EFT_FORM.pdf

PDF 418 KB Posted

Attached to
Lake Geneva Restoration Project
Solicitation number
25/26-013
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 authorizes Clay County's Comptroller Department and the vendor's designated financial institution to initiate electronic credit transfers and, if necessary, debit entries and adjustments for erroneous credits. The authorization remains in effect until the vendor submits written cancellation to the Comptroller Department. The form requires vendors to provide their complete banking information, including the financial institution name, account type (checking, savings, or other), transit/ABA/routing number, and account number. Vendors are advised to contact their financial institutions for accurate EFT information and may request direct deposit or EFT authorization letters or provide voided checks as supporting documentation. An authorized representative must sign and date the form to complete the authorization process.

This form is a standard administrative requirement for the Lake Geneva Restoration Project, a 342-acre environmental restoration initiative in Clay County, Florida, where the successful contractor must remove trees measuring four inches or greater in diameter from the exposed lakebed. Given the project's estimated contract value potentially exceeding $200,000 (with $250,000 in Florida Department of Environmental Protection grant funding), the EFT form ensures that progress payments, final compensation, and any necessary adjustments are processed electronically. Contractors awarded this 24-month contract (with two optional 12-month extensions) would be required to complete this form to facilitate timely payment processing by the County.

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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 .