EFT_FORM.pdf

This document is an Electronic Funds Transfer (EFT) Authorization Form issued by the Clay County Clerk of Court and Comptroller in Florida for the Washington Avenue Box Culvert Restoration Project. The form authorizes Clay County's Comptroller and a specified financial institution to initiate electronic credits and, if necessary, debit entries and adjustments for credit entries in error. The authorization remains in effect until the vendor cancels it in writing with the Comptroller Department. Bidders and contractors must complete this form to receive electronic payments related to the project, which involves the removal and replacement of damaged reinforced concrete box culvert sections and associated improvements affected by Hurricane Milton (FEMA-4834-DR-FL). Bids for this federally funded disaster recovery project are due September 14, 2026.

The form requires vendors to provide complete banking information, including the financial institution name, account type (checking, savings, or other), routing/ABA number, and account number. Individuals are advised to contact their financial institution for direct deposit or EFT letters or to provide voided checks if uncertain of their banking details, while businesses and vendors should verify their ACH/EFT information directly with their banks. The form must be signed and dated by an authorized representative. Vendors must notify the Comptroller Department immediately if they close or change their bank account. This EFT authorization is a prerequisite for receiving payment on the contract and applies to federally funded work subject to Davis-Bacon wage rates and 2 CFR Part 200 compliance requirements.