2020_ACH_FORM.pdf
PDF 54 KB Posted
- Solicitation number
- 25-S-056
- 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, located in the District of Columbia. The form is designed to authorize 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 financial institution. The agreement 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 notification that provides reasonable opportunity for both WCSA and the depository to process the request.
The form requires the authorized representative to provide their name, title, email address for ACH notifications, phone number, and signature, with an optional carbon copy recipient listed. A voided check must be attached to verify banking information. This form is ancillary to WCSA's solicitation for Commercial Window Film Purchase, Installation, Maintenance and Repair Services and serves as the payment mechanism for any awarded contract, ensuring efficient electronic fund transfers to the contractor's bank account upon invoice approval and payment authorization.
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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 .