EFT_FORM.pdf
PDF 418 KB Posted
- Solicitation number
- 25/26-055
- 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. The form authorizes Clay County's Comptroller and the vendor's financial institution to initiate electronic credits and, if necessary, debit entries and adjustments for any erroneous credit entries related to payments for the Clay County Fairgrounds Hurricane Roof Repairs project (IFB #25/26-055). Vendors must complete the form with their business name, contact information, and full banking details including the financial institution name, account type, routing number, and account number. The authorization remains in effect until the vendor submits written cancellation to the Comptroller Department. Vendors are instructed to notify the Comptroller Department immediately if their bank account is closed or changed, and individuals are advised to contact their financial institution for complete EFT information, such as a direct deposit letter or voided check, while businesses and vendors should contact their institution for complete ACH/EFT information.
The form serves as a prerequisite document for vendors bidding on the hurricane roof repair project, which involves restoration work to Exhibit Hall 2 and Cattlemen's Arena at Clay County Fairgrounds. Monthly payments for work completed will be processed via electronic funds transfer in accordance with the Florida Local Government Prompt Payment Act. Submission of the completed EFT Authorization Form is required as part of the vendor's bid package to enable timely payment processing once the contract is awarded. This administrative requirement ensures efficient payment distribution to the selected contractor upon invoice submission and approval of completed work.
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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 .