EFT_FORM.pdf
PDF 418 KB Posted
- Attached to
- Moody Park National Fitness Campaign Slab
- Solicitation number
- 24/25-126
- Issued by
- Clay County, Orlando City, 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 the Moody Park National Fitness Campaign Slab project. The form authorizes Clay County's Comptroller Department and the vendor's financial institution to initiate electronic credit entries, debits, and adjustments related to contract payments. The authorization remains in effect until the vendor cancels it in writing to the Comptroller Department. Vendors must provide complete banking information including the financial institution name, account type (checking, savings, or other), transit/ABA/routing number, and account number. The form requires an authorized signature and date from the individual, business, or vendor representative. Vendors are instructed to contact their financial institutions for complete ACH/EFT information if uncertain and to notify the Comptroller Department immediately if they close or change their bank account.
This form is a standard administrative requirement for Clay County vendors participating in the Moody Park project, which involves constructing a 72' x 38' reinforced concrete slab and approximately 1,000 square feet of sidewalk at 3510 Moody Avenue in Orange Park. Bids for this project are due October 6, 2025, at 4:00 PM, with a mandatory pre-bid meeting scheduled for September 22, 2025, at 1:00 PM. The EFT form must be completed as part of the vendor's submission package to establish the payment mechanism for any awarded contract. Contractors must provide comprehensive insurance coverage and a 5% bid bond, with the county evaluating bids based on the lowest responsive and responsible bid under its local preference policy.
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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 .