EFT_FORM.pdf
PDF 418 KB Posted
- Solicitation number
- 25/26-016
- 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 use by individuals, businesses, and vendors conducting transactions with Clay County. The form authorizes Clay County and the payee's designated financial institution to initiate electronic credit entries and, when necessary, debit entries and adjustments related to erroneous credits. 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/ABA transit number, and account number. The form requires authorized signature and date of execution, and vendors are instructed to notify the Comptroller Department immediately if their bank account is closed or changed.
This form is ancillary to Clay County's Request for Bids for Construction Engineering and Inspection (CEI) services for the SUN Trail project along Old Jennings Road and Long Bay Road, an FDOT-funded project. The EFT form would be required from the selected engineering firm as part of standard vendor onboarding procedures to facilitate electronic payment of contract invoices. Prospective bidders are prohibited from contacting County officials, board members, or evaluation committee members during the bid period, with exceptions only for formal inquiries submitted through the Purchasing Department, pre-bid conferences, or formal presentations to the evaluation committee. All bidder inquiries must be submitted through the designated Question and Answer tab in the Request for Bids 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 .