TE-00211658 - Appendix 1 - EFT Form.pdf
PDF 31 KB Posted
- Attached to
- ALTUS Project Management Software
- Solicitation number
- BPM058368
- Issued by
- Maryland
About this file
This is an Electronic Funds Transfer (EFT) Form appendix related to an Invitation for Bid for ALTUS Project Management Software issued by the State of Maryland. The form serves as a standardized template for bidders to provide banking and financial information necessary for electronic payment processing should their bid be selected for award. The document outlines the required banking details, account holder information, and authorization signatures needed to establish EFT capability for contract payments.
The EFT form requires bidders to supply their financial institution's routing number, account number, account type, and authorized representative information to facilitate direct deposit of contract payments. This appendix is a mandatory administrative requirement for bid submission, ensuring that the selected vendor can receive payments through electronic transfer methods. The form includes certification language wherein bidders affirm the accuracy of the banking information provided and authorize the State of Maryland to process payments via EFT upon contract award.
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Other files
| File | Type | Posted |
|---|---|---|
| TE-00211658 - Altus - IFB.pdf | ||
| TE-00211658 - Altus - Attachment B - Bid Form.xlsx | XLSX spreadsheet |
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Text version
Vendor Electronic Funds Transfer (EFT) Registration Request Form
Please submit this form to:
Maryland Transportation Authority Attn: Finance Division 2310 Broening Hwy.
Baltimore, MD 21224
Company name and address
Company Name Tax ID:
Address 1
Address 2
Do you want to receive your payments electronically?
Yes
No
City State ZIP
Financial institution information:
Please enter the information below or attach a voided check
Please retain a copy of this form for your records.
Bank Name
Bank Address
Allow 30 days for us to process your request. Be sure to notify us of any changes to your banking information
City State ZIP
ABA Number
Account No.
Checking
Money Market
Savings
I am authorized by this company to make the representations contained in this document. This company authorizes the Maryland Transportation Authority to register it for electronic funds transfer (EFT) using the information contained in and attached to this registration form. This company agrees to receive all funds from the Maryland Transportation Authority by electronic funds transfer according to the terms of the EFT program. This company agrees to return to the Maryland Transportation Authority any EFT payment incorrectly disbursed by the Maryland Transportation Authority to this company's account. This company agrees to hold harmless the State of Maryland and its agencies and departments for any delays or errors caused by inaccurate or outdated registration information or by the financial institution listed above.
Initiate all disbursements via EFT to the above account.
Signature of individual, company treasurer, controller, or chief financial officer
Date
Remittance advice email addresses:
Printed Name 1
Telephone Number 2
MdTA Dept of Finance 1/13/2015
File details come from the government source that posted it. Updated .