EFT_FORM.pdf

PDF 418 KB Posted

Attached to
Purchase and Installation of First Aid Metal Building at Clay County Fairgrounds
Solicitation number
25/26-053
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 payment processing related to the Purchase and Installation of First Aid Metal Building at Clay County Fairgrounds (RFQ #25/26-053). The form authorizes Clay County's Comptroller and the contractor's financial institution to initiate electronic credits and debits for contract payments. The RFQ seeks qualified contractors to purchase and install a code-compliant 14' x 24' steel building with a 4' x 24' covered porch at the Clay County Fairgrounds located at 2463 W State Road 16, Green Cove Springs, Florida, to serve as a first aid station during fairground events. The scope includes all permitting, site preparation, utility connections, ADA-compliant access and ramp, electrical installation with five outlets and two ceiling lights, HVAC installation using a Mitsubishi mini-split system, interior wall finishes with R-13 insulation, LVP floating flooring, and final inspection. The structure must include two 36" x 80" inward-swinging doors and four 36" windows with finishes matching existing exhibit halls. A mandatory pre-proposal meeting is scheduled for February 23, 2026, at 9:00 a.m. at the project site, with quotations due electronically through the ProcureNow portal on February 26, 2026, at 4:00 p.m. Substantial completion is required within two weeks of Notice to Proceed, with final completion within thirty calendar days of receiving the punch list.

Pricing shall be submitted as a single lump-sum total for all work, with monthly progress payments processed through electronic funds transfer using banking information provided on the EFT form in accordance with the Florida Local Government Prompt Payment Act. Contractors must be licensed, self-perform a minimum of forty percent of awarded work, and maintain comprehensive insurance coverage including Commercial General Liability ($1,000,000 each occurrence/$2,000,000 aggregate), Business Automobile Liability ($1,000,000 combined single limit), Workers' Compensation at statutory limits, and Builder's Risk property coverage at one hundred percent of project value. Required submissions include a completed W-9 form, EFT authorization form, E-Verify documentation, certificates of insurance, valid licenses and certifications, and Scrutinized Companies Certification. A two-year warranty on all workmanship and materials from substantial completion is required, and a performance and payment bond is required under Florida Statutes Section 255.05, with bond amounts to be specified upon contractor selection. The contractor must remit payment to all subcontractors and suppliers within ten days of receipt of progress payments. No specific budget range or award value is disclosed in the available materials, and no incumbent vendors or set-aside designations for disadvantaged enterprises are identified.

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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 .