EFT_FORM.pdf

PDF 418 KB Posted

Attached to
Generator Preventative Maintenance
Solicitation number
25/26-015
Issued by
Clay County, Harold CDP, Florida

About this file

This file contains an Electronic Funds Transfer (EFT) Authorization Form from the Clay County Clerk of Court and Comptroller in Florida, designed for use by vendors, businesses, and individuals contracting with Clay County. The form authorizes Clay County's Comptroller Department and the vendor's designated financial institution to initiate electronic credit entries and, if necessary, debit entries for payment processing and error adjustments. The authorization remains in effect until the vendor submits written cancellation to the Comptroller Department. Vendors are required to provide complete banking information including the financial institution name, account type (checking, savings, or other), transit/ABA/routing number, and account number. The form must be signed and dated by an authorized representative.

The form applies to the Generator Preventative Maintenance contract opportunity with Clay County in Florida. Vendors bidding on this contract must comply with Clay County's procurement policies, including a local preference policy and Buy American policy. All bidder inquiries must be submitted through the designated Question and Answer section of the Request for Bids, and bidders are prohibited from direct contact with county officials, board members, or evaluation committee members during the bid period. The county reserves the right to reject any and all bids without cause and to award the contract in the best interest of the county. Submission of the completed EFT Authorization Form is a standard requirement for payment processing upon contract award.

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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 .