EFT_FORM.pdf

PDF 418 KB Posted

Attached to
County Road 220 Phase 2 – Milling and Resurfacing
Solicitation number
25/26-119
Issued by
Clay County, Harold CDP, Florida

About this file

This is an Electronic Funds Transfer (EFT) Authorization Form issued by the Clay County Clerk of Court and Comptroller in Florida. The form is designed for contractors and vendors bidding on County projects, including the County Road 220 Phase 2 Milling and Resurfacing project. The form authorizes Clay County's Comptroller Department and the contractor's designated financial institution to initiate electronic credits and, if necessary, debit entries for payment processing. Contractors must provide their banking information, including the financial institution name, account type (checking, savings, or other), routing/ABA number, and account number. The authorization remains in effect until the contractor submits written cancellation to the Comptroller Department. Contractors are instructed to contact their financial institution if they need assistance obtaining complete EFT information and are advised to notify the Comptroller Department immediately if their bank account is closed or changed during the contract period.

This form is a mandatory administrative requirement for payment purposes and does not contain pricing terms, contract amounts, or project-specific financial details. Completion and submission of the EFT Authorization Form is a prerequisite for contractors seeking to receive payment for work performed on Clay County projects. The form requires an authorized signature and date from the individual or business entity submitting the bid.

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Text version

Clay County Clerk of Court and Comptroller

EFT Authorization Form

Individual/Business/Vendor Name: (Please Print)

Phone Number:

Email:

I/We hereby authorize Clay County Comptrollers and the financial institution listed below to initiate electronic credits, and, if necessary, debit entries and adjustments for any credit entries in error. This authority will remain in effect until I cancel it in writing to the Comptroller Department. *Notify the Comptroller Department immediately if you close or change Bank Account*

Account Information:

Financial Institution:

Type of Account (please circle one): Checking Savings Other:______________

Transit / ABA / Routing #:

Account Number:

*Individuals: If you are unsure of your complete EFT information please contact your financial institution. In most cases, your financial institution can provide you with a direct deposit/EFT letter or a voided check.

Businesses/Vendors: Please check with your financial institution for your complete ACH/EFT information.

Authorized Signature:_______________________________ Date: ___________

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