Attachment 2_DEAMS EFT Enrollment Form Updated 10_2022.pdf

PDF 352 KB Posted

Attached to
FM9 DSL Upgrade Federal contract opportunity
Solicitation number
FA527023QA039
Issued by
Department of the Air Force Pacific Air Forces

About this file

This document contains an electronic funds transfer enrollment form and details of a federal contract opportunity with the Department of the Air Force Pacific Air Forces. The enrollment form collects bank account information for electronic payments on contracts. It requests the vendor name, address, contact information, CAGE code if applicable, bank name, branch, address, SWIFT code, account name, number and type. The signature is also required.

The federal contract opportunity is a solicitation to upgrade network switches, install panel boards and modems at wiring closets, and complete all required hardwiring, fiber work, and device programming. The scope of work includes contractor management, system design, purchase of COTS equipment and infrastructure, installation, integration with existing systems, verification and acceptance testing, training, site support, and interim contractor support if ordered. All network equipment must be licensed for Windows 10 and terminations and programming of IDS must be done by U.S. nationals with appropriate clearances. Some line items are brand name only, as explained in an attached justification.

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0004_Extension due date.pdf PDF
0003 - Move the Site Visit.pdf PDF
0002_QA extension.pdf PDF
0001 - Site Visit.pdf PDF
Attachment 1_Price list.xlsx XLSX spreadsheet
Attachment 3_DFAS Japan AF EFT Submission (NEW DEAMS 202201).pdf PDF
FA527023QA039_COMBO_Final.pdf PDF
Attachment 4_Brand Name Justification_Redacted.pdf PDF
Attachment 5_SOW.pdf PDF
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Text version

INITIAL SUBMISSION DATE:

***Special Instructions:

1) Payments processed in DEAMS are made through ITS.gov and cannot be made to Japan Post Bank, Roukin Bank or internet bank accounts.

2) Please contact your bank to verify the bank information below, and ask if any additional information is required to receive payment from overseas. If so, please provide this additional information.

3) Please ask your bank to make sure the Account Name (beneficiary name in English ) provided matches exactly with the English beneficiary name registered on the bank's records. (必ず各取引銀行に海外送金の受け取りに必要な情報を確認の上、ご記入下さい)

4) If you never submit this EFT form under any contract payment before, please submit this form for your payment.

And this form can be applied for your future payment also.

If you already have submitted this form before for any of your contractual payment, there is NO need for you to submit again.

For MISC payment (Non contractual payment), you need to include this EFT form every time you submit MISC payment package.

< VENDOR INFORMATION >

1 Vendor (Recipient) Name:

2 Vendor Address:

City:

Province/Country: Zip Code:

3 Contact Name:

4 Contact Phone#: 81- POC Email:

5 CAGE Code: *Notes: 1. If there is no CAGE code , please type "N/A".

2. If vendor has a CAGE code, the information above

MUST match information registered in SAM system.

Zip Code:

< BANK INFORMATION >

6 Bank Name:

Branch Name:

7 Bank Address:

City/Province:

8 SWIFT Code:

9 Account Name:

10 Account Number:

(Checking) (Other)

JPY EFT ENROLLMENT FORM (For DEAMS)

DFAS Use Only (Form Revised October 2022)

*Must be in English*

UPDATE

Attention: Please provide us with an updated EFT Form if any of the above information changes as soon as possible. Your attention in this matter will help us to continue providing you with the customer service that you deserve and will help eliminate the possibility of delayed payments to your company.

11 Account Type: (Savings)

12 Email address for Payment Voucher:

(Could be registered up to 5 email addresses) 支払伝票送付が不要の場合は必ずN/Aとご記入下さい。

13 Signature of Vendor: ______________________________________________ ___________________________________________

Signature Typed Name

JPY DEAMS EFT Form

DATE:
undefined:
Vendor Address 1:
Vendor Address 2:
City:
ProvinceCountry:
Zip Code:
Contact Name:
Email:
CAGE Code:
Bank Name:
Branch Name:
Bank Address:
CityProvince:
Zip Code_2:
SWIFT Code:
10 Account Name 1:
10 Account Name 2:
11 Account Number:
undefined_2:
3:
Check Box11: Off
Check Box12: Off
Text13:
1:
Check Box14: Off

File details come from the government source that posted it. Updated .