Form 700-011-16B Build-Finance Firm Request for Specific Escrow Account and Unique Vendor Number Sequence for All Department Payments to Be Made on Contract - Florida

Form 700-011-16B is a Florida Department of Transportation form also known as the "Build-finance Firm Request For Specific Escrow Account And Unique Vendor Number Sequence For All Department Payments To Be Made On Contract". The latest edition of the form was released in July 1, 2018 and is available for digital filing.

Download a PDF version of the Form 700-011-16B down below or find it on Florida Department of Transportation Forms website.

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700-011-16B
CONSTRUCTION
OGC – 07/18
Page 1 of 2
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
BUILD-FINANCE
FIRM REQUEST FOR PROJECT SPECIFIC
ESCROW ACCOUNT AND UNIQUE VENDOR NUMBER SEQUENCE FOR ALL
DEPARTMENT PAYMENTS TO BE MADE ON CONTRACT #
[Firm Name] (hereinafter “BF
Firm”), the Build-Finance Firm contracting with the Florida Department of Transportation (hereinafter “Department”)
pursuant to Contract #
, FIN #
, and here doing so
solely for the BF Firm’s benefit and in furtherance of independent arrangements the BF Firm has made with its Lender,
(hereinafter “Lender”) and Surety,
(hereinafter “Surety”), hereby expressly
and irrevocably requests, authorizes and directs the Department to process, issue and transmit any and all future
payments otherwise payable directly to BF Firm to now be processed, issued and transmitted using BF Firm’s Project
Specific Escrow Account and unique vendor number sequence, in lieu of BF Firm’s regular vendor account, as follows:
A. PROJECT SPECIFIC ESCROW ACCOUNT DIRECTIONS: BF Firm requests all future payments on this
Contract be processed, issued and transmitted, based on the following information:
1.
BF Firm’s vendor number (FEID) is
.
2.
BF Firm hereby requests the Department’s Comptroller coordinate establishment of a unique
vendor number sequence for this Project Specific Escrow Account with
MyFloridaMarketplace/Department of Financial Services.
3.
BF Firm’s Project Specific Escrow Account mailing address will be:
(BF Firm Name)
(Continued)
(Continued)
(Address and Street)
(City, State, Zip)
4.
BF Firm acknowledges that all such Project Specific Escrow Account payments will be made by
written warrant and shall be mailed directly to the address in (3) above.
B. GENERAL TERMS:
1.
BF Firm understands and agrees that the Department will require reasonable time to respond and
initiate any requested changes as a result of a change in the payee vendor number sequencing
under this Contract; and, further, the Department shall have no liability, whatsoever, for any delay
in processing any such payee change as set forth above prior to expiration of twenty (20)
business days following the Department’s certified, return-receipt or registered mail receipt of BF
Firm’s formal request. BF Firm agrees hereby to indemnify, defend, and hold-harmless the
Department from any cause of action, suit, claim or other demand made against the Department
arising in any way out of the Department’s failure to process any such payee vendor number
sequencing change as set forth above, if the Department does so as set forth above prior to the
expiration of twenty (20) business days following the Department’s certified, return-receipt or
registered mail receipt of the appropriate formal request.
700-011-16B
CONSTRUCTION
OGC – 07/18
Page 1 of 2
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
BUILD-FINANCE
FIRM REQUEST FOR PROJECT SPECIFIC
ESCROW ACCOUNT AND UNIQUE VENDOR NUMBER SEQUENCE FOR ALL
DEPARTMENT PAYMENTS TO BE MADE ON CONTRACT #
[Firm Name] (hereinafter “BF
Firm”), the Build-Finance Firm contracting with the Florida Department of Transportation (hereinafter “Department”)
pursuant to Contract #
, FIN #
, and here doing so
solely for the BF Firm’s benefit and in furtherance of independent arrangements the BF Firm has made with its Lender,
(hereinafter “Lender”) and Surety,
(hereinafter “Surety”), hereby expressly
and irrevocably requests, authorizes and directs the Department to process, issue and transmit any and all future
payments otherwise payable directly to BF Firm to now be processed, issued and transmitted using BF Firm’s Project
Specific Escrow Account and unique vendor number sequence, in lieu of BF Firm’s regular vendor account, as follows:
A. PROJECT SPECIFIC ESCROW ACCOUNT DIRECTIONS: BF Firm requests all future payments on this
Contract be processed, issued and transmitted, based on the following information:
1.
BF Firm’s vendor number (FEID) is
.
2.
BF Firm hereby requests the Department’s Comptroller coordinate establishment of a unique
vendor number sequence for this Project Specific Escrow Account with
MyFloridaMarketplace/Department of Financial Services.
3.
BF Firm’s Project Specific Escrow Account mailing address will be:
(BF Firm Name)
(Continued)
(Continued)
(Address and Street)
(City, State, Zip)
4.
BF Firm acknowledges that all such Project Specific Escrow Account payments will be made by
written warrant and shall be mailed directly to the address in (3) above.
B. GENERAL TERMS:
1.
BF Firm understands and agrees that the Department will require reasonable time to respond and
initiate any requested changes as a result of a change in the payee vendor number sequencing
under this Contract; and, further, the Department shall have no liability, whatsoever, for any delay
in processing any such payee change as set forth above prior to expiration of twenty (20)
business days following the Department’s certified, return-receipt or registered mail receipt of BF
Firm’s formal request. BF Firm agrees hereby to indemnify, defend, and hold-harmless the
Department from any cause of action, suit, claim or other demand made against the Department
arising in any way out of the Department’s failure to process any such payee vendor number
sequencing change as set forth above, if the Department does so as set forth above prior to the
expiration of twenty (20) business days following the Department’s certified, return-receipt or
registered mail receipt of the appropriate formal request.
700-011-16B
CONSTRUCTION
OGC – 07/18
Page 2 of 2
2.
By signature below, Lender and Surety, in their respective capacities, understand, consent to,
and agree to be so bound by the entirety of the terms of this Build-Finance Firm Request for
Specific Escrow Account and Unique Vendor Number Sequence.
3.
This request is irrevocable by BF Firm, subject to BF Firm obtaining written concurrence by both
its named Lender and Surety, and acceptance by the Department of any such subsequent
request to change from this Project Specific Escrow Account and unique vendor number
sequence for the processing, issuance and transmittal of payments due under this Contract.
4.
The fully executed original of this Request Form #700-011-16 must be delivered to the District
Construction Engineer, and a copy of the fully executed Request Form also delivered to “FDOT
Comptroller, 605 Suwannee Street MS #24, Tallahassee, Florida 32399-0424.”
BUILD-FINANCE FIRM
(Signature)
(Printed Name of Signator)
(Official Capacity)
(Date of Signature)
LENDER
SURETY
(Signature)
(Signature)
(Printed Name of Signator)
(Printed Name of Signator)
(Official Capacity)
(Official Capacity)
(Date of Signature)
(Date of Signature)

Download Form 700-011-16B Build-Finance Firm Request for Specific Escrow Account and Unique Vendor Number Sequence for All Department Payments to Be Made on Contract - Florida

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