EFT_FORM.pdf

PDF 418 KB Posted

Attached to
Construction Engineering and Inspection Services for SUN Trail
Solicitation number
25/26-016
Issued by
Clay County, Harold CDP, Florida

About this file

This EFT Authorization Form is used by the Clay County Clerk of Court and Comptroller in Florida to establish electronic funds transfer (EFT) arrangements for vendor payments. The form authorizes Clay County's Comptroller Department and the vendor's financial institution to initiate electronic credits and, when necessary, debit entries and adjustments for erroneous credit entries. Vendors must provide complete banking information including the financial institution name, account type (checking, savings, or other), transit/ABA/routing number, and account number. The authorization remains in effect until the vendor submits written cancellation to the Comptroller Department. Vendors are required to notify the Comptroller Department immediately if they close or change their bank account. The form requires the vendor's name, phone number, email address, and authorized signature with date.

This form is a standard administrative requirement for the Construction Engineering and Inspection Services for SUN Trail project, a $17,051,455 FDOT-funded initiative in Clay County, Florida. All selected consultants must complete this EFT form to receive monthly payments based on work completed in accordance with the Florida Local Government Prompt Payment Act. By submitting this authorization, vendors enable the County to process timely electronic payments for services rendered, streamlining the payment process for both the County and the consultant throughout the project execution period expected to continue through project completion and demobilization, with construction completion targeted for June 30, 2026.

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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 .