EFT_FORM.pdf

PDF 418 KB Posted

Attached to
Clay County Sheriff's Office Building 500 Renovation
Solicitation number
25/26-061
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 vendors and contractors conducting business with Clay County. The form enables Clay County's Comptroller Department and the vendor's designated financial institution to process electronic credits and debits for payments related to county contracts. 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 number, and account number. The form requires an authorized signature and date, and vendors are instructed to notify the Comptroller Department immediately if they close or change their bank account.

This form is directly associated with the Clay County Sheriff's Office Building 500 Renovation project, a general contracting opportunity for interior renovation work at 1845 Town Center Boulevard, Fleming Island, Florida. Bidders selected for this project would be required to complete the EFT Authorization Form to receive payment from Clay County through electronic funds transfer rather than traditional check disbursement. The form serves as a mandatory administrative requirement for vendors awarded county contracts and ensures efficient processing of contractor payments throughout the project's duration.

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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 .