Enclosure D - Vendor ACH Authorization Form.pdf

This is a Vendor ACH Authorization Form used by Brookhaven National Laboratory/Brookhaven Science Associates (BNL/BSA), which operates under contract with the U.S. Department of Energy. The form is designed to establish electronic payment capabilities for vendors doing business with BNL/BSA.

The form requires vendors to provide their company information (including name, vendor number if applicable, and Tax ID Number), along with banking details (financial institution name, routing/ABA number, and checking account number). The authorization section grants BNL/BSA permission to initiate ACH credit entries and correcting entries to the specified account. The form must be signed by an authorized representative and includes fields for contact information including email and phone number. This appears to be a standard administrative document template used for vendor payment setup rather than containing specific contract requirements for the fuel storage tanks procurement.