EFT_FORM.pdf

PDF 418 KB Posted

Attached to
Agronomic Services for Clay County Parks
Solicitation number
25/26-009
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 for use by vendors, businesses, and individuals receiving payments related to county contracts. The form authorizes Clay County's Comptroller and the vendor's designated financial institution to initiate electronic credit entries and, if necessary, debit entries for error corrections. The authorization remains in effect until the vendor submits written cancellation to the Comptroller Department. Vendors must provide complete banking information including the financial institution name, account type (checking, savings, or other), routing/ABA number, and account number. The form emphasizes that vendors must notify the Comptroller Department immediately if banking information changes or an account is closed. Individual vendors are instructed to contact their financial institution for complete EFT information, which may be obtained through direct deposit letters or voided checks, while business vendors and larger entities should coordinate with their financial institutions for complete ACH/EFT details.

This EFT authorization form is a required administrative document for the Agronomic Services for Clay County Parks contract opportunity (Invitation for Bid #25/26-009). Bidders selected for the contract to maintain approximately 149 acres across 19 county park locations must submit this completed form as part of their procurement documentation to ensure proper payment processing. The form serves as a prerequisite for contract execution and payment administration, requiring vendors to maintain accurate and current banking information throughout the contract term to facilitate timely electronic payment of invoices for services rendered.

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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 .