2020_ACH_FORM.pdf
PDF 54 KB Posted
- Attached to
- PURCHASE AND/OR RENTAL OF GATORS AND GOLF CARTS
- Solicitation number
- 25-S-062
- Issued by
- District of Columbia
About this file
This is an Authorization Agreement for Automatic Deposits (ACH Credits) form associated with the District of Columbia's purchase and/or rental of Gators and Golf Carts procurement opportunity managed by Events DC. The form establishes the mechanism for the Washington Convention and Sports Authority (WCSA) to process electronic fund transfers to a contractor's designated banking account. The document 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, along with contact information including name, title, email, and phone number. The contractor must designate whether the account is a checking or savings account and authorize WCSA to initiate credit entries and debit entries for any corrections necessary.
The authorization remains in effect until WCSA receives written termination notice providing reasonable time for processing. Contractors must execute the form by signature and provide a voided check to verify banking information. This ACH authorization form is a standard administrative requirement for payment processing and does not contain information regarding contract pricing, quantities, delivery schedules, or other substantive contract terms specific to the Gators and Golf Carts procurement.
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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 .