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, designed for vendors and contractors receiving payments from the county. The form authorizes Clay County's Comptroller and the vendor's financial institution to initiate electronic credits and, if necessary, debit entries for payment processing. Vendors must provide complete 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 vendor submits written cancellation to the Comptroller Department, and vendors are required to notify the department immediately if they close or change their bank account. The form requires the vendor's name, phone number, email address, authorized signature, and date of authorization.

This EFT form is a mandatory submission requirement for the Agronomic Services for Clay County Parks contract opportunity (IFB #25/26-009), which seeks qualified contractors to provide comprehensive lawn and turf maintenance services across 19 county park locations covering approximately 149 acres. As part of the bid submission process, selected contractors and all potential award recipients must complete this form to establish the payment mechanism for contract compensation. The form streamlines the county's payment process through direct deposit, ensuring efficient fund transfers while maintaining proper financial controls and documentation.

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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 .