name, EIN or Tax ID, depository information including branch location, transit/ABA number, and account number. The authorization remains in effect until WCSA receives written termination notice providing the company and depository reasonable time to process the request. The contractor must complete all required fields including contact name, title, email address, phone number, and signature, and must attach a voided check to the form. This document is a standard administrative requirement for contractors performing work under the IFB for Replacement of Meeting Room Special Lite Doors at the Walter E. Washington Convention Center, which requires submission of W-9 forms, tax certifications, and other documentation as part of the bid process.

The ACH authorization form serves as a mechanism for payment processing and does not establish pricing terms, set-asides, or funding amounts. Rather, it facilitates the electronic transfer of contract payments once a bid is awarded and performance commences. Contractors bidding on the door replacement project must comply with all District of Columbia requirements including DSLBD certification, prevailing wage obligations under the Service Contract Act, and subcontracting requirements mandating 35 percent of contract value be awarded to certified small or business enterprises for contracts exceeding $250,000. Payment terms under the resulting contract will be structured according to the bid proposals submitted, with pricing submitted on an F.O.B. Destination basis and subject to District of Columbia law governance.

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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 .